Assessment of Kidney Function in Living Kidney Donors: Single-center Experience from A Developing Country

Background: In Bosnia and Herzegovina, the most common type of kidney transplant is from living donors. No national guidelines exist for assessing living donors, nor clear consensus among relevant guidelines on the best kidney donor function evaluation method.

Methods: We performed a retrospective-observational study in 170 potential donors between 1999 and 2020. We used the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modifcation of Diet in Renal Disease (MDRD) formulas to estimate glomerular fltration rate (eGFR), a web-based calculator for predicting GFR below 80 mL/min/1.73 m2 , and creatinine clearance (CrCl) as well as measured GFR (mGFR) through diethylenetriamine pentaacetic acid (DTPA) renogram.

Results: MDRD, CKD-EPI, and a web-based calculator had similar abilities to detect potential donors with GFR 2.5% and a specifcity of 24.20%. CrCl achieved a sensitivity of 100% at cutof value <90.57 mL/min/1.73 m2 , identifying all the donors with GFR<80 mL/min/1.73 m2 with the specifcity of 62.14%, and provided the most signifcant reduction in the need for mGFR (56.6%).

Conclusion: eGFR-based screening done on 2 separate occasions or combined with CrCl is suficient for most potential donors because the mGFR is likely between those values. mGFR with an exogenous marker is needed for borderline cases and selected groups.

Cite this article as: Aleckovic-Halilovic M, Mesic E, Pjanic M, Zukic E, Basic-Denjagic M. Assessment of kidney function in living kidney donors: Single-center experience from a developing country. Turk J Nephrol. 2024;33(4):372-380