Chronic kidney disease and the transplant recipient

The recent Kidney Disease Outcomes Quality Initiative (K/DOQI) classification of chronic kidney disease (CKD) includes transplant recipients. Although there are important differences between kidney transplant recipients (KTRs) and patients with native kidney disease, the inclusion of KTRs along with other CKD patients is an important step to improve long-term outcomes among transplant recipients. In this article we discuss the applicability of the K/DOQI classification of CKD to transplant recipients and the importance of premature patient death with graft function as a cause of graft loss. The implementation of a comprehensive program of CKD care beginning prior to transplantation and continuing after graft failure is discussed as a strategy to improve patient outcomes and specific areas of concern for KTRs are highlighted.