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.

You may need to eat more protein foods after you start dialysis.

Eating less salt can improve your blood pressure and make you feel less thirsty.

You may need to limit the amount you drink if recommended by your doctor, nurse or dietitian.

Some people need to reduce foods high in potassium and phosphate. Your dietitian will tell you if you should do this.

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

Protein foods include meat, fish, chicken, eggs, milk, yoghurt, cheese, lentils, beans, Quorn and tofu.  These foods are important for maintaining your strength, repairing muscles, healing wounds and fighting infection. 

PD increases your need for protein as some is lost during dialysis.  It is important to make sure you are eating enough protein now.  Not eating enough protein can cause muscle loss and weakness.  Try to eat 2 to 3 larger portions of protein foods a day.  Your dietitian can guide you on portion sizes to meet your protein needs.

Eating well is important to help you feel better and cope with any treatment you may need.  Many people find the following can help them to eat more:

• Eating little and often throughout the day
• Eating small nourishing snacks between meals such as cereal and milk, cheese and biscuits, cakes, biscuits, desserts, pastries
• Having a snack, sandwich or a milky drink if you cannot manage your normal meal
• Trying easy to prepare high protein meals such as cheese, scrambled egg, poached egg on toast or omelette
• Using full fat and full sugar versions of foods and drinks such as full fat milk, full fat yoghurt instead of diet or low fat ones
• Trying to eat more on days or at times you feel better
• Spreading butter, margarine, honey, jam and marmalade thickly on bread, croissants, crumpets
• Adding honey or sugar to cereals and puddings
• If you have diabetes or you are limiting potassium or phosphate speak to your dietitian for more information

Yes – most people eat too much salt.  Eating less salt can improve your blood pressure. If you have been advised to limit how much you drink, less salt reduces fluid build-up in your body (oedema) and makes you less thirsty.

Around ¾ of the salt we eat comes from salt in manufactured foods.  This salt FAQs will give you more information.

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

Most fluid comes from drinks.  The body passes out extra fluid in your urine.  You may notice you are passing less urine.  Some fluid is removed by dialysis.  If you drink more than is being removed this can cause sudden weight gain, swollen ankles, breathlessness and a rise in your blood pressure.

If this happens, your Doctor, nurse or dietitian may recommend you limit the amount you drink. It is important you also eat less salt to reduce the fluid build-up and feel less thirsty.

Ideas to help if you need to reduce your fluid:

• Try to have fewer drinks and spread your fluid throughout the day
• Use a small cup or glass for drinks
• If eating sloppy or liquid foods such as such as soup, custard, yoghurt, ice-cream, reduce how much you drink
• Spicy and salty foods can make you thirsty so try to reduce these foods
• Try using plastic ice-cubes in drinks to save extra fluid
• Rinsing your mouth, gargling with mouthwash and brushing your teeth can help freshen your mouth
• You can quench your thirst with slices of lemon, orange, frozen grapes, pineapple cubes, boiled sweets, sugar free mints and chewing gum
• If you have a dry mouth, artificial saliva sprays may help such as Glandosane (available on prescription)

Managing your blood glucose levels is important to reduce the risk of more damage to your kidneys. 

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

If you are on PD, well controlled diabetes can improve how well you dialyse.

You may find your blood glucose levels change when you start dialysis.  Continue to check your blood glucose levels regularly.  You can speak to your diabetes nurse or doctor about your diabetes tablets or insulin to help manage your levels. 

After you start PD you will speak to a dietitian for advice on eating well with diabetes and how to balance this with dialysis diet recommendations.

Constipation is a common problem with peritoneal dialysis.  This may cause poor drainage of dialysis fluid.  Eating a diet high in fibre can help you to avoid constipation.

Foods to choose to help you to eat more fibre:

• Wholemeal or granary bread
• Wholegrain cereals such as shredded wheat, weetabix, porridge
• Wholewheat pasta, brown rice and wholemeal flour
• Pulses such as beans, lentils and peas
• Fruit and vegetables - aim to eat 5 portions each day and fresh, frozen or tinned can all be eaten. The Eatwell Guide on the NHS website can give you more information.

Some people on HD will need to eat less potassium.  It depends on your blood potassium levels.  If your potassium level is regularly above 5.5mmol/l, you may be recommended to eat less potassium.   If you were limiting potassium prior to starting HD you may need to continue. 

Your levels will be checked each month and your dietitian will provide you with information.  Sometimes there can also be other causes for a high potassium level which will be looked at by your dialysis team.  This potassium FAQs will give you information about foods to choose if you have high blood potassium levels.

Some people on PD will need to eat less phosphate.  It depends on your blood phosphate levels.  If your phosphate level is regularly above 1.5mmol/l, you may be recommended to eat less phosphate.  If you were limiting phosphate prior to starting HD you may need to continue. 

Your levels will be checked each month and your dietitian will provide you with information.  This phosphate FAQs will give you information about foods to choose if you have high blood phosphate levels.

If your blood levels stay high, you may also be prescribed tablets called ‘phosphate binders’. These are taken with food to reduce the amount of phosphate absorbed from food.  Your dietitian, doctor or pharmacist can tell you how and when to take these tablets.

Water soluble vitamins are lost during the dialysis process.  A multivitamin tablet suitable for people with kidney disease is usually prescribed to replace those lost.  You are recommended to discuss any supplements with your dietitian or doctor before taking.

Not all people with kidney disease need to follow a low potassium diet.  It depends on your blood potassium levels and kidney function.  If your blood potassium level rises above 5.5mmol/l, you may be recommended to eat less potassium. 

