Will I still need a special diet after transplant?

Most people who have a kidney transplant are asked to follow a heart-healthy diet. Good nutrition after your kidney transplant helps you to recover from the surgery and stay healthy.

A heart-healthy diet limits added sugar, salt, and fat. Work with your dietitian to help you make healthy food choices and find an eating plan that works for you after kidney transplant.

These tips can help you develop your own healthy eating habits.

Long-term healthy eating goals:

• Eat 3 meals and 2 to 3 snacks every day.
• Eat a variety of foods from Canada’s Food Guide every day.
• Choose whole grain cereals and breads, as well as more vegetables and fruits.
• Choose low fat dairy products, lean meats, and foods prepared with little or no saturated (animal) fat.

Promote heart health – Your anti-rejection medicines may raise your blood levels of cholesterol and triglycerides (fats in your blood). These side-effects raise your risk of heart disease and stroke. You can lower your risk of heart disease and stroke by following the heart-healthy tips in the nutrition tips before kidney transplant section.

At each meal and snack eat some protein like lean meat, fish, chicken, legumes, tofu, eggs, peanut butter, or low-fat dairy products (milk, yogurt, cheese).

Vitamins and minerals

You may need to change the amount of vitamins and minerals in your diet depending on your blood test results. This includes potassium, phosphorous, magnesium, calcium, and vitamin D.

Salt (sodium) – To help to control high blood pressure and fluid retention (extra fluid in your body), limit the amount of salt you eat. The blood pressure and fluid changes are common side effects of anti-rejection medicines.

To lower the salt in your diet:

• use very little salt in cooking and none at the table
• limit or avoid processed, pre-packaged, and salty foods
• eat less fast food
• ask for your food to be prepared without added salt when you eat out

Potassium – Most people don’t need to limit potassium after transplant. You can enjoy many different fruits and vegetables.

Some transplant medicines can cause your blood level of potassium to go higher or lower. Talk to your dietitian about how much potassium is right for you.

Phosphorous – After your transplant you may have low phosphorous levels. Most people will be asked to eat more foods that have phosphorous after they’ve had a transplant. If your phosphorous level is low, choose foods high in phosphorous.

For example:

• whole grain foods
• bran cereal
• nuts
• dried beans or lentils
• dairy products

If your phosphorous level stays low, your transplant team may ask you to take a phosphorous supplement.

Magnesium – It’s common to have low magnesium levels after kidney transplant. You may be asked to eat more foods that have magnesium.

If your magnesium level is low eat more:

• green leafy vegetables
• tofu (firm)
• whole grains
• nuts
• seafood

If your magnesium level stays low, your transplant team may ask you to take a magnesium supplement. 

Calcium and vitamin D – To make sure your bones are strong and to lower your risk of bone disease, it’s important to get enough calcium and vitamin D. Your healthcare team may ask you to eat foods with more calcium and vitamin D. You may even be asked to take a supplement if your levels are too low. To check how strong your bones are you may have a bone density test.

Tips for healthy bones:​

• If you take prednisone, aim to get 1000 mg of calcium from the food you eat every day. If you don’t think you eat 1000 mg a day, ask your transplant team about taking a calcium supplement.
• Take 1000 IU of vitamin D as a supplement every day, unless your transplant team suggests other amounts.
• Begin a regular exercise program recommended by your doctor or physical therapist.
• Quit smoking.

Good sources of calcium:

• Milk, 1 cup (250 mL)
• Yogurt, ¾ cup (250 mL)
• Cheese, 1½ oz. (50 g)
• Fortified soy, rice, or almond beverages, 1 cup (250 mL)
• Salmon with bones, 2½ oz. (75 g)

Fluids

After your transplant it’s important to drink enough fluid.

• Aim to drink 10 to 12 cups (2½ to 3 L) of fluid each day, unless your transplant team suggests other amounts. Drink at least half of your fluid intake as water.
• Choose low-calorie beverages such as water, skim milk, sugar-free soft drinks, sugar-free crystal drinks, carbonated water, and decaffeinated tea and coffee.
• Choose regular pop, juices, iced tea, fruit drinks, or hot chocolate less often. These may add too many calories.
• Drink water before and between your meals to help manage your appetite.
• Limit drinks with caffeine like coffee, tea, and colas to 3 to 4 cups (750 mL to1 L) a day.
• Note: Avoid alcoholic beverages in the first few weeks after your transplant. Later, a drink once in a while is fine for most people but check with your transplant team first.

How can I drink 10 to 12 cups of fluid each day?

• Keep a bottle of water with you at all times.
• Store water in the fridge to drink at home.
• Add a lemon or lime wedge to water to keep it tasting fresh all day.

Your healthy body weight

Many people have a better appetite, a less limited diet, and feel better after having a kidney transplant. This can lead to weight gain. Anti-rejection medicines may also cause you to gain weight.

Carrying extra weight raises your risk of high blood pressure, diabetes, and heart disease. It also puts you at higher risk of wound infection and problems with your transplanted kidney.

If your weight is too low you can also have a higher risk of problems after your transplant. It’s important to eat enough protein and calories to get to and stay at a healthy weight. This will help your body to heal sooner after surgery.

Talk to your dietitian about how to get enough protein and calories or any weight gain after your transplant.