Kidney Transplant and Food

Most people will benefit from eating a healthy diet.  Some people have side effects from their medication, such as a bigger appetite, weight gain, high blood cholesterol and high blood glucose levels.   Small changes to your eating can help to manage your blood pressure, blood glucose and reduce your risk of heart disease. 

The Eatwell Guide on the NHS website shows how much of what we eat should come from each food group for a healthy diet.  You don’t need to get this balance with every meal or snack.  Try to get the balance right over a day.

Managing your blood glucose levels can give you more energy, good sleep, healthier skin and gums.  Also this can prevent problems with your nerves, eyes, feet and heart.  Find out more about Complications of diabetes at www.diabetes.org.uk

Some people may develop diabetes.  This is known as new onset diabetes after transplant (NODAT).

Use The Eatwell Guide to eat healthily and aim to get to or stay at a healthy weight.  Find out more about diet and diabetes at Diabetes UK.

Yes - Eating less salt can improve your blood pressure.  Around ¾ of the salt we eat comes from salt in manufactured foods.  This salt FAQ will give you more information.

Salt substitutes such as LoSalt, Saxa So Low and Solo are not recommended for people with kidney problems.

You can usually start to eat foods high in potassium and phosphate again. Sometimes blood levels can be high and you may need to limit some foods.  Your dietitian, consultant or specialist nurse will tell you if this is needed by looking at your latest blood test.

This potassium FAQs will give you information about foods to choose if you have high blood potassium levels.

This phosphate FAQs will give you information about foods to choose if you have high blood phosphate levels.

After your transplant you will be on medication to stop your immune system rejecting your new kidney.  This medication weakens your immune system and can increase the risk of food poisoning. You can reduce your risk by being careful about what you eat and how prepared and cooked.  The information below is a short guide.  Your dietitian will give you more information.

Here are some recommendations:

• Make sure your hands, work surfaces, utensils, chopping boards, dishcloths and tea towels are all clean when handling, preparing and cooking food
• Chill and store foods properly.  Eat them by the ‘use by’ dates
• Don’t let raw foods drip on or touch cooked foods, especially meat, fish and poultry
• Don’t handle food if you’ve had diarrhoea or vomiting recently
• Wash fruit, vegetables and salad before use
• Avoid unpasteurised soft cheese, soft blue cheese and cheese with rind such as brie, camembert, unless it is cooked until piping hot
• Milk should be pasteurised or UHT
• Avoid yoghurts labelled ‘Probiotic’ or ’Bio’
• Avoid eggs with runny yolks and foods with raw egg in them. Use eggs with a ‘red lion’ stamp, store them in the fridge and cook them until yolks are solid
• Avoid all raw or undercooked meat, poultry, fish and shellfish
• Avoid rotisserie chickens, buffets and foods from the deli counter. Choose pre-packaged foods instead
• Buy cooked meat or fish in sealed packs and eat within 24 hours of opening
• Avoid pâté, unless it is tinned

• Avoid eating out or takeaways for the first 6-8 weeks.  After that only eat from places known to be clean and hygienic.  You can check the food hygiene rating of businesses here https://ratings.food.gov.uk/  This gives you information about how clean a business is.
• Avoid takeaway rice.  It is important rice is freshly cooked and not reheated
• Avoid food from buffets, salad bars and street stalls
• Make sure hot food is piping hot and freshly cooked
• Be especially careful if travelling abroad.  Avoid tap water, ice and foods washed in tap water
More detailed information can be found here www.food.gov.uk/food-safety and Food and water abroad - NHS

Hepatitis E virus (HEV) causes liver disease.  There have been some cases in people after a transplant.  It is thought the HEV comes from under-cooked pork or pork products (such as sausages, bacon, cured meats and offal).  It is important to cook all meat thoroughly including barbequed meat.  If you have further questions about this please speak to your doctor, nurse or dietitian.

Grapefruit, grapefruit juice, pomelo, pomelo juice, some herbal remedies and high doses of vitamins can affect transplant medications, so should be avoided.  Discuss any vitamins or supplements (such as herbal or homeopathic products) with the transplant team before taking. 

Starfruit can be harmful to people with kidney disease and you are recommended to avoid eating it.

Transplant medications such as steroids can weaken your bones.  To reduce the risk of weak bones and fractures you need enough calcium and vitamin D.

The best sources of calcium are milk, cheese, yoghurt, tofu, tinned fish with bones, sesame seeds, tahini paste and foods with added calcium such as some plant milks and cereals.  Beans, lentils, nuts, dried figs, white bread and white flour products are also good sources.

Vitamin D helps you absorb calcium from your food.  It is found in eggs, oily fish, red meat and foods with added vitamin D such as skimmed milk powder, margarine, low fat spread, some cereals and plant milks.  You can find more information on foods for strong bones on the NHS website.

The best source of vitamin D is sunlight on the skin, but medications can increase your risk of skin cancer. Find out more on the british association of dermatologists.

Your calcium and vitamin D levels can be measured and supplements prescribed by your doctor if needed. 

Lifestyle factors such as regular weight-bearing exercise, not smoking, drinking less alcohol and keeping to a healthy weight can also help keep your bones healthy.