Strategies for assessing GFR and albuminuria in the living kidney donor evaluation.

PURPOSE OF REVIEW: The international guideline development group Kidney Disease Improving Global Outcomes (KDIGO) recently published a comprehensive set of recommendations for living donor evaluation which contains a new framework for decision making in the evaluation of kidney donor candidates.

RECENT FINDINGS: The guidelines recommend that decisions to accept or decline a candidate donor should be based on incorporation of multiple sources of information pertaining to the donor candidate's likelihood of serious adverse outcomes after donation. Two central components of assessment of risk are glomerular filtration rate (GFR) and albuminuria. We describe strategies for clinical decision making in assessment of GFR and albuminuria in the evaluation of living kidney donor candidates. Our premise is that all measurements will contain error; no single test result should lead to a decision to accept or decline a donor candidate.

SUMMARY: A structured apporach to use of information from multiple sources (e.g. estimated and measured GFR, estimated and measured albuminuria) aids in test interpretation and can lead to increased accuracy of testing and efficiency of evaluation strategies.