In October 2025, eight years after receving a kidney transplant, Tyler Smith entered the Mr Olympia body building competition in Las Vegas. He went up against the world's best body builders in front of a 5,000-strong audience for the Men's Physique category and came an impressive 16th out of 70.

"What a weekend it was! It went extremely well, considering my condition and being up against the world's best. My long-term coach helped me to get ready and prepare. We'd worked together for a number of years and lots of events after my kidney transplant, but the Mr Olympia show really was 'the big one', with all eyes on it from around the globe. I had the realisation that I was now amongst a group of the world's most elite athletes."

Kidney disease diagnosis and transplantation

"My kidney function decline was first detected in 2015. I was experiencing difficulty with breathing and one Sunday afternoon, I remember really having to fight for breath, so I went to A&E. They ran my bloods and monitored me over a couple of days and discovered that my lungs were filled with fluid because my kidneys couldn't get rid of the water my body was holding on to. My kidney function was around 33%, so it had been going on for some time. My kidney team think it was a progressive degeneration of the kidneys, possibly caused by undiagnosed high blood pressure.

"I was then referred to Leicester General Hospital where my kidney function was monitored for a couple of years. It remained stable but gradually dropped and when my eGFR reached a level of 14, my renal consultant spoke to me about the need of a transplant and for me to talk to my family about possible donors. My cousin Robert (known as Connie to the family) stepped up straight away and said, 'You can have one of mine!'

"That conversation is what sticks with me the most. I don't think I realised until after the transplant just how important it was and how much it really meant to me. I remember feeling very emotional at the time and it's still something I think about almost every day."

Basketball to body building

"I absolutely loved sport as a kid! I took a keen liking to athletics in my early teens and was successful at triple jump at country level. As I progressed into my teens, I took up basketball. At the age of 15 I was selected to play for the Leicester Riders Junior Academy and was sent to the USA at 16 to try out for colleges in Ohio. After returning from the States, I ended up playing with the first team for the Riders in the British Basketball League.

"I'm 6ft 3in, which is quite tall for the average person, but when you're playing basketball against guys who are 6ft 11in, that's actually quite small! I was told I needed to thicken my physique up a bit. I started going to the gym, and my body responded really well. But I got to a point where I was starting to get a bit too heavy and bulky to be running up and down the basketball court.

"I had to make a decision because playing professional basketball in this country is not highly paid, and everyone has a full-time job outside. I asked myself whether I should stick with the gym because I love it or carry on playing basketball. I chose the gym and body building.

"My first body building competition back in 2010 was very much a learning process. I didn't really know what to feel but I won, and that proved to me that I'd done everything as I should, listening to the guidance, following every step.

"I carried on going to the gym, as I wanted to keep fit to try and prolong my kidneys for as long as possible, and continued training, all the way up until my transplant in 2018."

Post-transplant aspirations

"Initially, I had no aspirations to compete in body building again after my kidney transplant, because the doctors told me the chances of doing so would be pretty slim. My goal was just to get back in the gym and to a level of fitness I was happy with and perhaps get my physique to a point where I'd be comfortable taking my shirt off by the pool!

"But around six months post-transplant, I went back to the gym and found my body was working in harmony and responding quickly to the training.

"When I made my body building comeback, I had zero expectations. For me it was more of a personal challenge to prove that I could still achieve something. I decided to give it a go, and 13 months post-transplant, I won an amateur competition.

"Things rapidly progressed and I entered a couple of other competitions – a British and a European championship – and won both. After that, my coach encouraged me to enter a professional qualifying event. I wasn't sure I was even ready or good enough, but I entered the event in late 2019 and I made it to the last two athletes remaining on stage. I returned in 2020 and took the pro title and earned the right to enter and compete in the pro league."

Dedication, sacrifice and being 'tan-tastic'

"When I started body building again post-transplant, I was on a very low protein diet. I'd have a blood test, and if everything was good, we would increase the protein by a very small amount. We repeated it to a point where the level was okay for my body to tolerate.

"There's always a focus on the correct amount of protein for muscle recovery and growth, but not too much that it becomes excessive for my kidney. My training regime is more about focusing on recovery and managing overall inflammation. Hydration plays a super important role too, with my water intake being around 4-5 litres daily since my transplant.

"Body builders restricting water leading up to a competition is actually a very outdated approach now and one that is rarely used. It used to be done because it was thought tjsy by restricting fluid, the body would appear to look 'drier' and leaner. But the approach is very different now. As the majority of muscle tissue is water, it's counterproductive to restrict water as then the muscles appear 'flatter' and not pumped and full.

"Some people still do it, but I keep my body hydrated and my muscles stay full because they have enough fluid. I won't do anything to risk my transplanted kidney and my eGFR now is still exactly the same as it was on the day my kidney was transplanted.

"In terms of my training plan, I train five days a week and have two rest days so that I can have adequate rest and recover well. My diet remains consistent: six balanced meals a day of protein, carbohydrates and fats. I eat the same meal, at the same time of day, every day! Working with my dietitian in the build-up to a competition, we gradually reduce the carbs over the weeks to help reduce overall calorie intake so that we can reduce my body fat to low as possible.

"I don't start on my tan until I get out to a competition. A couple of nights before the show, I put on a fake tan similar to the ones that you buy off the shelf."

Please consult with your GP or kidney specialist before embarking on any new diet or exercise regime.

Well-known in the community

"The reaction to my transplant and my success in the body building community since my operation has been absolutely incredible. Even now I'm still contacted by guys all over the world who are facing transplants but have seen my story and taken hope and inspiration that there can still be an amazing life after.

"And when I'm towards the end of a diet, pre-competition, and getting tired and hungry, some ask me how I cope with it. I say to them, 'Try living with kidney disease for five years and deal with that day-to-day.'

"If you've been through some sort of trauma or adversity, it doesn't have to define you. If anything, you can use it to springboard you onto something else. Mr Olympia propelled me forward to try even more, because it made me realise how fragile life can be. If you've got things that you want to do, just go and do them. Why wait?"

This story was first featured in Kidney Matters issue 31.