Nutrition Counseling

Did you know? By making better food choices you could lighten the workload on your kidneys and help keep your body in balance.

Nutrition After Transplant—Helpful Information

What about my diet immediately after transplant surgery?

After any surgery, you need a few weeks to heal and recover. During this time, a high protein diet will speed the healing along. Good high protein choices after a kidney transplant are nonfat and low fat dairy products, lean meats, fish, poultry and eggs. Vegetable foods that are high in protein include various beans, tofu and nuts. Your dietitian in the hospital will help start you on this phase of your care.

Sometimes the  new kidney does not work well right away. For a while, you might have a diet like the one you followed before your transplant.

What about exercise?

Until your incision has healed, slow walking is enough. After healing, it is time to gradually rebuild your muscle strength. You may not have had much energy before your transplant.  Now, you may be surprised that after you recover from your surgery, you are ready for more activities. Choose those that could be fun for YOU! Talk with your doctor about all your options now that you have a transplant. Whatever you decide, a regular schedule of activity will give you the best results.

I have heard that my new medicines could have nutrition-related side effects. What kind?

  • Sugar – Some people don’t tolerate sugar well. This is known as diabetes. High sugar may be temporary and due to the high doses of drugs like Prednisone and Prograf. It is more likely to happen if you have a family history of diabetes. This problem may improve as your drugs are adjusted. If you already have diabetes, then you may notice a change in your medications for blood sugar control.  If you take insulin, the dose will probably increase.  Your dietitian will help you work through any changes in your usual food and drink choices.
  • Salt – Prednisone and other drugs can cause you to retain fluid. Limiting salt can help this problem in some people. Salty foods include soups, cured meats, most frozen dinners and many snack items. Restaurant meals are usually very salty. Ask your dietitian for a more detailed review.
  • Minerals – Some medicines can cause minerals to be lost in your urine. Special supplements may be needed to help your body get enough minerals. Supplements ordered by your doctors may include phosphorus, calcium, iron or magnesium. Foods rich in these minerals might also be recommended. Some people notice a high potassium blood level after transplant. This is usually temporary and related to medicine doses. A few weeks on a low potassium diet may be helpful. Ask the dietitian for reminders about high potassium foods.
  • Stomach Upset – Some medicines may cause problems with your digestion. Let the doctor know if you have indigestion, diarrhea or other concerns. Your medicines can be adjusted. Some people are sensitive to caffeine. If your stomach is sensitive, choose caffeine-free drinks. Some people don’t tolerate milk. Lactose-free milk may be easier on your stomach.

Why is unwanted weight gain such a big problem after transplant?

There are several reasons why people tend to gain weight after getting a new kidney.

  • A person usually feels better and has a better appetite.
  • The sense of taste also improves.
  • Some people think they no longer need to watch what they eat.
  • Prednisone can be an appetite stimulant.

Weight gain may not happen right away. You may have the new kidney for a few months before noticing a change. You may even want to gain weight! Talk with your dietitian about what you want for your future and ways to make it happen.

What are some long-term nutrition side effects of transplant medicines?

Some of the “short-term” problems you just read about may continue. Others may also occur.  Your dietitian will help you and your family work through short-term and long-term concerns.

  • Weight gain – Many people gain more than they ever imagined after a kidney transplant. Better food choices, low fat cooking and more exercise will be very important to keep your weight under control.
  • Diabetes – Intolerance to sugar may be caused by Prednisone and Prograf

It may happen soon after your transplant or at a later time. Having a family history of diabetes is a risk factor. The chance for diabetes usually increases if you gain weight. There are ways to help manage blood sugars. Regular meals are important. You will want to learn about carbohydrates in foods and drinks.

  • Cholesterol – Prograf, Neoral (cyclosporine) and prednisone can increase your cholesterol level. A low saturated fat diet is good. If you also want to control weight, meals low in total fat are best. Ask your dietitian to tell you about different kinds of fat. Learn about reading food labels. You will want to change your favorite recipes into healthier meals.
  • Bone changes – Eating foods high in calcium can help keep bones healthier. When potassium is not a problem, non-fat and low fat dairy foods are great. Talk to your dietitian about more high calcium ideas.

Tell me about food safety.

Safe foods are important for everyone. After a transplant, you will be on strong medicines that lower your immune system to avoid rejection. That means your body will not be able to fight off germs and bacteria like it used to. It will be easier for you to get sick from foods that are not safe or not clean.

After your transplant, you will meet with a dietitian at the hospital for more details. The dietitian at DTI will also talk to you about keeping your food safe. Some ideas on food safety are:

  • Avoid raw or undercooked meats or eggs.
  • Keep all meats refrigerated and under 40 degrees
  • Cook beef and pork until 160 degrees at the center
  • Cook poultry to 180 degrees at the bone.
  • Clean raw fruits and vegetables well.
  • Melons should be washed before cutting
  • Sanitize kitchen surfaces. Use 1 teaspoon of bleach in 1 quart of water as a good rinse for countertops and cutting boards.

Will it be necessary to take vitamins after transplant?

Before your kidney transplant, you were probably on vitamins and minerals made for people with kidney disease. With a new kidney that works well, your appetite will be much better and supplements may not be needed. With your doctors and dietitian, you may decide that supplements could be of benefit. Usually, a general product with 100% of the Daily Value is enough. Sometimes the doctor orders extra minerals, like phosphorus, magnesium, calcium or iron.

Is it safe to take herbal preparations/supplements after transplant?

You may have heard about many kinds of herbs and botanicals. It is true that herbs are the base for many medicines. But at this time, the FDA does not regulate these for dose or strength. Some products are advertised to enhance the immune system. Since this is not known, a person with a kidney transplant would NOT want to use these products. Your immune system is being suppressed intentionally by your post-transplant medicines. Herbal products may interfere with the medicines you take after transplant. Do not take any herbal product without first discussing this with your doctor and dietitian.

How much fluid should I drink each day after my transplant?

After a transplant, intake of liquids is very important to keep your new kidney working. At least 2 quarts (2 liters) is the minimum amount. If you have been drinking very little on dialysis, this is quite a change! Keep a drink handy throughout the day. This is even more important in hot weather. If you are trying to control your weight, choose drinks without calories. Even fruit juices can be high in calories!

I have heard that grapefruit juice does not mix with some medicines.

Research has found that grapefruit juice, and other fruits, can change the way some drugs are absorbed by the body. One group that may be affected is transplant medicines. Grapefruit products are not recommended after a transplant. It is safest to take medicines with water.

What about other nutrition problems?

The dietitian at Dallas Transplant Institute will be available to help you and your family with nutrition and lifestyle changes. Ask to see the dietitian when you are at DTI. You may also leave a message on her extension and she will call you back later.