Following a kidney transplant, your food and nutrition will play a critical part in your recovery. It is essential to have a healthy diet for your wounds to heal fully. If you’ve experienced renal failure, you may have had to adhere to some dietary restrictions. However, unlike the haemodialysis diet, most of these restrictions are removed following surgery, making it simpler to stick to a food plan. 

For optimal wound healing, sufficient calories and protein are required, just as they are after any operation. In addition, anti-rejection drug side effects may raise nutritional needs. The importance of a good diet in the recovery following kidney transplantation cannot be overstated. 

Do medicines affect your diet?

Yes. Medicines to prevent rejection of your fresh kidney transplant may have an impact on your diet. The following are some examples of anti-rejection medications that may affect your diet:

• steroids (prednisone)
• cyclosporine (Sandimmune, Neoral, Gengraf)
• tacrolimus (Prograf)
• azathioprine (Imuran)
• mycophenolate (CellCept)
• Sirolimus (Rapamune)

These medications may alter the way your body functions in a variety of ways. Increases in hunger, blood lipids (such as cholesterol and triglycerides), blood sugar, potassium, and blood pressure are all possible side effects of some of these medications. Some may also cause magnesium and other minerals to be depleted. Your medical team will track these changes over time.

What can a Balanced and Healthy diet do?

The following are some of the advantages of eating a healthy diet:

• Avoiding gaining too much weight

• Maintaining blood sugar levels that are within the usual range

• Assist in lowering cholesterol levels in the blood

• Assist in maintaining a healthy blood pressure level

• Helps to keep your bones healthy by supplying calcium.

• Aids in the prevention of anaemia

What should be the requirements of a healthy diet?

The basic guidelines for the diet for a person after a kidney transplant:

• Keep yourself hydrated by drinking plenty of water (approximately 2 liters per day). It would be best if you kept hydrated; therefore, you should also restrict your caffeine intake.
• Proteins: Protein is essential for regaining lost weight and muscular mass. Your dietitian will be able to advise you on how much protein you should consume.
• Phosphorous: When a replacement kidney is implanted, the body begins to repair bone mass that has been lost due to renal failure. If your blood phosphorus levels have dropped, your dietician may prescribe foods high in phosphorus, such as low-fat dairy products.
• Potassium: Transplant medications frequently influence potassium levels in the body (increase or decrease), leading to muscle and cardiac function issues. You will also be given nutritional recommendations to assist in regulating your blood potassium levels.
• Sodium or Salt: Kidney transplant surgery might result in high blood pressure or fluid retention, among other things. Low-salt foods will be advised in these situations. Unlike potassium and phosphorus levels, which may be controlled in a few months, a low-sodium diet may be prescribed for a longer time.

Diet Chart After Kidney Transplant:

Let us see one by one what all nutrients and in what amount do we require after a kidney transplant:

1. Protein:

You will be healing from the stress of surgery for the first month after a kidney transplant. To aid wound healing, make sure you have adequate protein and overall calories. You’ll also need more protein to help you recover from the muscle breakdown induced by high prednisone dosages. The following foods are suggested to help you achieve your protein requirements:

• a variety of meats (beef, pork, poultry, turkey, seafood)
• Fish
• Products derived from milk (mild cheese, yogurt)
• eggs (but no more than 3 to 4 yolks per week)
• Alternatives to eggs (egg whites)

The following are some high-protein vegetarian options. These foods satisfy your protein demands when consumed in sufficient amounts as part of a well-balanced diet:

• Nuts
• Peanut butter is a delicious spread.
• beans
• Peas 
• Soy-based goods
• Tofu

1. Sodium:

Following a kidney transplant, many patients have high blood pressure or fluid retention. As a result, you may need to limit your salt intake. The “no added salt” diet is commonly recommended. Because salt includes sodium, it’s better to use it sparingly while cooking and avoid adding it to the table.

 If you have issues with fluid retention or high blood pressure, the nutritionist will include low-salt meals in your meal plan. While the phosphorus and potassium issues discussed here are usually resolved in a month or two, a low-sodium diet may be required permanently.

1. Sugars:

Some medicines impair the body’s capacity to utilize blood sugar as an energy source. It might result in a rise in blood sugar levels (glucose). Hyperglycaemia, often known as steroid-induced diabetes, is the medical term for this disease.

