Kidney Diet Tips

Managing Cholesterol after Kidney Transplant

Kidney transplant is not a cure for kidney failure. It is kidney replacement therapy, also known as renal replacement therapy. There may be changes to blood cholesterol and fats after a kidney transplant.

Transplant Considerations

When a person receives a kidney transplant there are many things to consider, including nutrition care. A patient’s nutritional status is influenced by many different things such as appetite, electrolytes, gastrointestinal issues, medications, weight, and pre-existing medical conditions. After transplant it is important for the healthcare team to monitor the patient’s progress, reassess nutrition goals and address possible complications related to the transplant. Frequent follow-up visits with the transplant doctor and dietitian are essential. Check out the video clip below on what to expect during your transplant recovery.

Transplant and Dyslipidemia

One common complication after transplant is high cholesterol and fat (triglycerides) in the blood, also called dyslipidemia. It is reported to affect as many as 60% to 79% of transplant patients. Many of the medications commonly used to suppress the immune system and keep the body from rejecting the new kidney can make cholesterol and triglycerides go up. Dyslipidemia, in turn, can lead to cardiovascular disease (CVD).  CVD is linked to health problems like heart attack and stroke. Obesity, weight gain, age, male gender, history of diabetes, sedentary lifestyle, and certain diuretics and blood pressure medications can also contribute to dyslipidemia.

Tips to Help Manage Cholesterol and Triglycerides

Because of the increased cardiovascular risk in transplant patients, dyslipidemia should be taken very seriously. This is important because cardiovascular events such as stroke and heart attack are the leading cause of death in kidney transplant patients. So, how can you help prevent or manage cholesterol and triglycerides after transplant?

Diet Changes

  • If you are overweight, talk with your doctor or dietitian about a plan to reach a healthy body weight. In general, ideal BMI is from 25.0 – 28.0, but this varies from person to person. Ask your dietitian for your personal goal.
  • Decrease intake of saturated fat, trans-fat, and cholesterol. Saturated fats are found in most high-fat meats such as bacon, sausage, chicken skin, and fat on steaks and pork chops. Trans-fats are found in donuts, pastries, and foods made with shortening. Limit or avoid these foods in your diet. Choose lean meats and less-processed desserts instead.
  • Add fiber, nuts, and plant stanols to your diet. Whole wheat breads and vegetable oils like canola or olive oil are good sources of plant stanols.
  • Limit high sugar foods and alcohol if triglyceride levels are too high.

Other Changes

  • Take fish oil if prescribed by your doctor. Some studies showed heart-healthy benefits of taking fish oil supplements every day. Ask your doctor or dietitian what they recommend before adding any supplements to your diet.
  • Stop smoking. Any tobacco use greatly increases your risk of dyslipidemia.
  • Increase your physical activity if approved by your doctor. Exercise can help manage cholesterol levels. Aim for 30 minutes a day most days of the week, or 150 minutes a week. If you are just beginning an exercise regimen, then start smaller and work your way up. Ten minutes of brisk walking is a good starting point. If 30 minutes all at once is too difficult, you can do small, 10-minute sessions throughout the day to add up to 30 total minutes of exercise.

In summary, there are concerns about higher cholesterol and triglyceride levels after a kidney transplant. However, knowledge and tips, along with guidance from your doctor and dietitian, can help you manage dyslipidemia.


A Clinical Guide to Nutrition Care in Kidney Disease, second edition, by Laura Byham-Gray, Jean Stover, and Karen Wiesen. Page 94. Chapter: Nutrition Management of the Adult Renal Transplant Patient.

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Natalie Sexton, MS, RDN, CSR, LD

Natalie Sexton, MS, RDN, CSR, LD

Natalie is a registered dietitian and Board Certified Specialist in Renal Nutrition. She has and continues to work in many different healthcare settings including acute care hospitals, LTACHs, nursing homes, private practice, wellness companies, outpatient clinics, research, and writing. She stays busy but loves all of her jobs! When she’s not working, she fills her time with family, friends, pets, gardening, crafting, reading, and learning new hobbies.