Background: Although dialysis nutritional problems are well described, nutritional problems after renal transplantation (RT) have received little attention. Methods: Body composition as assessed by dual-energy x-ray absorptiometry in 115 stable patients 6.6 ± 5.9 years after RT and repeated 2.9 years later, when a 3-day dietary history was obtained in 79 patients. Results: Patients diet was generally sufficient, but was characterized by a high fat intake and deficiencies in folic acid, vitamin D, thiamine, iodine, selenium, and iron intake. Patients were often overweight, and at any given weight had a 4% to 5% higher proportion of body fat than normal. Loss of fat weight was related to high initial fat weight, long RT duration, and low plasma bicarbonate, but not steroid dose. Conclusion: Dietary advice concerning fat intake is indicated for RT patients, and nutritional supplements with folic acid and vitamin D are generally required. Their main nutritional problem is obesity. This is not adequately measured by body mass index, which should be supplemented by dual-energy x-ray absorptiometry. Attention should be paid to the prevention of acidosis.