Background The transition from end-stage renal disease to transplantation presents a metabolic challenge due to hormonal shifts, fluctuation in energy expenditure and the metabolic derangements associated with immunosuppression therapies. There are only limited recommendations for malnutrition and adverse effects post-transplantation. Food restrictions vary before and after transplantation along with other changes in lifestyle affect the health behaviours of recipients of renal transplants. Not only are guidelines limited, but little is known about dietary trends among recipients of post-renal transplants, especially in adolescent patients. This case study is meant to assess the nutritional status in a 19 year old post renal transplant patient.   Method Dietary assessments were done in one of the public hospitals in Yogyakarta, Indonesia 4 months after the renal transplant, the patient is a 19 year old woman who was readmitted to the hospital because of anastomotic uretery leakage that caused discomfort and urine excretion difficulties. Interviews with the patient and her family were done to know her dietary behaviour after the transplant, anthropometric changes measured and laboratory results were obtained.   Results Ms. E was afraid of eating certain kinds of food so her weight dropped drastically, she lost around 26,1% of her body weight within a period of three weeks after the transplantation. She gained a bit of weight after three weeks but has failed to come close to the pre-transplant weight.   Conclusions Psychological aspect may have implications for dietary management in post renal transplant patient. Therefore, nutrition counselling should be carried out to avoid the risk of malnutrition, especially in adolescents who have undergone renal transplantation.