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A low-salt diet is enormously important in kidney disease and also after a successful kidney transplant. It lowers blood pressure, ensures that blood pressure-lowering medications work better, and thus plays a major role in keeping your new kidney functioning well for as long as possible.
Here's what you need to know
Das solltest du wissen
Ecco cosa c'è da sapere
Voici ce qu'il faut savoir
Esto es lo que debe saber
  • A low-salt diet is recommended for most people after transplantation, as it is very important for optimal blood pressure, for the effectiveness of medications, and for fluid balance.

  • A good reference for a low salt diet is <6 grams per day, which is almost half of an average daily consumption

  • There are many tips & tricks to mastering a low-salt diet - the hardest part is not necessarily the taste, but mainly changing certain habits
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What do water, salt and sodium have to do with each other?

The elements chlorine and sodium together form the chemical compound for classic table salt (=sodium chloride). Since salt does not only contain sodium, a small conversion is necessary: 1 gram of table salt corresponds to about 0.4 grams of sodium, the rest is chlorine. Your doctor has probably talked to you before about the importance of a low-salt diet after transplant. But how are sodium, table salt and early-stage kidney disease related?

When you consume table salt in your diet, sodium naturally enters your body. This sodium binds water in your body and blood vessels. Healthy kidneys can keep the sodium balance and therefore the water balance in your body in balance. When you have kidney disease, this balance is thrown off.

I'm have a transplant - why should I eat a low-salt diet?

After the transplant, your new kidney needs some time to function properly. At the same time, you should try not to overstress your new kidney, but to take it easy. This is especially true with regard to your diet.

If you eat a lot of table salt, the sodium contained in it binds water in your body and thus increases your feeling of thirst. So the more salt you eat, the more water your body needs to deal with the salt in your body. When this happens, salt binds more water in the body and thus stores water in the body. This in turn promotes the development of high blood pressure, which can be very dangerous for your cardiovascular system and your new kidney.

You have probably heard, for example, that a Mediterranean diet is often recommended. One of the main reasons for this is that it tends to be lower in salt. But of course there are also other reasons for this, such as the fact that relatively much emphasis is placed in it on fresh fruit and vegetables. So that still applies to life with your new kidney.

How much sodium should I have in my blood?

A low-sodium diet is very important after transplant. As mentioned at the beginning, it lowers blood pressure, ensures that medications work appropriately, and keeps your water balance in check. In case you're interested, an approximate target for your blood sodium is 135 - 145 mmol/l. Unfortunately you cannot blindly use your blood sodium level to judge whether you are eating too much or too little. This is because your levels can fluctuate quite a bit throughout the day and your blood level is often influenced by a number of other factors. For this reason, using daily guidelines to guide your diet is even more important.

How much salt do you eat per day on average?

The average salt consumption in many European countries is 8-10 grams per person per day. However, this is considerably more than the 6 grams recommended as a daily guideline by the German Nutrition Society, for example. Of these 8-10 grams, about one-third comes from natural foods, one-third from industrially produced foods, and another third from salt used to season food. This is not surprising, because ready-made products such as a canned soup or a ready-made pizza often contain between 5 and 10 grams of table salt directly.

How much salt should I eat daily if I have kidney disease?

Most of the time, you will be recommended a low-salt diet after a transplant. More specifically, this probably means that your transplant team will recommend that you reduce your daily salt intake to less than 6 grams, if possible. That equates to a maximum of 2,400 mg of sodium. So that's a little less than half the amount of salt you normally consume. If you can manage this in your daily life, you will complement your medication measures in the best possible way and thus create a better basis for keeping your new kidney healthy for as long as possible.

Should I completely give up salt now?

Absolutely not, because the body needs salt to function. However, since we already add too much salt to our diets, it is usually not difficult to reduce the amount of salt in your diet. You can do this with just two important tricks, which are probably the best basic rules:

1. Get in the habit of seasoning without salt

It's a bit of an adjustment for some at first. But it's actually not that difficult and tastes just as good, if not better. Spices are more versatile and in some cases much more flavorful than seasoning with just salt.

2. Pay attention to the salt content in your choice of processed products.

Salt is often used to preserve convenience foods. If you buy more fresh produce and pay attention to the salt content on the package label for processed products, you can also save a relatively large number of "salt points" fairly easily.

Perhaps you are now saying to yourself that food without salt is rather tasteless. This is only partly true, because the need for salt has been trained in humans. And it's just as easy to get rid of it. The taste buds of the tongue adapt to new amounts of salt in just 2-3 weeks.

"I can't offer my guests unsalted food!"

Instead of salt, you can use a variety of spices to add magic to your dishes. Many countries, such as Italy or Asian countries, produce delicious dishes despite low-salt preparation. And did you know that professional chefs often cook completely salt-free? Only at the end, i.e. shortly before serving, do they add a little sea salt, depending on the dish. The reason for this is that as soon as salt gets into the food, it prevents all the other existing flavorings from developing further. Of course, you don't have to become a professional chef... Guests at the table and family members can always reach for the salt shaker if necessary.

If you find it difficult to eat a low-salt diet, there are many more tips & tricks in the Mizu app, as well as examples, alternatives and recipe suggestions for a lower-salt diet. After your kidney transplant, it is incredibly important for your health to optimize your diet. This way you can protect yourself from blood pressure, protect your new kidney and support it in its new job in the best possible way.

Medically reviewed by:
Medizinisch überprüft durch:
Verificato dal punto di vista medico da:
Médicalement vérifié par :
Médicamente comprobado por:
Dr. Diego Parada Rodriguez (en)
Specialist in training for Nephrology
  • ABIM Laboratory Test Reference Ranges ̶ July 2021
  • Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, Fouque D, Friedman AN, Ghaddar S, Goldstein-Fuchs DJ, Kaysen GA, Kopple JD, Teta D, Yee-Moon Wang A, Cuppari L. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020 Sep;76(3 Suppl 1):S1-S107.
  • Deutsche Gesellschaft für Ernährung
  • Stevens PE, Levin A; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013 Jun 4;158(11):825-30.
  • Ernährung nach der Transplantation. Abgerufen am 15.11.2022
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