Donor renal function

An accurate assessment of the glomerular filtration rate (GFR) should be undertaken in all potential donors. The benefit of obtaining a directly measured GFR (thought to be more accurate) over an estimated GFR, has not been proven in live donors (refer to CARI guidelines titled 'Use of estimated glomerular filtration rate to assess level of kidney function' and 'Direct measurement of glomerular filtration rate'). When the GFR is estimated it is recommended that this be on the basis of serum creatinine using, for example, the Cockcroft-Gault (CG) formula or the Modified Diet in Renal Disease (MDRD). Measurement of creatinine clearance calculated from a 24 h urine collection is also acceptable, if collected accurately. The estimated glomerular filtration rate (eGFR) should be confirmed on at least two separate occasions. If there is doubt regarding the GFR from estimated methods, further techniques can be used to assess or clarify this. Acceptable methods include a direct evaluation of the GFR by methods such as Cr-EDTA (nuclear GFR), iohexol or inulin clearance. It is preferable not to accept kidneys from donors with GFR < 80 mL/min per 1.73 m(2). Final submission: June 2009.