Chronic renal insufficiency in kidney transplant recipients is caused by chronic graft rejection, recurrence of the original renal disease or chronic cyclosporine toxicity.
Protein Intake: Stable kidney transplant recipients on a maintenance immunosuppression regimen, irrespective of renal function, should not exceed the NHMRC recommended daily intake of protein for the general population of 0.75 g protein/kg body weight for females and 0.84 g protein/kg body weight for males. Until there is stronger evidence to suggest otherwise, low protein intake (i.e. 0.55 g/kg) in kidney transplant recipients with chronic graft rejection should be avoided, as this may be associated with negative nitrogen balance. In the first 4 weeks after transplant, a diet providing at least 1.4 g protein/kg body weight may reverse negative nitrogen balance and lead to increased muscle mass in kidney transplant recipients.
Kidney transplant recipients require high dose glucocorticoids (steroids) in the early post-transplant period. Such high doses are associated with a higher protein catabolic rate and greater risk of a state of negative nitrogen balance. Unless protein intake is increased to match protein metabolism, poor wound healing, muscle mass loss and other morbidities may result.
Regular review by a dietitian is desirable in the long term to ensure that protein requirements are neither exceeded (potentially placing unnecessary pressure on the kidney graft) nor inadequate (possible in periods of acute rejection when prednisone dose may be increased).
The above is as per NEPHROLOGY 2010; 15, S68–S71; doi:10.1111/j.1440-1797.2010.01238.x.
Food recommended for kidney transplant patient are fruits, vegetables, lean meat (chicken), less oily fish (small fish), pomegranate, grapes, berries, (shehtoot, jamun, strawberries, amla) etc. The rule is to soak the vegetables and fruits in plain water 30 minutes and wash repeatedly three times to clean the fruits/ vegetables. only fresh fruits should be taken by the patient. Freshly cooked vegetables with less oil and spice to be given to the patient. The purpose is to avoid any kind of infection through ingestion of bacteria/ fungus infected food. If milk is given, it should be boiled for 15 minutes. Only home made fresh curd may be given to the patient. Any stored food item is always with preservatives. Atleast for initial few months after transplant, it is advised not to take preservative induced food products or fermented food products.
Fruit juice, chocolate, cola, soda, fermented food like dosa, idli, oily food like egg/ chicken rolls, fried food like samosas, bhajiyas, should be strictly avoided. Due to immunosupressasnt medicines, patient may have side effects like diarrhoea, constipation, nausea and vomiting tendency. It is advised to take small regular meals divided into 3 large meals (breakfast at 9.00 am, lunch at 1 pm and dinner at 8 pm) and four small meals (morning 7.00 am, mid day meal at 11.00 am and evening 3.00 pm and 6.00 pm). One should not fast at any cost while under medication. One should not overeat at all as the digestive system will be overloaded leading to indigestion, acidity.
Chhole, Chana, hara moong, dalia, etc may be included in the diet in small quantities. One should eat low glycemic index food (like wheat-atta, parboiled rice-mota dana chawal, unrefined sugar-bura, jaggery-gur) instead of high glycemic index food (like basmati, dehradun rice, maida, pasta, refined sugar, etc). Homemade bicuits with ragi, wheat, oat is better than maida biscuits. Fibre rich food should also be included in the diet. All types of gourd-lauki, papita, jhinga, etc should be included in the diet.