Kidney transplantLiving with

The following lifestyle advice is usually recommended to help you stay healthy after a kidney transplant.

Stop smoking

If you smoke, it's strongly recommended that you stop as soon as possible because smoking can reduce the life of your new kidney and can increase your risk of developing some types of cancer.

The NHS Smokefree website can provide support and advice to help you stop, and your GP can also recommend and prescribe treatments that can help. Read more about stopping smoking.

Diet

Most people are able to enjoy a much more varied diet after a kidney transplant, although you may be advised to avoid some foods after the operation until the kidney is working properly.

During the early stages after a transplant, while you're on higher doses of immunosuppressant medication (see below), you should avoid eating foods that carry a high risk of food poisoning, including:

• unpasteurised cheese, milk or yoghurt
• foods containing raw eggs (such as mayonnaise)
• undercooked or raw meats, fish and shellfish

Once your kidney is working properly and the best immunosuppressant dose for you has been identified, you'll usually be advised to follow a generally healthy diet, as this can reduce your risk of complications such as diabetes. 

Read more about the risks of a kidney transplant.

A healthy diet should include:

• at least 5 portions of fruit and veg a day
• plenty of potatoes, bread, rice, pasta and other starchy foods; ideally you should choose wholegrain varieties 
• some milk and dairy foods
• some meat, fish, eggs, beans and pulses, and other non-dairy sources of protein 

Avoid food that contains high levels of salt, as salt can cause high blood pressure, which can be dangerous for people with a kidney transplant. See facts about salt for more information and advice.

Exercise and weight loss

Once you've started to recover from the effects of surgery, you should try to do regular physical activity.

Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity exercise every week. This includes any activity that increases your heart and breathing rate – it may make you sweat, but you are still able to hold a normal conversation.

Examples include:

• fast walking
• riding a bike on level ground or with few hills
• swimming
• tennis

Choose physical activities that you enjoy, as you're more likely to continue doing them.

It's unrealistic to meet these exercise targets immediately if you have not exercised much in the past. You should aim to start gradually and then build on it.

If you're overweight or obese, you should try to achieve a healthy weight. This can be safely done through a combination of eating a healthy, calorie-controlled diet and regular exercise. Aim for a body mass index (BMI) of 18.5 to 25.

Read more about exercise and losing weight safely.

Alcohol, drugs and medications

Regularly drinking alcohol above the maximum recommended limits can raise your blood pressure, which can be dangerous for people with a kidney transplant. To keep your risk of alcohol-related harm low, the NHS recommends:

• not regularly drinking more than 14 units of alcohol a week
• spread your drinking over 3 days or more if you drink as much as 14 units a week
• it's a good idea to have several alcohol-free days each week

Read more about alcohol units and get tips on cutting down your alcohol consumption.

Alcohol is also high in calories, so you'll gain weight if you drink regularly. Being overweight will also increase your blood pressure. Read more about the calories in alcohol.

You should also avoid taking any illegal drugs after a kidney transplant, as they can damage your kidneys, cause a sudden rise in blood pressure and react unpredictably with your immunosuppressant medications.

Finally, always check with your care team before taking any medication, including over-the-counter medication and herbal remedies such as St John's wort. Some medications could be potentially harmful if you have had a kidney transplant and are taking immunosuppressant medication.

Immunosuppressants and infection

If you have a kidney transplant, you'll usually need to take immunosuppressant medications for the rest of your life to prevent your body's immune system from attacking the new kidney.

Widely used immunosuppressants include tacrolimus, ciclosporin, azathioprine, mycophenolate, prednisolone and sirolimus.

However, taking immunosuppressive medications on a long-term basis will weaken your immune system and make you more vulnerable to infections, so you'll need to take extra precautions against infection:

• avoid contact with people you know currently have infections, such as chickenpox or flu
• practise good personal hygiene – wash your hands regularly with soap and hot water, particularly after going to the toilet and before preparing food and eating meals

• if you cut or graze your skin, clean the area thoroughly with warm water, dry it, then cover it with a sterile dressing

  Make sure your vaccinations are up to date, although you won't be able to have any vaccines that contain live viruses, such as the measles, mumps and rubella (MMR) vaccine.

When to get medical advice

If you think you may have an infection, contact your GP or transplant centre for advice. Prompt treatment may be required to prevent serious complications developing.

Symptoms of infection can include:

• a high temperature of 38C or above
• feeling hot and shivery
• headache
• aching muscles
• diarrhoea
• vomiting