Kidney Transplant

Nutrition After Kidney Transplant

After your child's kidney transplant it is important that he or she eats a healthy diet. Healthy eating habits will help prevent some health complications that post-transplant medications can cause.

A healthy diet can . . .

• Keep blood sugar levels within normal limits, which prevents diabetes. Blood sugar can go up after transplant.

• Keep blood cholesterol levels within normal limits, which keeps the heart healthy. Cholesterol levels can become elevated after transplant.

• Prevent excessive weight gain. Some patients gain too much weight after transplant.

• Help to keep blood pressure normal directly after transplant when your child has the appropriate salt intake.

• Keep your child's bones strong when your child gets enough calcium. This can help support growth. Patients on prednisone after transplant have higher calcium needs.

What Is a Healthy Diet?

A healthy diet is:

• Low in Sugar -- Limit juice, soda, candy, chocolate, sweets, ice-cream.
  
  

  • Limit juice, soda and other high sugar content drinks to less than 8 ounces a day.
  • Limit candy or dessert type foods to one serving a day or less a day. Use the food label to determine what is considered a portion size.
  • Limit added sugar to foods or drinks such as cereal, coffee and tea. Some healthy foods contain added sugar such as yogurt and chocolate milk.

• Low in Fat -- Limit butter, margarine, red meat, fried foods, poultry skin, bacon, sausage, full fat dairy, eggs, mayonnaise and junk food.
  
  

  • Choose skinless poultry and fish more often than red meat.
  • Limit red meat to three times a week or less. Choose cuts with "loin" or "round" in the name. Keep serving sizes to 3 to 4 ounces of cooked meat. Cut off all visible fat from the meat.
  • Choose low-fat or nonfat dairy products.
  • Choose low-fat or nonfat additives to foods such as margarine, mayonnaise, salad dressing, sour cream etc.
  • Limit foods like chips, crackers and cookies. Try baked or low-fat versions of your favorites.

• High in Fiber -- Eat fruits, vegetables, whole grains, legumes and lentils.
  
  

  • Eat two to four pieces of fruit a day. Choose fruit instead of juice. A serving of fruit is equal to a small or medium size piece or 1/2 cup.
  • Eat three to five servings of vegetables a day. A serving is equal to 1/2 cup cooked or raw vegetables or 1 cup raw leafy vegetables.
  • Include whole grains in your diet every day. The goal is three servings a day of whole wheat versions of bread, pasta, couscous, tortillas, pita bread, oatmeal, wheat or oat cereals. Look for whole-wheat flour instead of enriched wheat or enriched white flour on the ingredients list. Try grains such as quinoa and amaranth.
  • Eat beans and lentils three times a week or more. Add to salad, stir-fries, soups, chili and burritos or eat plain.

• Moderate in Sodium -- Most patients should be limiting sodium to 3 to 4 grams a day or 3,000 to 4,000 milligrams a day. Use the food labels to help guide you. One teaspoon of salt = 2400 milligrams of sodium. This restriction can usually be liberalized after the first four weeks after transplantation. Talk with your dietitian for guidance.
  
  

  • Limit salt added to food during cooking. Use herbs, spices, lemon juice and vinegar to flavor foods.
  • Do not use a salt shaker at the table.
  • Limit salted foods such as chips, crackers, French fries, lunch meat and hot dogs.
  • Limit processed foods such as frozen meals, processed cheese, sauce or powder flavor packets for noodles or rice, soups and canned vegetables. The more processed the food usually the more salt.

• Adequate in Calcium -- Try to meet your calcium needs with foods. Supplementation may be necessary but is not appropriate for all patients. Talk with your doctor and dietitian for guidance. Great sources of calcium are milk, yogurt, cheese and calcium-fortified orange juice -- each has about 300 milligrams per serving. A serving is equal to 8 ounces of milk or yogurt or 1 ounce of cheese. Good sources of calcium are dark green vegetables like spinach and broccoli.
  
  

  • Children between 1 and 3 years of age should get 400 to 600 milligrams of calcium each day.
  • Children between 4 and 8 years of age should get 800 to 1,000 milligrams of calcium each day.
  • Children between 9 and 18 years old should get 1,300 to 1,500 milligrams of calcium each day.

Why Do I Need to Monitor My Weight Gain?

