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Nutritional tips for managing electrolyte imbalances in post-renal transplant patients.

MOST PATIENTS LOOK forward to the nutrition and dietary freedoms after kidney transplant; however, electrolyte imbalances can still be of concern. Delayed graft function and side effects of immunosuppressive medications can typically lead to hyperkalemia and require a potassium restriction. Another common characteristic in post-renal transplant patients is persistent hypophosphatemia. One factor that can contribute to hypophosphatemia is persistent secondary hyperparathyroidism. Another factor identified by several studies is the phosphotonin fibroblast growth factor-23 as a key cause of hypophosphatemia after transplantation. In addition, glucocorticoidinduced gluconeogenesis in the renal proximal tubule contributes to phosphaturia. In some cases, increased intake of high-phosphorus foods may not be sufficient for repletion, and oral replacement may be needed. Educating patients on optimizing nutrition after kidney transplant is individualized. Laboratories must be monitored frequently, and nutrition recommendations can be made accordingly. Unfor-