The Road to a Healthy Kidney Transplant

Kidney transplantation is often considered as a treatment option by people with chronic kidney disease (CKD) and those on dialysis. Referrals for kidney transplant can be made by your physician, a social worker or by self-referral, once glomerular filtration rate (GFR) is < 20 ml/min. The road to kidney transplant may be challenging. The average wait time for an individual’s first kidney transplant is 3.6 years (1).

Kidney Transplant Evaluation

You may have already started the process of pre-transplant evaluation. Or perhaps you are wondering if the process is right for you. A doctor will assess your health status pre-transplant and help you set goals to achieve to prepare for transplantation. The kidney transplant evaluation process includes measuring antibodies, blood type, potassium levels and nutrition status prior to surgery. A measure of body mass index (BMI) and cardiac function are also included in the transplant evaluation.

What is BMI?

BMI is a calculation used to estimate whether or not a person is at a healthy weight, overweight or obese. Post-transplant research has shown a correlation between poor outcomes and high BMI levels (2). Achieving and maintaining a healthy BMI prior to transplant is critical for graft healing and recovery. Your transplant center will inform you of your BMI goal. Proper nutrition and exercise may be recommended to help achieve a healthy BMI.

Nutrition Pre-Transplant

The primary goal of pre-transplant nutrition is to promote optimal health. Preventing malnutrition and achieving a well-nourished state is essential pre-transplant (3). In fact, protein is a critical nutrient to track pre-kidney transplant. Normal blood protein levels of albumin of 3.5 mg/dL and greater (4-5) have been shown to decrease graft rejection. Other important goals pre-kidney transplant are A1C levels < 7% (6) if you have diabetes. Also, a normal potassium level is critical for improved surgical outcomes (7). Surgeries can be delayed or even cancelled due to high potassium or high glucose levels. Learn more about healthy food choices that are low in potassium and high in protein on DaVita.com.

Other nutrition considerations pre-transplant include, normal cholesterol and blood fat levels, and optimal bone health. Ask your renal dietitian to help you create a customized healthy eating plan that will help you achieve your nutrition goals.  

Exercise Pre-Transplant

Simple exercises, such as walking and stretching may be safe for many people considering a kidney transplant. Exercise and nutrition go hand in hand to control weight and strengthen bones. Other benefits of exercise include improving endurance and strengthening your heart. (8) In fact, many transplant programs will encourage exercise after transplant. (9) Prior to starting any type of exercise program, speak with your doctor and work with your healthcare team to determine what type of exercise may be right for you.

References

1. https://pressreleases.davita.com/2019-04-24-Helping-Patients-Along-Their-Kidney-Transplant-Journey
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622900/
3. https://emedicine.medscape.com/article/431031-overview#a3
4. https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.111.000358
5.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083471/
6. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547083/all/Kidney_Transplantation
7. https://www.kidney.org/sites/default/files/02-10-6785_HBE_Hyperkalemia_Bulletin.pdf
8. https://www.ncbi.nlm.nih.gov/pubmed/31389870?_ga=2.208804562.1379115343.1582844434-1642302308.1582844434
9. https://health.ucdavis.edu/transplant/

Additional Kidney Diet Resources

Visit DaVita.com and explore these diet and nutrition resources:

• DaVita Food Analyzer
• DaVita Dining Out Guides
• DaVita Kidney-Friendly Recipes
• Today’s Kidney Diet Cookbooks
• Diet and Nutrition Articles                                                                                           
• Diet and Nutrition Videos
• Kidney Smart® Virtual Classes

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.