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

Am J Transplant. 2016 Oct;16(10):3024-3032. doi: 10.1111/ajt.13908. Epub 2016 Jul 15.


The value of estimated glomerular filtration rate (eGFR) in living kidney donors screening is unclear. A recently published web-based application derived from large cohorts, but not living donors, calculates the probability of a measured GFR (mGFR) lower than a determined threshold. Our objectives were to validate the clinical utility of this tool in a cohort of living donors and to test two other strategies based on chronic kidney disease epidemiology collaboration (CKD-EPI) and on MDRD-eGFR. GFR was measured using 51 Cr- ethylene-diamine tetraacetic acid urinary clearance in 311 potential living kidney donors (178 women, mean age 50 ± 11.6 years). The web-based tool was used to predict those with mGFR < 80 mL/min/1.73 m2 . Inputs to the application were sex, age, ethnicity, and plasma creatinine. In our cohort, a web-based probability of mGFR <90 mL/min/1.73 m2 higher than 2% had 100% sensitivity for detection of actual mGFR <80 mL/min/1.73 m2 . The positive predictive value was 0.19. A CKD-EPI-eGFR threshold of 104 mL/min/1.73 m2 and an MDRD-eGFR threshold of 100 mL/min/1.73 m2 had 100% sensitivity to detect donors with actual mGFR <80 mL/min/1.73 m2 . We obtained similar results in an external cohort of 354 living donors. We confirm the usefulness of the web-based application to identify potential donors who should benefit from GFR measurement.

Keywords: clinical research/practice; donors and donation: donor evaluation; donors and donation: living; glomerular filtration rate (GFR); internet; kidney transplantation/nephrology.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Biomarkers / analysis*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate*
  • Health Status Indicators
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies


  • Biomarkers