Sometimes there can be other causes for a high potassium level that will be looked at by the doctor first.  You don’t need to reduce potassium in your diet unless you have been advised to by your doctor or dietitian.

Potassium is a mineral found in many foods.  It helps our nerves, muscles and heart to work properly.  Our kidneys help to control the level of potassium in the blood.  Potassium not needed by the body is usually passed out in the urine.  The normal range for potassium in the blood is 3.5 – 5.3mmol/l.

When your kidneys are not working properly, potassium can build up in your blood.  A high level of potassium can be dangerous, as it can affect your muscles and heart.

Some food and drinks are higher in potassium. These include:

• Some fruits such as apricots, avocado, bananas and dried fruit
• Some vegetables such as mushrooms, parsnips, spinach and tomatoes
• Potatoes which have not been boiled such as chips and jacket potatoes
• Snacks such as potato crisps, nuts, chocolate and liquorice
• Drinks such as coffee, malted milk drinks and fruit juices
• Alcoholic drinks such as cider and strong ales
• Soups containing tomatoes and vegetables
• Salt substitutes such as Losalt, Saxa So low and Solo

If you have diabetes you may have been advised to eat more fruit, vegetables and nuts. Your dietitian can advise you on appropriate quantities and help you choose lower potassium food and drinks.

If you need to change your diet, you can ask your doctor about a referral to a dietitian for more advice.  You can find more information on Lifestyle - diet, fluids and exercise on the Kidney Care UK website.

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

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

Drink plenty of fluids, unless your doctor has advised otherwise.  The Eatwell Guide recommends 6-8 cups or glasses a day.  If you have CKD aiming to drink at least 8-10 cups a day can help the kidneys by diluting your urine

Yes – most people eat too much salt.  Eating less salt can improve your blood pressure and slow down worsening of your kidney function.  If you have been advised to limit how much you drink, eating less salt reduces fluid build-up in your body (oedema) and makes you less thirsty.

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.

Getting to and staying at a healthy body weight will help you to control your blood pressure and blood cholesterol levels which can help to protect your kidneys from further damage. Check if you are a healthy weight on the NHS live well bmi calulator.

Following the Eatwell Guide will help ensure you follow a healthy diet whilst losing weight.  If you would like more detailed information there is an NHS 12 week weight loss guide.

If you have kidney problems you should follow the Government's sensible drinking guidelines at www.nhs.uk unless you have been given different advice by a healthcare professional.

Managing your blood glucose levels is important to reduce the risk of more damage to your kidneys. 

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

It is important to follow any diet and lifestyle advice you have previously been given to help control your diabetes.  The recommendations for eating well with diabetes are based around the The Eatwell Guide on the NHS website.  This is the same healthy diet that is recommended for the general population and should be combined with aiming to get to or stay at a healthy weight.  Find out more about diet and diabetes at Healthy eating with Diabetes and at Diabetes UK.

If your kidney function reduces or you start dialysis, you may be advised to follow other dietary advice such as a low potassium or low phosphate diet.  Balancing this can be difficult so you can ask to speak to a dietitian.

Protein foods include meat, fish, chicken, eggs, milk, cheese, lentils, beans, Quorn and tofu.  These foods are important for maintaining your strength, repairing muscles, healing wounds and fighting infection.  Most people eat too much protein.  When you eat these foods the kidneys need to get rid of the waste.  If your kidneys are not working well, this waste will build up in the blood which can make you feel less well.  

As part of a balanced diet, it is recommended to:

• Keep to 2 to 3 medium sized portions of protein foods a day
• Eat 5 portions of  fruit and vegetables
• Base your meals on starchy foods e.g bread, rice, pasta, potatoes.  Choose wholegrain or higher fibre versions where possible
• Use The Eatwell Guide on the NHS website and the Portion sizes food fact sheet which is available at www.bda.uk.com to get the right balance between the different food groups

Not all people with kidney disease need to follow a low potassium diet.  It will depend on your blood potassium levels and kidney function.  You don’t need to reduce potassium in your diet unless you have been advised to by the doctor or dietitian.  This potassium FAQ will give you information about foods to choose if you have high blood potassium levels.

This will depend on your kidney function and if the level of phosphate in your blood is above the normal range.  Eating less high phosphate foods can help you to control the level of phosphate in your blood.  You don’t need to reduce phosphate in your diet unless you have been advised to by the doctor or dietitian.  This phosphate FAQ will give you information about foods to choose if you have high blood phosphate levels.

If your blood levels stay high, you may also be prescribed tablets called ‘phosphate binders’. These are taken with food to reduce the amount of phosphate absorbed from food.  The dietitian, doctor or pharmacist can tell you how and when to take these tablets.

No, do not take any multivitamin or mineral supplements unless you have discussed this first with your doctor, pharmacist or dietitian.  A healthy balanced diet should provide you with all the essential nutrients you need.

Eating well is important to help you feel better and cope with any treatment you may need.  Many people find the following can help them to eat more:

• Eating little and often throughout the day
• Eating small nourishing snacks between meals such as cereal and milk, cheese and biscuits, cakes, biscuits, desserts, pastries
• Having a snack, sandwich or a milky drink if you cannot manage your normal meal
• Trying easy to prepare high protein meals such as cheese, scrambled egg, poached egg on toast or omelette
• Using full fat and full sugar versions of foods and drinks such as full fat milk, full fat yoghurt instead of diet or low fat ones
• Trying to eat more on days or at times you feel better
• Spreading butter, margarine ,honey, jam and marmalade thickly on bread, croissants, crumpets
• Adding honey or sugar to cereals and puddings
• If you have diabetes or you are limiting potassium or phosphate speak to your dietitian for more information