The Evaluation of Kidney Function in Living Kidney Donor Candidates.
CKD-EPI
GFR
creatinine clearance
kidney function
living kidney donor
measure GFR
transplantation
Journal
Kidney360
ISSN: 2641-7650
Titre abrégé: Kidney360
Pays: United States
ID NLM: 101766381
Informations de publication
Date de publication:
30 09 2021
30 09 2021
Historique:
received:
04
05
2021
accepted:
28
06
2021
entrez:
4
4
2022
pubmed:
5
4
2022
medline:
8
4
2022
Statut:
epublish
Résumé
Living kidney donors incur a small increased risk of ESKD, of which predonation GFR is an important determinant. As a result, kidney function assessment is central to the donor candidate evaluation and selection process. This article reviews the different methods of GFR assessment, including eGFR, creatinine clearance, and measured GFR, and the current guidelines on GFR thresholds for donor acceptance. eGFR obtained using the 2009 CKD Epidemiology Collaboration equation that, although the best of estimating estimations, tends to underestimate levels and has limited accuracy, especially near-normal GFR values. In the United States, the Organ Procurement and Transplantation Network policy on living donation mandates either measured GFR or creatinine clearance as part of the evaluation. Measured GFR is considered the gold standard, although there is some variation in performance characteristics, depending on the marker and technique used. Major limitations of creatinine clearance are dependency on accuracy of timed collection, and overestimation as a result of distal tubular creatinine secretion. GFR declines with healthy aging, and most international guidelines recommend use of age-adapted selection criteria. The 2017 Kidney Disease: Improving Global Outcomes Guideline for the Evaluation and Care of Living Kidney Donors diverges from other guidelines and recommends using absolute cutoff of <60 ml/min per 1.73m
Identifiants
pubmed: 35373109
doi: 10.34067/KID.0003052021
pii: 02200512-202109000-00019
pmc: PMC8786144
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1523-1530Informations de copyright
Copyright © 2021 by the American Society of Nephrology.
Déclaration de conflit d'intérêts
D. Mandelbrot reports being a scientific advisor or member of CareDx and CSL Behring. E. Poggio reports having consultancy agreements with Renalytix; and reports receiving honoraria from CareDx, Novartis, and Reata. N. Garg repo rts receiving honoraria from CareDx; reports being a scientific advisor or member of BMC Nephrology Associate Editor, and the Advisory Board for CareDx.
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