(Brussels, Belgium) – – – – Kidney Disease: Improving Global Outcomes (KDIGO) announced today that its latest evidence-based clinical practice guideline has been released for public comment. The Clinical Practice Guideline on the Evaluation and Follow-up Care of Living Kidney Donors represents the culmination of a multi-year, robust development process.
Krista Lentine, US, and Amit Garg, Canada, lead the guideline work group in collaboration with evidence review professionals at the University of Minnesota in Minneapolis, USA. The guideline also includes research completed by the Chronic Kidney Disease Prognosis Consortium, headquartered at Johns Hopkins University in Baltimore, Maryland, USA. The guideline provides recommendations on various aspects of selection and management of living kidney donors, as well as on the processes of living donation.
As part of the rigorous scientific process, all KDIGO guidelines are made available for public review prior to publication. Any individual or organization that wishes to comment on the guideline is encouraged to do so. KDIGO will collate the public review comments and provide all feedback to the Work Group for their consideration. The guideline will then be refined based on the public input and submitted for publication.
This guideline was developed in collaboration with Canadian Blood Services, the Canadian Society of Nephrology, and The Transplantation Society (TTS), and will be published in Transplantation, the official journal of TTS. KDIGO guidelines are global and translate the latest available science into clinical practice recommendations for clinicians and patients around the world.
A New Paradigm for the Evaluation of Living Kidney Donor Candidates
Living kidney donation is a vital part of the treatment options available for those who suffer total kidney failure. This guideline presents a new framework for estimating the short-term and long-term risks of kidney failure for relatively healthy individuals who wish to donate a kidney to someone in need. In collaboration with KDIGO, the CKD Prognosis Consortium examined 52,988 living kidney donors from the United States and developed a risk calculator for kidney failure based on the donor’s individual characteristics (for example, gender, race, age) and risk factors (for example, high blood pressure, obesity, smoking).
This risk calculator, now available at www.transplantmodels.com/esrdrisk, allows anyone to derive his or her personal estimates. This information can ultimately be used not only to assist with an individual’s decision-making on donation but would also allow transplant centers to evaluate a donor candidate based on their composite risk profile rather than focusing on a single risk factor as has been done in the past.
Bertram Kasiske, KDIGO Co-Chair said, “This guideline and the risk calculator will provide clinicians, potential donors, patients and their families with a more rigorous scientific basis to make a decision about donation. We feel that such information based on a more transparent approach will empower individuals to make better decisions.
We did not conduct this work to encourage or discourage living donors. We simply want them to have solid scientific information on which to base their decision. We need living donors to provide transplants for our kidney failure patients but they deserve to have all the available facts prior to undergoing a major procedure like donation,” Kasiske added.
Care of Living Donors
Among other key recommendations addressed in the draft guideline are the roles and responsibilities of care providers in the living kidney donation process; the requisite elements of informed consent for donation; ethical, legal and policy considerations relevant to living kidney donation; and most importantly, the standards for post-donation follow-up care. Such follow-up care is extremely important in view of the altruistic act performed by these admirable donors and the health information we gather will also provide future donors with improved risk estimates and help better guide their decision-making.
KDIGO is a Belgian foundation committed to developing and implementing nephrology guidelines that improve patient outcomes on a global basis.
For further information please contact KDIGO at KDIGOcommunications@kdigo.org.
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