ESRD Risk Tool for Kidney Donor Candidates

Projected Incidence of End-Stage Renal Disease:
Pre-Donation 15-Year*
Pre-Donation Lifetime*
Post-Donation 15-Year**
Post-Donation Lifetime**
blue: < 1%, green: 1-2%, yellow: 2-3%, orange: 3-5%, red: >5%

The pre-donation risks represent projections if a person does not donate a kidney. Details about estimating post-donation risk are provided below.
print summary

Patient Characteristics:

Age (18-80yrs)
Race (White or Black)
eGFR (mL/min/1.73m²)
Systolic Blood Pressure (mmHg)
Hypertension Medication
BMI (kg/m²)
Non-Insulin Dependent Diabetes
Urine Albumin to Creatinine (mg/g)
click on units to change between mg/g and mg/mmol
Smoking History

* Pre-donation projected risk of end-stage renal disease (in the absence of kidney donation): This model is intended for low-risk adults considering living kidney donation in the United States1. It provides an estimate of the 15-year and lifetime incidence of end-stage renal disease given a set of demographic and baseline (pre-donation) health characteristics. It does not take into account any added risk a donor might incur due to the nephrectomy or resultant single kidney status. For risk factors that are not captured in this risk tool, estimates reflect the US population average. Please note that some studies have found higher risk associated with obesity2,3; caution is suggested when considering potential donors with higher BMI, particularly in the younger age groups.

The study population used to derive risk estimates included the low-risk subgroup of 7 general population cohorts with median followup ranging from 4 - 16 years. Risk factor associations were determined using Cox proportional hazards models. Absolute risk was calibrated to annual ESRD incidence estimate derived from actual ESRD incidence from the United States Renal Data System and mortality from the United States Census.

** Post-donation projected risk of end-stage renal disease (after kidney donation): Previous studies have estimated that the 15-year absolute increase in the risk of ESRD from kidney donation averages 0.27%4,5. This risk varies depending on a donor candidate's demographic and health characteristics. At the present time we do not have data on the lifetime post-donation risk of ESRD according to a donor candidate's characteristics.

1. Grams ME, Sang Y, Levey AS, Matsushita K, Ballew S, Chang AR et al. Kidney-Failure Risk Projection for the Living Kidney-Donor Candidate. NEJM 2015 (epub ahead of print)
2. Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med 2006;144:21-8.
3. Vivante A, Golan E, Tzur D, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med 2012;172:1644-50.
4. Mjøen G, Hallan S, Hartmann A, et al. Long-term risks for kidney donors. Kidney Int 2014;86:162-7.
5. Muzaale AD, Massie AB, Wang MC, et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014;311:579-86.

Website developed by Eric Chow 2015

LIMITATIONS OF LIABILITY When you access this website, you agree that the Johns Hopkins University School of Medicine shall not be liable to you for any loss or injury caused in procuring, compiling, or delivering the information gained from the site. In no event will the School be liable to you or anyone else for any action taken by you on the basis of such information or for any incidental, consequential, special, or similar damages.

DISCLAIMER This website is provided on an "as is" basis. The Johns Hopkins University disclaims all responsibility for any loss, injury, claim, liability, or damage of any kind resulting from, arising out of, or any way related to any errors in or omissions from this Web site and the content, including but not limited to technical inaccuracies and typographical errors. The Johns Hopkins University does not warrant or present that the information available on or through the site will be correct, accurate, timely, or otherwise reliable. The Johns Hopkins University may make improvements and/or changes to its features, functionality, or content at any time.

NOT MEDICAL ADVICE The content contained on this site is not intended to and does not constitute medical advice, and no doctor/patient relationship is formed. The accuracy, completeness, adequacy, or currency of the content is not warranted or guaranteed. The use of information on the site or materials linked from the site is at the user's own risk. The contents of the site, such as text, graphics, images and other materials are informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should always seek the advice of physicians or other qualified health providers with any questions regarding a medical condition. Users should never disregard professional medical advice or delay in seeking it because of something on the site.

COPYRIGHT Copyright of the text contained in this website is owned by The Johns Hopkins University. These text materials may be used, downloaded, reproduced, publicly displayed, or reprinted for personal or nonprofit educational or research purposes provided that the following attribution appears in all copies: "Reproduced with permission of the Johns Hopkins University School of Medicine, Baltimore, MD." Written permission is required for all other uses. The text reproduced from this Web site must not be modified in any way.

The site may also contain graphic images and other non-text-based materials. All rights to these materials are reserved to The Johns Hopkins University and/or the copyright owners who license such materials to us. Prior written permission to use, download, reproduce, publicly display, or reprint any of these materials must be obtained from the Johns Hopkins Bloomberg School of Public Health or other copyright owner.

Copyright Johns Hopkins University 2015

hits counter