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Can you suggest a diet for a kidney transplant recipient?

Q: What are high urea and low urea foods? I am a 23 years old boy who has undergone a kidney transplant 7 months back and my blood urea level is 20 mg/dl. Please advise.

A:One of the benefits of a successful renal transplant is that you can enjoy a more varied diet. Usually your potassium restriction is lifted enabling you to eat foods you previously had to limit, e.g. chocolate, wafers, chips and nuts etc. However, beware! It is a common problem for post transplant patients to rapidly gain weight. For most dialysis patients some weight gain will do no harm but it is sensible to monitor your weight weekly. Weight gain is the result of steroids, an improvement in appetite and the lifting of dietary restrictions. A healthy diet, which is low in fat and sugar and high in fibre, will help to prevent excessive weight gain and to help keep you fit and healthy. It is a diet that is recommended for everybody (unless they are following dietary restrictions). The lifting of your potassium restriction also means that you can eat a greater variety of fruits and vegetables. Oranges, grapes, peaches, jacket potatoes, palak and beans are a good source of vitamins and minerals, are high in fibre and low in calories and fat. Other high fibre foods include whole-grain breakfast cereals, jowar, bajra, wholemeal bread. High fibre foods add bulk to your diet, are filling and help to prevent constipation. Try to include these foods in your diet every day. A healthy diet allows you to eat anything in moderation. However, some foods should not be eaten too often or in large quantities if you want to prevent weight gain. There are two main types of fat: polyunsaturated, e.g. sunflower margarine, corn oil, and saturated fat, e.g. butter, fat on meat and fat in cheese etc. Both types of fat are equally high in calories but polyunsaturated fat is better for your heart. Try to cut down the total amount of fat that you eat and choose polyunsaturated rather than saturated fats. Switch over to low fat sunflower margarines and avoid frying food; grill, bake, or steam instead where possible. Try low fat dairy products, e.g. semi-skimmed milk, low fat cheeses and low fat yoghurts. Sugar and sugary foods contain calories but little goodness. If you are gaining weight, try low calorie drinks and sugar free squashes and have fruit or yoghurts for desserts rather than cakes or biscuits. As a dialysis patient you have probably cut down on salt in your diet. As salt may contribute to high blood pressure it is sensible to continue to use a little in cooking but avoid adding salt to food at the table. You can now enjoy a much greater variety of foods. A healthy diet does not mean that you should not enjoy the occasional treat. However, treats should be included as part of a balanced diet which contains starchy foods, fruits, vegetables, dairy products and meat or meat alternatives. Your body needs protein every day for growth, building muscles and repairing tissue. After your body uses the protein in the foods you eat, a waste product called urea is made. If you have lost kidney function, your kidneys may not be able to get rid of this urea normally. You may need to reduce the amount of protein you eat to avoid build-up of urea in your body. Protein is found in two types of foods: In large amounts in foods from animal sources such as poultry, meat, seafood, eggs, milk, cheese and other dairy products. In smaller amounts in foods from plant sources such as breads, cereals, other starches and grains, and vegetables and fruits. PROTEIN is restricted to about 60 grams per day. This means limiting your total intake for the day of meat, poultry and fish to 6 ounces. Ideally this should be divided between lunch and dinner- 3oz. at lunch and 3oz. at dinner (or 2oz. and 4oz. if you prefer a larger portion at dinner). A 3 oz. portion is about the size of a chicken thigh, small mutton chop or small paneer slice. A 2 oz. portion would be 4 cubes of paneer or ½ small can of tuna. A 4 oz. portion of meat is the size of a deck of cards. Other sources of protein are eggs, milk, cheese and yoghurt. One egg or 1 oz. cheese contains as much protein as 1 oz of meat and can be substituted if they have not been restricted in your diet for other reasons. You may use a small amount of milk in your coffee and/or cereal. Limit to 1 cup per day or less. If you do not use milk, one cup of yoghurt can substitute. While you may need to limit the amount of protein you eat, it is important that you eat the right amount of protein. This helps to keep your body healthy.

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