The adverse effects of steroid medicines reduce by avoiding concentrated carbs. You should eat this food in small quantities because they are rich in simple sugars:

• Sugar
• Molasses
• Pies
• Sweet yogurt
• Soft drinks
• Cookies, candy
• Ice cream
• Fruit juice
• Honey
• Doughnuts and sweet rolls
• Jams, jellies, marmalades
• Chewing gum with sugar
• Sweetened mineral water
• Sweetened condensed milk

1. Potassium:

Some medications can raise potassium levels in the blood. Other drugs can lower your potassium levels. Problems with muscle and cardiac function might arise when potassium levels are excessively high or too low. Your potassium level in your serum (blood) may necessitate a modification in your medication or food. Potassium-rich foods include:

Fruits and fruit juices:

• Apricots
• Dried fruits
• Oranges
• Avocados
• Melons
• Tomato juice
• Bananas

Vegetables:

• Green leafy Vegetables
• Potatoes
• Dried beans
• Tomatoes
• Pumpkins

Other foods:

• Milk and dairy products
• Peanut butter
• Chocolate
• Nuts

1. Calcium:

Steroids may hamper calcium absorption. Calcium is a mineral that maintains the strength of your bones and teeth. Low calcium levels in the blood can exacerbate bone fractures. To keep your bones healthy, aim for at least three servings of dairy or calcium-fortified meals each day. Make an effort to satisfy your calcium requirements through diet. Supplementation is sometimes essential, but it isn’t for everyone. 

Milk, yogurt, cheese, and calcium-fortified drinks, including soy milk and orange juice, are all excellent sources of calcium, with each serving containing around 300 milligrams. (Eight ounces of milk or yogurt, or one ounce of cheese, constitutes one serving.) Calcium is also found in dark green vegetables such as spinach and broccoli.

1. Fiber:

Try to fulfill your fiber needs as they are an essential part of your diet. Some of the fiber-rich sources are:

• fruits
• vegetables
• whole grains
• legumes
• lentils
• beans

1. Magnesium:

Magnesium is also a nutrient that is essential as it aids in the maintenance of proper nerve and muscle function, as well as a healthy immune system, a steady pulse, and strong bones. It also aids in the regulation of blood glucose levels. It helps with energy and protein synthesis. Some sources rich in Magnesium are:

• Grains and Cereals
• Beans and Legumes
• Protein-Rich Foods
• Starchy Vegetables
• Fruits

1. Phosphorus:

Getting adequate phosphorus should be a priority in your diet. If your kidneys are functioning normally, you should stop using phosphate binders and eat a phosphorus-rich diet. Your body can repair bones when your replacement kidney begins to work. Transplant medicines can reduce phosphorus levels. Therefore, your transplant nephrologist may prescribe phosphorus-raising tablets. Magnesium and potassium are abundant in many high-phosphorus diets. The daily phosphorus, potassium, and magnesium goals are 1,500 mg, 2,000 mg, and 300 mg, respectively.

1. Fat:

A low-fat diet is essential for keeping a healthy weight and avoiding heart disease, among other ailments. According to the American Heart Association, total fat calories should not exceed 30% of total calories. If you eat 2,000 calories each day, that’s roughly 65 grams of fat or fewer per day.

1. Fluids:

You won’t need to observe a hydration limit after your replacement kidney starts operating. After the transplant, you may get dehydrated, so drink enough fluids every day based on your specific needs. Unless your transplant team tells you differently, your GOAL when your kidney is functional is to drink at least eight glasses of water (64 ounces) each day. Caffeine and alcohol-containing beverages may cause you to lose fluids, so don’t include them in the 64 ounces of water you should drink each day.

Some food items to avoid after Kidney Transplant:

• Pomegranate and Grapefruit: Pomegranate and grapefruit, even as juice, can have serious side effects when combined with the immunosuppressant medicine provided after surgery and must be avoided.
• Herbs: Avoid consuming any herbs or herbal teas after your transplant since they may interact with your post-transplant medicine and cause problems.
• Raw food: Due to your compromised immune system, eating raw or undercooked food might put you at risk for severe bowel disease. As a result, it is advised that you avoid eating raw meat, shellfish, or poultry.
• Unpasteurized Dairy Products: Avoid raw milk cheeses, yogurts, and other dairy products.
• Sprouts, such as alfalfa or bean sprouts, should be avoided.
• Avoid dining out and eating food off the side of the road.
• Deep-fried or greasy foods.
• Do not consume food that has been left out overnight.
• Mayonnaise and raw eggs
• Red meat.
• Cold meat.
• Overripe fruits.
• Do not eat packaged food that has beyond its expiration date.
• Avoid foods like bananas, coconut water, and fruit juices/pulp if your potassium level is high.
• If your blood sugar is high, stay away from sweets and fruits like mangoes.

Why is a Proper Diet Important after Kidney Transplant?

Diet and nutrition play an essential role in wound healing by lowering the risk of rejection and infection. A dietician will propose a diet plan that is appropriate for your lifestyle and kidney health. In some circumstances, you may be able to consume items that were previously off-limits to you. Dietary advantages include:

• Preventing excessive weight gain 
• Maintaining appropriate blood sugar levels
• Assisting in the regulation of blood cholesterol 
• Assisting in the maintenance of normal blood pressure 
• Providing calcium to keep your bones healthy 
• Preventing anemia

Many people can only eat regular meals following a kidney transplant after a considerable time. Some people may experience an increase in appetite, which can lead to overeating and weight gain. While a replacement kidney may not require dialysis, there is always a risk of harm. A well-balanced diet can help prevent problems and manage the diseases that can lead to renal failure.

