PATIENT EDUCATION

Feature Editor: Catherine M. Goeddeke-Merickel, MS, RDN, LD

Nutrition and the Kidney Donor

Stacey Phillips, MS, RD,* and Samantha DeMello BS†

healthy weight and overall good health is recommended.3,4

A CCORDING TO THE United States Department of
Health and Human Services Organ Procurement and
Transplantation Network, 3,276 individuals served as living
Research has shown a higher incidence of hypertension
and risk of kidney compromise in individuals who are
kidney donors in 2013.1 Many donors are family members, overweight before donation.5 The attached handout was
but nondirected donation is also increasing for transplant created to support a healthy nutrition intake and lifestyle
donations. This type of donation occurs when the individ- following kidney donation.
ual and donor do not necessarily know the recipient
receiving the organ. There are several benefits when the References
kidney donor comes from a living source. For individuals
who are family members, genetics are more likely to be 1. U.S. Department of Health and Human Services. Organ Procurement
and Transplantation Network (OPTN). http://optn.transplant.hrsa.gov/
compatible, and this therefore reduces the risk of kidney latestData/viewDataReports.asp. Accessed October 17, 2013.
rejection. The surgical time of kidney removal and trans- 2. National Kidney Foundation. Q& A on Living Donation. http://www.
plant is less than when compared with a deceased donor, kidney.org/transplantation/livingdonors/infoqa.cfm. Accessed October
which supports a more rapid transplant function response. 17, 2013.
Last, testing for the donor and recipient can be done before 3. National Kidney Foundation. Living Donation: What to Expect After
Transplantation. http://www.kidney.org/transplantation/livingdonors/infoQA.
the scheduled surgery, making the matching process more cfm?id57#7d. Accessed October 17, 2013.
of a success.2 If living donation is not an option, deceased 4. Nation Kidney Registry. Facilitating Living Donor Transplants. http://
donor transplantation has also been successful for individ- www.kidneyregistry.org/living_donors.php?cookie51. Accessed October
uals requiring kidney transplantation. 28, 2013.
After kidney donation, one of the most common con- 5. Noqueira J, Weir M, Jacobs S, et al. A study of renal outcomes in obese
living kidney donors. Transplantation. 2010;90:993-999.
cerns is how quickly the donor will heal and return to
normal health. Nutrition in particular is of concern,
because donors hope to continue with their normal eating Other Reference
habits. According to the National Kidney Foundation and 6. National Kidney and Urologic Diseases Information Clearinghouse
National Kidney Registry, there is no specific nutrition (NKUDIC). Solitary Kidney. http://kidney.niddk.nih.gov/kudiseases/
regimen suggested after donation, but a diet supporting a pubs/solitarykidney/. Accessed October 29, 2013.

*Mercy Health Saint Mary’s, Nutrition Services, Grand Rapids, Michigan.

†Department of Nutrition & Dietetics, Western Michigan University Dietetic
Internship Program Kalamazoo, Michigan.
Financial Disclosure: The authors declare that they have no relevant financial
interests.
Address correspondence to Stacey Phillips, MS, RD, Mercy Health Saint
Mary’s, Nutrition Services, 200 Jefferson Ave. SE, Grand Rapids,
MI 49503. E-mail: staceycphillips@yahoo.com
Ó 2014 by the National Kidney Foundation, Inc. All rights reserved.
1051-2276/$36.00
http://dx.doi.org/10.1053/j.jrn.2013.12.001

Journal of Renal Nutrition, Vol 24, No 2 (March), 2014: pp e15-e17 e15

e16 PHILLIPS AND DEMELLO

Nutrition and the Kidney Donor

Kidney donation does not necessarily require a special  Look for labels that say 100% whole wheat or
nutrition intake or diet; a healthy weight and blood pres- whole grain when purchasing breads or cereals.
sure are two goals to keep in mind following donation.  Aim to make half of your daily intake of grains
Nutrition and lifestyle can promote a healthier you come from whole grains.
and serve as tools for disease prevention, too. These rec-  Try incorporating beans, legumes, and non-
ommendations can help you to achieve these important starchy vegetables into some of your favorite
goals. dishes.
 Snack on fruit in between meals or try adding to
1. Salt
breakfast items such as cereals, oats, or whole
Salt is an important nutrient involved in water balance in
grain pancakes, or alongside eggs and toast.
the body; however, a diet too high in salt can cause an
increase in blood pressure. The goal number for blood
pressure is 130 mm Hg for systolic and 80 mm Hg for
diastolic. Maintaining an intake of ,2,000 mg of salt Foods Recommended Foods to Limit/Avoid
per day can help to meet this goal, especially if you
have a past history of hypertension. Whole grains such as oats, White rice, pastas/noodles,
 Choose fresh, frozen, or canned food items barley, brown rice, macaroni
quinoa, popcorn, millet,
without added salt.
etc.
 Limit the amount of salty snacks you eat. 100% Whole wheat Enriched white flour
 Avoid adding salt when cooking or at the dinner breads, whole grain products such as white
table. pastas, and cereals breads, baked goods,
 Select unsalted or reduced sodium versions of pancakes, and pizza
crusts
broth, soups, and other processed foods.
Fresh, frozen, or canned* Pulp-free fruit juices
 Experiment with spices and herbs in place of salt fruits and vegetables
when cooking. Beans and legumes
(dried/canned)
Nuts, nut butters and seeds
*Remember to pick canned items without added syrups or salts.
Foods Recommended Foods to Limit/Avoid

