Managing long-term side effects of a kidney transplant

This information answers questions about your diet after having a kidney transplant. 

A common long-term side effect after a kidney transplant is weight gain, especially in the first year. There are several reasons for this, including:

• having fewer restrictions on your diet
• feeling well
• often having a better appetite
• the effects of some medicines needed after a kidney transplant (steroids)

It is important that you have a healthy, balanced diet to help control your weight and cholesterol levels. Controlling your cholesterol levels helps to reduce your risk of heart disease and stroke. You also need to include calcium in your diet to keep your bones healthy and reduce the risk of osteoporosis (weak bones).

Having a healthy, balanced diet

The NHS Eatwell Guide lists the different food groups that make up a healthy, balanced diet. It also tells you the proportion that a food group should contribute to your diet, as shown in the following picture:

Fruit and vegetables

Try to have at least 5 portions of fruit and vegetables each day. A portion is about a handful. 

Fruit and vegetables give you vitamins and minerals. They are also a good source of fibre.

Protein

It is best to choose low-fat sources of protein, such as:

• fish
• chicken
• lean red meat
• beans and pulses
• eggs

You need protein for muscle repair and growth.

Dairy products and other options

Try to choose products that are low in fat and sugar. Dairy foods are a good source of calcium and protein. 

Starchy carbohydrates

Bread, pasta, breakfast cereal and potatoes are examples of starchy carbohydrates. They give your body energy.

Try to choose wholegrain options, which:

• are high in fibre
• keep you feeling full for longer

Carbohydrates should make up about one-third of your diet.

Fat and oils

Try to reduce the amount of unhealthy saturated fats in your diet, such as:

• butter
• fat on meat
• cheese
• cake

You can replace them with healthier unsaturated fats, such as:

• olive oil
• nuts
• avocado
• oily fish

Salt

Try to avoid too much salt because this can cause high blood pressure.

To reduce the salt in your diet:

• it is best to eat fresh and unprocessed foods
• do not add salt in cooking or at the table
• try to limit salty snacks like crisps or nuts

Alcohol

You need to limit how much alcohol you drink. Alcohol can be high in calories and contribute to weight gain.

According to the current guidance, you need to avoid drinking more than 14 units of alcohol a week on a regular basis. This should be spread across 3 days or more. Try to have several alcohol-free days each week.

The following table shows how many units of alcohol different drinks contain:

Alcoholic drink	Number of units
Single shot of spirits (25ml, alcohol by volume or ABV 40%)	1
Bottle of lager, beer or cider (330ml, ABV 5%)	1.7
Can of lager, beer or cider (440ml, ABV 5.5%)	2.4
Pint of lower strength lager, beer or cider (ABV 3.6%)	2
Pint of higher strength lager, beer or cider (ABV 5.2%)	3
Small glass of wine (125ml, ABV 12%)	1.5
Standard glass of wine (175ml, ABV 12%)	2.1
Large glass of wine (250ml, ABV 12%)	3

Risk of bone disease after a kidney transplant

After having a kidney transplant, there is a higher chance of getting bone disease. This can happen due to the use of kidney transplant medicines, such as steroids.

For this reason, it is important that you get enough calcium (a mineral) in your diet. It is recommended that you try to have either:

• 1,000mg of calcium each day (or 1,300mg each day after the menopause)
• 4 servings of foods that contain calcium each day

Here are some examples of 1 serving of calcium:

• 200ml cow's milk or calcium-enriched soya, oat, almond, rice or coconut milk
• 150g yoghurt
• 200g calcium-enriched soya or oat yoghurt
• 30g hard cheese
• 2 cheese triangles
• 60g tinned sardines or salmon (with bones)
• 60g tofu
• 150g spinach or watercress
• 100g dried figs (about 5 figs)
• 200g rice pudding
• 400g tin of baked beans
• 2 tablespoons of sesame seeds
• 2 heaped teaspoons of tahini (a paste made from sesame seeds)

If you think you are struggling to eat enough calcium after you leave hospital, please speak to your renal dietitian.

Exercise

Regular exercise or physical activity is good for you because it helps to:

• keep your heart healthy
• strengthen your bones , muscles and joints
• control your weight
• control your blood sugar and cholesterol levels
• lower your blood pressure
• make you feel more positive

Try to make exercise a part of your daily routine. Here are some tips that may help:

It is best to start with gentle exercise and build up your activity levels gradually. If you choose an activity that you enjoy, this will help you keep to an exercise routine.

Try to do 30 minutes of exercise throughout each day. We do not recommend heavy exercise in the first 3 months after your kidney transplant. Please ask your healthcare team before you start any heavy exercise or formal exercise programme.

Useful information

This section lists places where you can find more information about a healthy diet and lifestyle.

Kidney Care UK

The UK's leading kidney patient support charity.

Website: www.kidneycareuk.org 

Kidney Beam

A website to help people living with kidney disease feel good through movement, education and wellbeing support.

Website: beamfeelgood.com

Food Standards Agency

The government organisation that is responsible for food safety and food hygiene in England, Wales and Northern Ireland.

Website: www.food.gov.uk 

NHS Diabetes Prevention Programme

This identifies people at risk of getting type 2 diabetes and refers them onto a 9-month, evidence-based lifestyle change programme.

Website: www.preventing-diabetes.co.uk 

Diabetes UK

The leading charity for people living with diabetes in the UK.

Website: www.diabetes.org.uk 

Drinkaware

This charity gives independent alcohol advice, information and tools to help people make better choices about their drinking.

Phone: 0300 123 1110 (weekdays, 9am to 8pm and weekends, 11am to 4pm)

Website: www.drinkaware.co.uk 

NHS Weight Loss Plan

You can download the free 12-week NHS Weight Loss Plan. This helps you to have healthier eating habits, be more active and start losing weight.

Website: www.nhs.uk/better-health/lose-weight 

Couch to 5K and Active 10

Couch to 5K is a running programme for beginners. The Active 10 app anonymously records every minute of walking that you do.

Website: www.nhs.uk/better-health/get-active  

NHS Live Well

NHS advice about healthy living. This includes eating a balanced diet, having a healthy weight, exercising, stopping smoking and drinking less alcohol.

Website: www.nhs.uk/live-well