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Renal & Pancreatic Transplant
Your Kidney Transplant Nutrition


Good nutrition plays a key role in successfully recovering from kidney transplantation. As after any surgery, adequate calories and protein are needed for proper wound healing. Also, possible side effects of the anti-rejection medications can increase nutrient requirements. Because of these special concerns, you may have to change your diet for a time period after your transplant. However, dietary therapy is always adjusted by the transplant team to meet your specific needs and tolerances:


Protein

In the first month following kidney transplantation you will be recovering from the stress of surgery. It is important to consume enough protein and total calories to help your wounds heal. You also need added protein to help overcome muscle breakdown caused by high doses of prednisone. To help meet your protein needs, the following foods are recommended:

  • Meats (beef, pork, poultry, turkey, seafood)
  • Fish
  • Dairy products (mild cheese, yogurt)
  • Eggs (but no more than 3 to 4 yolks per week)
  • Egg substitutes (egg whites)

The following are vegetarian selections high in protein. When taken in adequate amounts as part of a well-balanced diet, these foods meet your protein needs:

  • Nuts
  • Peanut butter
  • Dried beans
  • Split peas
  • Soy products
  • Tofu

Sugars

Some medications can decrease the body's ability to use its blood sugar for energy. This can cause increased blood sugar (glucose). This condition is called hyperglycemia or steroid-induced diabetes.

Avoiding concentrated carbohydrates will help decrease the side effects of steroid medications. These foods are high in simple sugars and should be avoided:

  • Sugar
  • Molasses
  • Sugar pies
  • Fruited yogurt
  • Puddings
  • Soft drinks
  • Cookies, candy
  • Ice Cream
  • Fruit Ice
  • Canned fruit or juice with added sugar or syrup
  • Honey
  • Syrup
  • Doughnuts and sweet rolls
  • Jams, jellies, marmalades
  • Chewing gum with sugar
  • Sweetened mineral water
  • Sweetened condensed milk
  • Sherbet
  • Jello
  • Frozen fruit or juice with added sugar or syrup

If you develop hyperglycemia, your diet may need to be changed to adhere to the following guidelines:

  • Eating three meals per day, consumed at regular and evenly-spaced times.
  • Limiting fruit to one serving per meal, and eating fresh or water-packed canned fruit only (no syrup or added sugar).
  • Reading food labels to avoid foods with sugar, honey, sucrose, dextrose, or corn syrup listed as the first or second ingredient.

Sodium (salt)

Prednisone can increase sodium and water retention and increase your blood pressure. Therefore, sodium may need to be restricted in your diet. The "no added salt" diet is generally prescribed. Salt contains sodium, so it is best to limit salt when cooking and not add salt at the table. High sodium foods to avoid include:

  • Commercial Soups: Bullion cubes, dehydrated soup mixes, canned broth, and canned soup (unless labeled "low sodium")
  • Processed Meats: Ham, bacon, sausage, frankfurters, cold cuts (bologna, salami, pastrami), corned beef, smoked or dried meat or fish. Canned meats and fish (unless labeled "no salt added"), salt pork, processed cheese, and frozen packaged dinners.
  • Processed Vegetables: Pickles, sauerkraut, canned vegetables (unless labeled "no salt added"), and frozen vegetables with sauces.
  • Starches: Salted crackers, pretzels, potato chips, corn chips, salted popcorn, salted nuts or seeds, etc.
  • Beverages: Buttermilk, tomato juice, and vegetable juice (unless labeled "low sodium").
  • Condiments for use in moderation: catsup, prepared mustard, horseradish, and sauces (i.e., barbecue, chili, and Worcestershire).
  • Condiments to avoid altogether: pickle relish, olives, garlic salt, onion salt, monosodium glutamate (MSG)(Accent), soy sauce, meat tenderizers, and salad dressings (unless homemade).
  • Salt substitutes are high in potassium and should only be used with your doctor's permission.

Potassium

Some drugs (Cyclosporine® or Prograf®) can increase the potassium level in your blood. Other drugs (Lasix®) can decrease your potassium level. When potassium is too high or too low, problems with muscle and heart function can develop. Your serum (blood) potassium level can mandate a change to your medication and/or diet. High potassium foods include:

Fruits and Juices

  • Apricots
  • Dried fruits
  • Oranges
  • V-8 juice
  • Avocados
  • Melons
  • Orange juice
  • Tomato juice
  • Bananas
  • Nectarines
  • Prune juice

Vegetables

  • Leafy greens
  • Potatoes
  • Dried beans
  • Tomatoes
  • Pumpkins
  • Split peas
  • Lentils

Other Foods

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

Nutrition for Pediatric Patients

Children and adolescents who undergo kidney transplantation may have experienced weight loss or delayed weight gain and growth before the surgery.

After surgery, however, the goal is to provide enough calories, protein, and other essential nutrients to promote healing, weight gain, and growth. Restrict your child's diet as little as possible and encourage him or her to eat a variety of foods. The team's dietitian will work with you and your child to identify wholesome and tasty foods that are easily tolerated.

Some adjustments may be necessary to compensate for medication side effects, and if so, the same adult guidelines outlined above should be followed. This is especially true of foods that are high in sodium (salt) and sugar, both of which are found in high concentrations in "fast foods," favorites with children and adolescents. The dietitian will give you specific guidelines regarding fast foods, and offer suggestions for alternatives that your child can enjoy. Be sure to ask the dietitian any questions you have about the nutritional needs of your child.


Long-Term Nutritional Management

Many transplant patients develop nutrition-related problems in the months and years following transplant. The most common are excessive weight gain (as fat) and high blood cholesterol that are usually caused by steroids and other medications. The best management for you includes weight control by following a "heart healthy" diet and exercising. Here are some guidelines that will help decrease the amount of total fat and cholesterol in your diet. They will help reduce your risk for heart disease and excessive weight gain.

Eat Heart Healthy!

Read food labels carefully to avoid foods that are high in saturated fats and cholesterol. Some of these foods include lard, butter, shortening, ice cream, sausage, and bacon. Coconut and palm oils are saturated fats found in many convenience baked goods, whipped toppings, coffee creamers and fried foods.

In addition, follow these guidelines:

  • Choose low-fat milk and other low-fat or nonfat dairy products.
  • Limit egg yolks to 3 or 4 per week. Many recipes can be made with egg whites or an egg substitute without compromising taste.
  • Choose the leanest varieties of beef and pork; avoid fried meats.
  • Poultry (without skin), beans, and fish are excellent main course selections when cooked without fat.
  • To increase the fiber in your diet, eat more fresh fruits, raw vegetables, and whole grains. A high-fiber diet may also help lower your cholesterol.
  • Reduce your total calories by eating smaller portions and avoiding second helpings.
  • Choose low-calorie snacks, such as fresh fruit, low-fat cookies or crackers and unsalted pretzels. Remember, just because a food is "low-fat" does not mean that you won't gain weight if you eat too much.
  • Continue to limit salt intake and high-sodium foods to control blood pressure.
  • Continue to limit simple sugars, especially if you are overweight.
  • Do not eat sushi or any other raw or undercooked meat or fish.

Low-Fat Cooking Tips

  • Microwave, broil, grill or steam without adding fat.
  • Use nonstick sprays and/or cookware.
  • Trim all visible fat off meat, and remove skin from poultry.
  • Experiment with reducing the amount of oil you use in baking. Often your recipes will taste just as good with less oil.

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