Estimated or Measured GFR in Living Kidney Donors Work-up?

Gaillard, F.; Flamant, Martin; Lemoine, Sandrine; Baron, Stéphanie; Timsit, Marc‐Olivier; Eladari, Dominique; Fournier, Catherine; Prot-Bertoye, Caroline; Bertocchio, Jean‐Philippe; Vidal‐Petiot, Emmanuelle; Lamhaut, Lionel; Morélon, Emmanuel; Péraldi, Marie-Noëlle; Vrtovsnik, François; Friedlander, Gérard; Méjean, A.; Houillier, Pascal; Legendre, Christophe; Courbebaisse, Marie

doi:10.1111/ajt.13908

Cited by 31 publications

(25 citation statements)

References 17 publications

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“…This observation is in accordance with what was reported regarding the relationship between eGFR and mGFR among potential donors [19]. Moreover, we recently published two studies showing that mGFR (and not eGFR) divided by the volume of the remaining kidney could be used to predict functional gain of the remaining kidney following donation [20] and that measured GFR could not be predicted precisely by calculators or equations for nearly 60% of donors [19]. For these reasons, we think that eGFR cannot replace mGFR in living donor screening.…”

Section: Discussionsupporting

confidence: 94%

What is the significance of end-stage renal disease risk estimation in living kidney donors?

et al. 2017

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Two end-stage renal disease (ESRD) risk calculators were recently developed by Grams et al., and Ibrahim et al. to calculate ESRD risk before donation among living kidney donors. However, those calculators have never been studied among potential donors for whom donation was refused due to medical contraindications and compared to a group of donors. We compared 15-year and lifetime ESRD risk of donors and nondonors due to medical cause as estimated by those two calculators. Nondonors due to medical cause (n = 27) had a significantly higher 15-year ESRD risk compared to donors (n = 288) with both calculators (0.25 vs. 0.14, P < 0.001 for that developed by Grams et al. and 2.21 vs. 1.43, P = 0.002 for that developed by Ibrahim et al.). On the contrary, lifetime ESRD risk was not significantly different between the two groups. At both times (15 years and lifetime), we observed a significant overlap of ESRD risk between the two groups. ESRD risk calculators could be complementary to standard screening strategy but cannot be used alone to accept or decline donation.

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Section: Discussionsupporting

confidence: 94%

What is the significance of end-stage renal disease risk estimation in living kidney donors?

et al. 2017

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“…One study validating these computations in donor candidates has been reported. 131 Future studies should address prediction accuracy among racial and ethnic groups for whom the accuracy of eGFR is less certain (eg, nonblack, nonwhite persons).…”

Section: Measurement Methodsmentioning

confidence: 99%

Survival in Living Kidney Donors: An Australian and New Zealand Cohort Study Using Data Linkage

Mata

Clayton

Kelly

et al. 2020

Transplantation Direct

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The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a "proof-in-concept" risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided.

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“…The second eGFR could either be derived from Scr and cystatin C levels or simply be a repeat assessment of eGFR using Scr level alone. [26][27][28][29] This recommendation is a substantial departure from current practice in the United States 27 and would not be compliant with current UNOS policy. For transplantation programs to use this approach yet be compliant with UNOS policy, that policy would first need to be revised.…”

Section: Commentarymentioning

confidence: 99%

KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

Mandelbrot

Reese

Garg

et al. 2020

American Journal of Kidney Diseases

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Living kidney donation is widely practiced throughout the world. During the past 2 decades, various groups have provided guidance about the evaluation and care of living donors. However, during this time, our knowledge in the field has advanced substantially and many agreed on the need for a comprehensive, unifying document. KDIGO (Kidney Disease: Improving Global Outcomes) addressed this issue at an international level with the publication of its clinical practice guideline on the evaluation and care of living kidney donors. The KDIGO work group extensively reviewed the available literature and wrote a series of guideline recommendations using various degrees of evidence when available. As has become recent practice, NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) convened a work group to provide a commentary on the KDIGO guideline, with a focus on how these recommendations apply in the context of the United States. In the United States, the United Network for Organ Sharing (UNOS) guides and regulates the practice of living kidney donation. While the KDIGO guideline for the care of living kidney donors and UNOS policy are similar in most aspects of the care of living kidney donors, several important areas are not consistent or do not align with common practice by US transplantation programs in areas in which UNOS has not set specific policy. For the time being, and recognizing the value of the KDIGO guidelines, US transplantation programs should continue to follow UNOS policy. As they are designed to reflect the views and recommendations of the responsible KDOQI Commentary work group and because they are reviewed and approved by KDOQI and NKF leadership, KDOQI Commentaries are not peer reviewed by AJKD. This article was prepared by a KDOQI Commentary work group comprising the authors and cochaired by Drs Didier Mandlebrot and Emilio E. Poggio. It was reviewed and approved by the NKF Scientific Advisory Board. Complete author and article information provided before references.

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Estimated or Measured GFR in Living Kidney Donors Work-up?

Cited by 31 publications

References 17 publications

What is the significance of end-stage renal disease risk estimation in living kidney donors?

What is the significance of end-stage renal disease risk estimation in living kidney donors?

Survival in Living Kidney Donors: An Australian and New Zealand Cohort Study Using Data Linkage

KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

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