Q: I have juvenile diabetes for the past 35 years. I had a kidney transplant when I was 36 years old. My mother was the donor. Now I am 51 years old. I have proteinurea of about 2000 mg/per day. I am a vegetarian and have started eating egg whites. When I have dals, my urine becomes frothy and foamy. What diet should I follow and what should I avoid? I am on Wysolone 5 mg and Losartan 75 mg and Cyclosporin and other drugs.

A:The proteinurea after renal transplantation may continue to occur from pre-existing kidneys, as well as from the transplanted organ. The presently available evidence on newly originated proteinurea after renal transplantation shows that microalbuminuria, and more significantly proteinurea, after transplantation are markers of graft dysfunction, correlated both to graft failure and to cardiovascular risk indicators. In patients with proteinurea, one has to exclude recurrent glomerulonephritis in order to avoid unnecessary immunosuppression. While proteinurea is a sensitive marker of allograft dysfunction, there is currently insufficient evidence to assume that it plays a major causal role in graft loss. The reason for proteinurea may have to be ascertained with a graft biopsy. You must have a healthy balanced diet with normal proteins. Being a vegetarian, you must have dals, curd, soybean and paneer to keep up your proteins. You must see a transplant physician for further work up on proteinurea, and advise regarding diet, which is going to be dependent on your present renal functions and lipid profile.