Food and Drinks to Avoid After a Kidney Transplant

At each stage of chronic kidney disease (CKD), good nutrition is key to staying healthy. What you can and cannot eat depends on your kidney function and other medical conditions.

Dialysis and kidney transplant also have major impacts on how you eat. If you have had a kidney transplant, you may be able to eat foods that were off-limits before. You will also have some new things to consider to support your kidney health.¹

A healthy and balanced diet will help you feel your best. Your healthcare team, including a registered dietitian, can help you develop an eating plan that includes foods you enjoy.¹

Food safety

After a kidney transplant, you will need to take drugs that prevent your body from rejecting your new kidney. These drugs also weaken your immune system, which puts you at higher risk of infection.^1-3

Certain foods can make you sick from germs like bacteria, viruses, and parasites. Take the following steps to reduce your risk of illness from food:^1-3

• Wash your hands, utensils, and food prep surfaces after handling raw meat, fish, poultry, and eggs
• Wash your hands before you eat
• Wash fresh fruits and vegetables before eating or cutting
• Keep cold foods cold and hot foods hot
• Avoid well water or other water sources that could be contaminated
• Avoid "high-risk" foods (see list below)

“High-risk” foods to avoid

The following foods carry a higher risk of causing illness. Avoid these foods if you have had a kidney transplant.^1,3,4

Meat, fish, poultry, and eggs

• Raw or undercooked meat, fish, and poultry
• Cold deli meat
• Raw or undercooked eggs (including eggnog and homemade Caesar dressing)
• Refrigerated smoked fish
• Sushi, sashimi, and ceviche

Dairy

• Unpasteurized (raw) milk, yogurt, and cheese

Fresh fruit and vegetables

• Grapefruit and pomegranate (they can interfere with certain medicines)
• Unwashed raw fruits, vegetables, and salads
• Pre-packaged cut fresh fruit and vegetables
• Salad from salad bars, delis, or restaurants
• Sprouts

Drinks

• Grapefruit and pomegranate juice, since they can interfere with certain medicines
• Unpasteurized (raw) Kombucha and other fermented drinks
• Unpasteurized juices or ciders
• Fresh squeezed juices or smoothies from unwashed fruit
• Unpasteurized (raw) milk
• Ice in drinks

Other

• Food that is spoiled, moldy, or past its "use-by" date
• Leftovers more than 3 days old

For more information about food safety, refer to the US Food and Drug Administration (FDA) recommended diet for people after transplant.³

Positive food choices

Studies show that a Mediterranean-style diet and the DASH (dietary approaches to stop hypertension) diet improve outcomes for people with kidney disease. These diets focus on vegetables, fruits, whole grains, fish, poultry, and healthy fats, like extra virgin olive oil. These eating plans limit sugar, salt, red meat, and convenience foods.^5-8

Eat more of the following to support your overall health and protect your kidney function:^5-8

• Fresh vegetables and fruits
• Legumes like beans, peas, lentils, soy products
• Whole grains like whole grain bread and cereal, oats, brown or wild rice, barley, and quinoa
• Low-fat dairy products, including milk, yogurt, cheese
• Nuts and seeds like sunflower seeds, pumpkin seeds, walnuts, almonds, nut butter
• Fish and poultry
• Extra virgin olive oil

Eat less of the following to prevent health problems:^5-8

• Prepackaged and processed food
• Red, processed, and fatty meats, including beef and pork
• Sodium (salt), and limit daily intake to 1500 to 2300 mg or less
• Sugar and sweetened drinks
• Saturated and trans fats, and limit full-fat dairy and tropical oils like coconut and palm oil

The National Kidney Foundation has more information about eating for kidney health.⁹

Steroid effects

You may also need to take steroids after kidney transplant. Steroids cause changes in your body that can affect your health. Steroids can cause the following changes:¹

• Increased appetite
• Weight gain
• Fluid retention
• Changes in cholesterol
• Increased blood sugar
• Damage to muscles and bones

Stay active and eat heart-healthy foods to reduce your risk of steroid-related health problems like heart disease, diabetes, and high blood pressure.⁵

General tips

Work with your doctor and dietitian to find out how much water and protein you need every day. In addition to choosing nutritious foods, you can support your kidney function by doing the following:¹⁰

• Stay hydrated – Drink the right amount of water is good for your new kidney.
• Eat enough protein ­­­– Protein will help your body heal and support your immune system.
• Talk to your doctor before taking any over-the-counter (OTC) medicines – Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can harm the kidneys. Antihistamines and antacids can affect how prescription drugs work.
• Avoid herbal supplements – Certain herbal supplements can interfere with prescription drugs.
• Limit alcohol.

There is no single diet that works for everyone. The best eating plan is one that includes healthy foods you enjoy. Talk to your transplant team and a registered dietitian for more information about what to eat after a kidney transplant.