ESRD Risk Tool for Kidney Donor Candidates

Estimates 15-year and lifetime risk for kidney donors

ESRD Risk Tool for Kidney Donor Candidates

ESRD Risk Tool for Kidney Donor Candidates

Pre-donation Projected Risk of End-Stage Renal Disease

This model is intended for low-risk adults considering living kidney donation in the United States. It provides an estimate of the 15-year and lifetime incidence of end-stage renal disease given a set of demographic and baseline (pre-donation) health characteristics.

Note: Some studies have found higher risk associated with obesity; caution is suggested when considering potential donors with higher BMI.
Note: For most healthy donor candidates, eGFR is typically ≥90 mL/min/1.73m²

Risk Estimates

Pre-donation risk (without kidney donation):

15-year risk of ESRD:

Lifetime risk of ESRD:

Post-donation considerations:

Previous studies have estimated that the 15-year increase in relative risk of ESRD from kidney donation may be at least 5-fold. At the present time we do not have data on the lifetime post-donation risk of ESRD according to a donor candidate’s characteristics.

Disclaimer: This tool does not take into account any added risk a donor might incur due to the nephrectomy or resultant single kidney status. For risk factors that are not captured in this risk tool, estimates reflect the US population average.

About This Tool

This model is intended for low-risk adults considering living kidney donation in the United States. It provides an estimate of the 15-year and lifetime incidence of end-stage renal disease given a set of demographic and baseline (pre-donation) health characteristics. It does not take into account any added risk a donor might incur due to the nephrectomy or resultant single kidney status.

The study population used to derive risk estimates included the low-risk subgroup of 7 general population cohorts with median follow up ranging from 4 – 16 years. Risk factor associations were determined using Cox proportional hazards models. Absolute risk was calibrated to annual ESRD incidence estimate derived from actual ESRD incidence from the United States Renal Data System and mortality from the United States Census.

References

  • Grams ME, Sang Y, Levey AS, Matsushita K, Ballew S, Chang AR et al. Kidney-Failure Risk Projection for the Living Kidney-Donor Candidate. NEJM 2015.
  • Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med 2006;144:21-8.
  • Vivante A, Golan E, Tzur D, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med 2012;172:1644-50.
  • Mjøen G, Hallan S, Hartmann A, et al. Long-term risks for kidney donors. Kidney Int 2014;86:162-7.
  • Muzaale AD, Massie AB, Wang MC, et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014;311:579-86.

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