CSR Kidney Transplant Nutrition

Question 1

In the immediate post-kidney transplant period (0–4 weeks), which nutritional concern is the HIGHEST priority due to high-dose corticosteroid immunosuppression?

Accepted Answer

High protein catabolism from corticosteroids requiring protein intake of 1.3–2.0 g/kg IBW/day

Answer

Fluid restriction to prevent graft rejection

Answer

Strict phosphorus restriction due to immediate hyperphosphatemia

Answer

Low-calorie diet to prevent early weight gain

Question 2

Post-kidney transplant patients on calcineurin inhibitors (tacrolimus, cyclosporine) must avoid which specific food/drink due to potentially dangerous drug interactions?

Accepted Answer

Grapefruit and grapefruit juice

Answer

Whole milk and dairy products

Answer

White rice and white bread

Answer

Lean chicken breast and fish

Question 3

Post-transplant weight gain and new-onset diabetes mellitus after transplantation (NODAT) are common nutritional complications. Which dietary pattern is MOST recommended to address both complications?

Accepted Answer

Moderate-calorie diet emphasizing low glycemic index foods, lean proteins, complex carbohydrates, and healthy fats — similar to Mediterranean or DASH pattern — combined with physical activity

Answer

High-fat ketogenic diet to minimize insulin secretion

Answer

Very-low-calorie (600 kcal/day) crash diet to rapidly achieve weight loss

Answer

High-protein (3 g/kg/day) low-carbohydrate diet

Question 4

A kidney transplant patient develops new-onset hypertension and hyperlipidemia at 6 months post-transplant. Aside from antihypertensive medications, which dietary intervention has evidence for improving both conditions?

Accepted Answer

Mediterranean-style diet with olive oil, fish, legumes, vegetables, and reduced sodium (< 2.3 g/day)

Answer

High-sodium, low-carbohydrate diet

Answer

High-protein, high-saturated-fat diet

Answer

Elimination of all fruits and vegetables

Question 5

Long-term kidney transplant recipients (>5 years) who have declining graft function (GFR 30–45 mL/min) should be managed nutritionally how?

Accepted Answer

Transition back toward CKD Stage 3b nutrition guidelines: moderate protein restriction (0.6–0.8 g/kg/day), phosphorus and potassium management, sodium restriction, and preparation for potential return to dialysis

Answer

Use the same nutrition guidelines as stable end-stage dialysis patients

Answer

No dietary changes needed until GFR falls below 15 mL/min

Answer

Increase protein to 1.5 g/kg/day to prevent graft rejection

Question 6

Post-kidney transplant patients on corticosteroids long-term are at risk for which bone disease, and what is the FIRST-LINE nutritional prevention strategy?

Accepted Answer

Corticosteroid-induced osteoporosis; adequate calcium (1000–1200 mg/day) and vitamin D (800–1000 IU/day) supplementation

Answer

Paget's disease; restrict vitamin D intake

Answer

Osteomalacia from phosphate excess; restrict dairy

Answer

Rickets from vitamin A toxicity; reduce fat-soluble vitamin intake