NKF Investigators Review Guidelines on Caring for Living Donors

Kidney Disease Outcomes Quality Initiative team offers opinion for American doctors treating donors
New York, NY January 29, 2020 – Today, the American Journal of Kidney Diseases (AJKD) published the “KDOQI Commentary on KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors,” which reviews the most recent guidelines published by a global nonprofit for kidney health. The National Kidney Foundation’s evidence-based guidelines development program, the Kidney Disease Outcomes Quality Initiative (KDOQI), published a U.S. commentary on those guidelines.
            KDIGO – Kidney Disease Improving Global Outcomes – put together a comprehensive document outlining what they found to be the global best practices to evaluate, select, counsel and care for living donor candidates, and the follow-up long-term care these patients need. The KDIGO guidelines were first published in July 2017.
            Today, KDOQI is releasing its commentary on their applicability and relevance within the United States.
            “Professionals should know that the living donor guideline provides extensive and useful information, but that some of the recommendations do not strictly apply in the U.S. context, which is extensively regulated by UNOS [United Network for Organ Sharing],” said Dr. Didier Mandelbrot, lead author of the KDOQI commentary, and medical director of the Living Kidney Donor Program at the University of Wisconsin School of Medicine and Public Health. “Also, the guideline relies heavily on the use of the ESKD risk estimator tool, which has significant potential limitations.”
            Dr. Mandelbrot reported that the team which evaluated the guideline believes that further research is needed to help define factors that affect long-term risk of kidney disease after a living donation, and they need to be incorporated in the risk calculator.
            “The publication of this KDOQI commentary is quite timely,” said NKF’s Senior Vice President, Scientific Operations, Jessica Joseph. “Between NKF’s continued advocacy efforts to protect and expand financial assistance for living donors, and with the announcement of the Advancing American Kidney Health Initiative, awareness about living donation is at an all-time high.  As more and more Americans consider living donation, it’s important for both clinicians and potential donors to understand the benefits and risks in order to make informed decisions. 
            “With a growing number of former living kidney donors (approximately 5,000 to 6,000 new donors per year as of 2018), not only transplant providers but importantly, primary care practitioners will be caring for donors throughout their lives,” concluded the 16 authors of the commentary. “The medical and psychosocial complexity of this population has increased over past decades, therefore as with other clinical practice guidelines, the KDIGO Clinical Practice Guideline on Evaluation and Care of Living Kidney Donors serve as a valuable tool that will facilitate clinical decision making with the ultimate goal of continuously advancing the field of living kidney donation.”
            The commentary will appear in the National Kidney Foundation’s AJKD today. AJKD is the leading kidney disease journal. It reaches thousands of healthcare professionals each month. To read more about the authors and to read the commentary, please visit: https://www.ajkd.org/article/S0272-6386(19)31117-5/fulltext
Kidney Disease Facts
In the United States, 37 million adults are estimated to have chronic kidney disease— and more than 90% aren’t aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history.  People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease.  African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end-stage kidney disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.