Considerations for Post-Transplant Diet for IgA Nephropathy

Table of Contents

• Introduction
• IgA Nephropathy and Kidney Transplant
• Nutrition Recommendations for Transplant
  • Balanced Diet
  • Electrolyte Balance
  • Hydration
  • Special Diet Considerations
• Food Safety Concerns
• Understanding and Managing Side Effects of Medications
  • Managing Blood Sugar and Maintaining a Healthy Weight
  • Nausea and Vomiting
  • Constipation
  • High or Low Electrolytes
• Conclusion
• References 

Introduction

IgA Nephropathy can be a progressive disease that requires a kidney transplant. It is important to be aware of healthy eating habits, safety considerations, and side effects of transplant medications.  This article reviews the nutritional considerations for a post-transplant eating pattern. 

IgA Nephropathy and Kidney Transplant

IgA Nephropathy (IgAN) is a rare auto-immune kidney disease. When you have IgAN, your body overproduces the antibody IgA, and it clumps together, causing damage to the kidney’s filtering system ⁽¹⁾. This kidney damage leads to protein and blood leaking into your urine, causing foam or cola-colored urine. You may also experience swelling in your feet and ankles. Over time, this can lead to damage and scarring of the kidneys. Many people with IgAN will need a kidney transplant within their lifetime ⁽²⁾. Kidney transplantation allows people to live without dialysis after their original kidneys are no longer working; however, transplant does require particular medication routines and safety protocols to prevent illness. 

Nutrition Recommendations for Transplant

After healing from a kidney transplant most people are told to “follow a healthy diet.” Kidney transplant does allow for a less restrictive eating pattern; however it is important to keep your new kidney as well as yourself healthy for many years to come. 

Balanced Diet

It is very important to follow an eating pattern that is rich in vegetables, fruits, legumes, nuts, and seeds. These foods contain fiber, vitamins, and minerals and help people maintain weight, blood sugar, and blood pressure and decrease general health risks. 

Electrolyte Balance

Your potassium and phosphorus limitations will most likely be lifted after a transplant. However, you do want to watch your lab results because people can have high or low potassium or phosphorus after a transplant. You may find you need to eat more or less of these foods to keep your blood levels in range. It is good to continue to follow a low-sodium diet, as lower-sodium diets are good for heart health and general health. 

Hydration

Before your transplant, you may have been on a fluid restriction. This will not be the case after your transplant. You want to stay well-hydrated and follow your doctor’s recommendations for fluids. Great ways to stay hydrated include water, sparkling waters, fruit or veggie-infused homemade waters ⁽³⁾, or other sugar-free options. Limiting sugar-sweetened beverages like sodas is always recommended for health. 

Special Diet Considerations

IgAN can come back in transplanted kidneys ⁽⁴⁾. If you were following special diet changes related to your immune system, you should continue. Examples of these eating patterns would be a gluten-free diet, anti-inflammatory foods, or a plant-based diet. 

Food Safety Concerns

After your transplant, you are at a higher risk for foodborne illness. Make sure to take food safety very seriously. Avoiding raw/undercooked meats, and unpasteurized products is important. Wash your hands thoroughly ⁽⁵⁾ and cook foods to their intended internal temperature ⁽⁶⁾. 

Avoid Raw and Undercook Meats

Wash your Hands

Cook Foods to Right Temperature

Understanding and Managing Side Effects of Medications

Transplant medications do have side effects that can affect how you eat. Here are some helpful tips for managing these side effects. 

Managing Blood Sugar and Maintaining a Healthy Weight

Filling half your plate with non-starchy veggies, adding fruits or veggies at snacks, and getting the recommended daily amount of fiber (7) are great ways to limit blood sugar spikes and maintain weight. 

Including movement throughout your daily routine and moderate-intensity workouts multiple times a week also helps to maintain blood sugar and weight (and lower stress, too!).  

Nausea and Vomiting

Some transplant medications can cause nausea and vomiting. If you are having these symptoms, remember to try smaller meals, drink plenty of fluids, and avoid cooking foods that have a lot of smell (like broccoli or cauliflower). Eating cut-up, well-washed, raw veggies or fruits is sometimes tolerated easier when nausea is brought on by smell.  

Constipation

Increasing fluid and fiber intake and including exercise in your usual routine are great ways to prevent or alleviate constipation. Fruits, veggies, beans, legumes, and whole grains are all good sources of fiber. If you are looking for gluten-free sources of fiber, check out our article on IgAN and the gluten-free diet. (8)

High or Low Electrolytes

Having labs drawn as recommended is important to maintaining your kidney transplant. There may be times when specific electrolytes like phosphorus or potassium are elevated or low. Increasing or decreasing particular foods to help keep those electrolytes is important. If you need help figuring out how to do this, reach out to a renal dietitian. (9,10)

Conclusion

Many people with IgAN will need a transplant in their lifetime. Following these healthy diet principles and food safety practices can lengthen the life of your new kidney and increase your health.  Join us at the IgAN Foundation for continued support in your kidney journey. 

References 

1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). IgA nephropathy. Retrieved August 2, 2024
2. IgA Nephropathy Foundation. IgA nephropathy (IgAN). Retrieved October 18, 2024, from https://igan.org/#:~:text=IgA%20Nephropathy%20(IgAN)%20is%20a,or%20kidney%20transplantation%20to%20survive.
3. Cukebook. Cucumber lemon water. Retrieved October 18, 2024, from https://www.cukebook.org/recipes/cucumber-lemon-water/
4. Zhou, X., & Chen, J. (2022). Current status and perspectives on recurrent IgA nephropathy after kidney transplantation. Nephrology, 147(Suppl. 1), 9-16. https://doi.org/10.1159/000836744
5. Centers for Disease Control and Prevention. How to wash hands. Retrieved October 18, 2024, from https://www.cdc.gov/healthyschools/bam/child-development/how-to-wash-hands.htm
6. Penn Medicine. (2018, July). Practicing food safety after transplant. Retrieved October 18, 2024, from https://www.pennmedicine.org/updates/blogs/transplant-update/2018/july/practicing-food-safety-after-transplant
7. United States Department of Agriculture. (2015, March 31). Online nutrition resources at your fingertips. Retrieved October 18, 2024, from https://www.usda.gov/media/blog/2015/03/31/online-nutrition-resources-your-fingertips
8. IgA Nephropathy Foundation. (n.d.). Gluten-free diet and IgA nephropathy. Retrieved October 18, 2024, from https://igan.org/diet-nutrition/gluten-free-diet-and-iga-nephropathy/
9. Penn Medicine. Kidney transplant medication side effects. Retrieved October 18, 2024, from https://www.pennmedicine.org/-/media/documents%20and%20audio/patient%20guides%20and%20instructions/transplant/kidney_transplant_medication_side_effects.ashx
10. Chronic Kidney Disease Research and Development. Chronic kidney disease research and development. Retrieved October 18, 2024, from https://sites.google.com/view/ckdrd/home