Fresh fruits and Salted canned/frozen

vegetables vegetables
Fresh meats, poultry, High-salt, processed
eggs, fish, and breakfast and lunch meats
3. Protein
low-salt deli meats (bacon/ham/sausage) Moderate protein intake is recommended after kidney
Low-salt/no-salt High-salt prepackaged/ donation. Beef, chicken, turkey, pork, eggs, soy, and
prepackaged processed meals, soups, tofu are all protein-rich foods. Monitor portion sizes
items such as rice or noodle dinners, fast to reduce extra protein intake. Keep the following ideas
soups, vegetables, foods
meats, rice/noodle
in mind, when choosing protein sources.
dinners  One ounce of meat, fish, or cheese equals 7 g of
Low-fat or nonfat milks, High-salt cheeses (cottage protein.
yogurts, and low-salt cheese, American, Velveeta,  A palm-sized portion of meat is 3 ounces.
cheeses (Swiss, feta, gorgonzola)  Most people require about 6 to 7 ounces of meat
mozzarella, goat)
per day.
 Limit portions of meat high in salt or
2. Fiber preservatives.
A nutrition intake high in fiber promotes a healthy  Try different sources of plant proteins to help
bowel function, and helps to remove the bad cholesterol limit excess fat and cholesterol.
from your body. There are two types of fiber—soluble  Be cautious with protein powder supplements
and insoluble—each is beneficial in the foods you eat. because the safety of these products may not be
Below are some tips to increase daily fiber intake. regulated.
 NUTRITION AND THE KIDNEY DONOR e17

Foods Recommended Foods to Limit/Avoid 5. Multivitamin Supplementation

Consuming a well-balanced diet of whole grains, fruits,
Lean meats like chicken, Salty or cured meats like vegetables, dairy, and protein should provide you with
pork, turkey, and gamey hotdogs, sausage,
all of the necessary nutrients. In some cases, multivita-
meats (venison/buffalo) bacon, or salami
Low-fat/fat-free milk, High-fat cuts or mixes of mins may be recommended if you are not getting
yogurt, and cheese beef, pork, or lamb enough of certain nutrients from the foods you are
Seafood such as fish, Deep fat-fried meats and eating. Be sure to talk to your dietitian before taking
scallops, shrimp fishes any multivitamins or supplements.
Eggs and egg whites
 When purchasing multivitamins or supplements
Soy products like tofu,
tempeh, edamame, soy look for those that say no more than 100% daily
milks recommended value.
Unsalted heart healthy  Avoid those that contain superdoses, unless rec-
seeds, nuts, and nut ommended by your dietitian or physician.
butters like peanuts,
 Women may need to supplement calcium for
almonds, walnuts, and
cashew bone health.
 Vitamin D3 may be supplemented if your dieti-
tian and physician determine that you are
4. Fluids and Hydration deficient.
It is important to monitor your fluid intake to prevent 6. Achieve a Healthy Body Weight
becoming dehydrated. Signs of dehydration include thirst, A healthy body weight can be achieved with a bal-
dry cough, fatigue, light-headedness, and dark-colored ance of a healthy nutrition intake and exercise.
urine. Below are some tips on how to prevent dehydration. Your goal body mass index should be between 19
 General guidelines recommend drinking seven and 24 kg/m2.
to eight 8-oz glasses of fluids per day.  Monitor portion sizes of foods eaten at meals.
 Fluids include water, low-fat/fat-free milk, 100%  Limit fats, sweets, and desserts to eliminate un-
fruit juices, decaffeinated teas, popsicles, fruits, wanted, additional calories.
and vegetables.  Eat meals slowly and chew well. Decide if you are
 Remember to increase intake of fluids during ex- actually still hungry before getting second help-
ercise or hot weather owing to an increase fluid ings at a meal.
loss from sweat.  Try to eat at the dinner table instead of in front of
 Being sick with a fever or having diarrhea can in- the television to eliminate ‘‘mindless’’ eating.
crease fluid needs.  Develop a medically approved plan for exercise
 Limit caffeinated or alcohol beverages, which can once you have recovered from kidney donation
cause dehydration. to reach a healthy body weight.