Hard illicit drug use is associated with higher risk of CKD progression and all-cause mortality, tobacco smoking is associated with higher risk of all-cause mortality, and alcohol drinking is associated with lower risk of all-cause mortality among patients with CKD.

Background and Objective The use of trained kidney transplant recipients as patient navigators resulted in increased completion of the steps in the transplant process by dialysis patients [1]. We sought to understand the experiences of these patient navigators. Setting and Participants Six kidney transplant recipients were hired and employed by transplant centers in Ohio, Kentucky, and Indiana. The transplant navigators received formal training as peer educators, met with dialysis patients on a regular basis, and provided tailored education and assistance about transplantation to each patient. They worked closely with the pre-transplant coordinators and social workers to learn the details of each patient’s transplant work-up. Methodology We queried navigators using open-ended questions to learn about their experiences. Navigator responses were coded and common themes identified. A thematic auditor reviewed and refined the coding. Results Two primary categories of themes emerged about the navigator experience: 1) practical comments that supported programmatic or implementation observations of the navigators, and 2) affective comments that reflected a shared experience among the navigators and patients. The navigators were able to fill voids in the transplant process that were not fulfilled by other caregivers. This was accomplished by a natural bond based upon a shared experience (of dialysis and kidney failure) between the navigator and the patient. The patient and navigator became experiential partners. Conclusion Kidney transplant recipients trained as patient navigators fill the role of a non-traditional medical provider, offer support during the transplant process, and provide an added-benefit to complement routine dialysis and nephrology care.

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