Nephrology

535 Nutrition After Renal Transplantation

  • Nutrition After Renal Transplantation 

    The focus of dietary management changes significantly following a successful renal transplant.  Previous dietary information from predialysis or dialysis needs to be disregarded.  A more normal pattern of eating a healthy well balanced diet, which fits into the demands of the remainder of the family, needs to be commenced.

    Energy

    Energy intake post transplant needs to be adjusted to achieve and maintain ideal weight for height.  Anti-rejection medications that the child is prescribed post transplant often cause an increased appetite and results in excessive weight gain.  Therefore the diet to be encouraged both in the short and long term should be one that is minimising an excessive intake of energy from simple carbohydrates and fats.  Appetites should be satisfied by increasing the intake of complex carbohydrates which are rich in dietary fibre.

    Fats

    Hyperlipidaemia and hypercholesterolaemia has been reported after renal transplantation.  In order to reduce the risk of developing coronary heart disease in later life, a diet which reduces the intake of saturated fat and replaces it with poly and monounsaturated fats is recommended.  Some dietary fats can form an important part of a child's diet, therefore care needs to be taken to ensure that the modified diet is providing adequate nutrition for normal growth and development.

    Vitamins and Minerals

    In general if a nutritionally adequate diet is being consumed, no additional vitamins and minerals should be required after transplantation.  However if a poor dietary intake does persist a more general vitamin or mineral supplement can be used.

    References

    Brown, E. et al.  (1994)  A Clinical Guide to Nutrition in End Stage Renal Disease Second Edition. The American Dietetic Association