Patients on glucocorticoids (prednisone) after kidney transplantation often have very large appetites, feeling hungry all day. This can cause people to eat larger portions than usual and to eat more often.

Eating more calories than your body needs can cause you to gain weight. All children who are still growing in height need to continue to gain weight, but the goal is to avoid gaining too much weight too fast.

• Follow all of the guidelines outlined above for following a healthy diet.
• Remember that usually the more fat a food contains, the higher in calories it will be.
• Ask your nutritionist of a handout on recipe modification ideas to help decrease calories in food preparation.

How Do I Avoid Gaining too Much Weight?

• Monitor Portions -- One of the most important things to monitor is the portion sizes of foods eaten.
  
  

  • Keep meat to 3 to 4 ounces cooked -- the size of deck of cards or a woman's palm -- at meals.
  • Keep servings of starches such as pasta, rice, oatmeal, cereal, bread or tortillas to about two servings per meal. One serving is equal to 1/2 cup pasta, rice, oatmeal; 3/4 to 1 cup dry cereal; 1 slice of bread; or 1 6-inch tortilla. This will vary from child to child and is somewhat dependent of age. Work with your dietitian to determine appropriate amounts.

• Fill Up on Vegetables -- Vegetables are very low in calories. They also contain a lot of fiber that helps make you feel full.

What About Snacks?

Snacks should be included in a child's diet. Eating one to two snacks a day can help prevent a child from getting too hungry and therefore eating too much at their meals.

Choose low-fat and low to moderate calorie snacks such as fruits and vegetables. Do not snack on junk foods like candy, chips or sweets.

Be Active

Children should be active every single day. Encourage your child to go for a walk, ride your bike or play with friends. Be active with your child. Sign your child up for a group or individual sport like soccer, basketball, baseball/softball, dance or gymnastics. Being active makes you healthy and happy. It also will help to manage your child's weight. Your child's doctor can tell you what kinds of activities are allowed after transplant.

Restrictions

Potassium Restriction -- There is no longer a potassium restriction.

Phosphorus Restriction -- There is no longer a phosphorus restriction.

Protein Restriction -- There is no longer a protein restriction if you were on one before transplant.

Dairy Restriction -- There is no longer a dairy restriction.

Some patients may have low levels of potassium, phosphorus and magnesium in their blood. These patients often need supplements to raise levels of the minerals in the blood. In addition to supplements, your child should eat foods rich in these minerals.

High Potassium Foods

• Fruits and Juices -- Cantaloupe, dried apricots, orange juice, honeydew melon, mango, banana, papaya, prune juice, prunes, nectarine, apricot nectar, raisins, dates, kiwi and oranges.

• Protein Rich Foods -- Sole, halibut, salmon, red snapper, trout, flank steak (lean), tempeh, tofu, chicken, turkey and peanut butter.

• Cereals -- Bran flakes, All Bran cereal

• Vegetables -- Baked potato with or without skin, avocado, yams, winter squash, bamboo shoots, sweet potato, tomato juice, vegetable juice, mashed potatoes, cabbage, spinach and tomato.

• Beans and Legumes -- Refried, lima, pinto, and kidney beans as well as black eyed peas and lentils.

• Dairy Products -- Low-fat milk, chocolate milk and yogurt.

High Phosphorus Foods

• Dairy Products -- Milk, yogurt, cheese, ice-cream, frozen yogurt, pudding and custard.

• Protein Rich Foods -- Red meat (lean), fish, pork, chicken, turkey, eggs, beans and lentils, nuts and peanut butter.

• Other -- Chocolate and caramel, limit portion and frequency because high in sugar.

High Magnesium Foods

• Grains and Cereals -- 100 percent Bran Cereal, brown rice, soybean flour, bran flakes, oatmeal, wheat germ, instant oatmeal and whole wheat bread.

• Beans and Legumes -- Black, navy, refried, pinto, lima and kidney beans as well as lentils.

• Protein Rich Foods -- Tofu, sunflower seeds, almonds, cashews, walnuts, peanut butter, peanuts, beef, poultry and fish.

• Vegetables -- Spinach, Swiss chard, avocado, baked potato with skin, beet greens, broccoli and okra.

• Fruits -- Figs, pineapple, banana and raisins.

Learn more about kidney transplants at UCSF Children's Hospital:

• Kidney Transplant Program
• Kidney Transplant Experts
• Kidney Transplant Procedure

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated May 8, 2007

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.