Food Safety after Kidney Transplant:

Aside from adopting a healthy diet, it’s also critical to preserve food safety. Even if you follow the prescribed diet, if you don’t manage food appropriately, it might cause significant problems. Here are some recommendations to follow to keep your food safe:

• Wash your hands well before handling food, primarily if you’ve handled raw meat, chicken, or fish, or if you’ve handled pets, for example.
• Separate raw and cooked foods; fully prepare food; check food labels for components, expiration dates, and other information.
• Stay away from smoked meat, sushi, seafood, and unpasteurized dairy products, among other things.
• When dining out, be cautious.

Tips while preparing and consuming food:

• Food should be prepared in a sanitary manner.
• Before you start cooking, make sure to clean your equipment thoroughly.
• In clean water, wash and cook.
• Use water that has been boiled or filtered.
• Small, frequent meals are recommended.
• Drink plenty of liquids; there are no restrictions on how much you may drink.
• Unless you have high blood pressure, you don’t need to limit your salt intake.
• After washing properly and peeling off the skin, eat many fresh fruits and green leafy vegetables.
• Maintain a healthy, low-fat, high-protein diet.
• Calcium-rich foods include skimmed milk, cheese, soya, eggs, poultry, and fish.
• Patients can continue eating as they did before the transplant in a few weeks.

Long term Management of Diet and Nutrition:

A heart-healthy diet and exercise are part of long-term nutritional management. The adverse effects of prescription medications are felt months or years later. Excess weight gain or high cholesterol levels are two of these effects contributing to heart disease. Your kidney specialist will maintain track of your health’s improvement, and you may be requested to keep track of your blood pressure and weight.

A heart-healthy diet contains low-fat milk, lean meat and fish, fiber, lots of veggies, and minimal salt, among other things. Patients who receive a kidney transplant should engage in regular exercise and cook using low-fat oils.

Activity and Exercise:

• Patients are usually permitted active walking and regular tasks like bending or climbing stairs after they are discharged. Regular exercise boosts energy, strengthens muscles, and helps you feel more energized.
• For the first few weeks following transplant, it is typical to suffer weakness and minor stomach discomfort near the site of the procedure, especially with movements. It should not be an excuse to put off exercising. Talk to the transplant team if you’re having a lot of trouble moving about.
• Deep breathing exercises will help you expand your lungs and cough out phlegm.
• The physiotherapist will teach limb exercises to strengthen limb muscles, improve blood circulation, and minimize the risk of problems like venous thrombosis.
• Speak with a physiotherapist about gradually increasing your activity level and optimizing your exercise routine.
• Make sure you get enough rest and sleep.

• For the first three months, avoid lifting high weights (> 5 kg) or doing abdominal workouts to enable the scar to strengthen and prevent hernia in the long run.
• After three months, one can resume typical physical activity, such as abdominal workouts, weight training, and swimming. These will aid in the strengthening of abdominal muscles as well as the flattening of the stomach.

Some Indian Diet and Recovery Tips after Kidney Transplant:

• Your blood pressure, blood sugar, and cholesterol levels may be raised by the drugs recommended as part of your postoperative regimen. That is why some lifestyle modifications are required:
• Low salt intake: After your kidney transplant, make a conscious effort to eat less salt in your food. This action is performed to keep fluid retention and blood pressure under control. Also, avoid high-sodium preserved foods such as canned foods, processed meat, high-sodium snacks, pickles, and packaged meals.
• Reduce fat consumption to a bare minimum: The anti-rejection medications will cause increased blood cholesterol levels following the kidney transplant. Reduce your intake of fried meals, full-fat dairy products, and other high-fat foods. After a kidney transplant, you must eat a low-fat diet.
• Increase your phosphorus consumption: Renal failure would have resulted in a considerable loss of bone mass. The bones begin to heal after a kidney transplant. As a result, it’s critical to eat foods high in phosphorus after your transplant since your blood phosphorus levels may decline.
• Increase your protein intake: A different proteinaceous diet is suggested until around six weeks following your transplant to speed up the post-surgical healing process. Because substantial doses of corticosteroids are recommended following the transplant, a high protein diet compensates for muscle breakdown caused by these medications. You can resume your regular protein consumption a few months following surgery (during the recovery phase).
• Maintain a healthy weight: If you want to recuperate quickly, keep your weight under control. Following a kidney transplant, certain postoperative medications may cause you to gain weight, which is harmful to your health. Consult your kidney specialist about workout recommendations to help you maintain your weight.
• Get enough rest: After a kidney transplant, postoperative care requires nutritional changes and rest. Relax at home after you’ve been released from the hospital to speed up your recovery. Do not drive or move heavy things weighing more than 10 pounds for the following 3 to 4 weeks. You will be able to resume some activities as soon as six to eight weeks following the transplant if there are no problems.