Health promotion and disease prevention in kidney transplant recipients

Patients with end-stage renal disease have a critical need for health maintenance. Due to the shortage of donor organs, kidney transplant--the treatment of choice for end-stage renal disease--is not available to all individuals listed on the national waiting list. Therefore, treatment must be optimal to maximize graft survival and length of life in this high-risk population. Transplant recipients are exposed to the inherent risks of immunosuppression. Chronic use of pharmocologic agents to maintain graft survival is associated with conditions such as coronary artery disease, stroke, infection, and malignancy. A needs assessment revealed that many identified risks were modifiable through proper education and intervention. Therefore, health promotion and disease prevention--namely cancer screening and prevention, cardiovascular risk factors, and dietary guidelines--were identified as educational priorities. In an environment of fiscal constraint and priority setting, transplant centers are obligated to provide quality outcomes with cost-containment. Transplant teams must therefore focus on minimizing risks and preventing diseases to reduce costs and produce positive long-term outcomes.