Research developments that have implications for nephrology and urology certainly are not limited to the meetings and journals targeting these specialties. That is why our news coverage extends to meetings that nephrologists and urologists usually do not attend and journals they usually do not read.
Such is the case with the cover article of this issue, which reports on a study presented at the American Academy of Dermatology annual meeting in San Antonio. The study looked at skin cancer risk awareness in solid-organ transplant recipients. It found that 62% of subjects reported not being informed about their elevated risk of skin cancer following their organ transplant, despite documented verbal education while in the hospital. Previous research suggests that this risk is up to 200 times greater when compared with the non-transplant population.
The study got me thinking about the tradeoff that transplant recipients have to make. Renal transplant recipients look forward to a life without dialysis and accept that they must take immunosuppressive medications to prevent rejection. As a result, these patients face an increased risk of infection and cancer.
In a previous study, researchers at the University of Illinois in Chicago looked at the incidence of post-transplant malignancy among 674 solid-organ transplant recipients (including 305 renal). The investigators detected malignancies in 79 patients (48 heart, 28 renal, two lung transplant patients and one heart/lung recipient). The overall cancer frequency was 11.7%. It was 9.2% for kidney recipients and 15.6% for heart recipients (Clin Transplant. 1996;10:248-255).
It would be a great travesty if, after years of waiting for a renal transplant, a patient’s prospect for a better life is dashed by the development of cancer, especially if it was a potentially preventable malignancy like skin cancer. The new study found that only 28% of transplant recipients reported wearing sunscreen regularly, a slight increase from 22% who reported wearing sunscreen regularly before transplantation.
Numerous health professionals are involved with the care of a transplant patient, but in the case of renal transplant patients, it is incumbent on nephrologists to take the lead in ensuring that kidney recipients are aware of their elevated skin cancer risk and of the need to wear sunscreen.