Kidney transplantation in patients suffering from end-stage renal disease, although beneficial, may result in potential complications increasing cardiovascular risk of mortality. Common metabolic problems after surgery are weight gain, hypertension, hyperlipidemia, and insulin resistance. Immunosuppressant therapy can enhance comorbidity progression. Early identification and treatment of these abnormalities can promote transplant function. Lifestyle modifications have shown to be promising in the reduction of the metabolic syndrome symptoms, but there remain limited trials focusing on this area. This article reflects a comprehensive review of the available research of each of the potential metabolic complications within the renal transplant population. Immunosuppressant medication effects, biochemical values, and medical nutrition therapy intervention are also included with regard to their influence with these metabolic disorders. Methods for review completion included a MEDLINE search for peer-reviewed research, using the following keywords: transplant, chronic kidney disease, nutrition, metabolic syndrome, and diet after transplantation. (c) 2012 by the National Kidney Foundation, Inc. All rights reserved.