Evaluation and Management of Candidates for Kidney Transplantation
Patient Guideline Summary
Publication Date: April 1, 2020
This patient summary means to discuss key recommendations from the Kidney Disease: Improving Global Outcomes (KDIGO) for Evaluation and management of candidates for Kidney Transplantation. It is limited to adults 18 years of age and older and should not be used as a reference for children.
- Many kidney diseases are progressive, eventually leading to failure. Each has unique characteristics that must be addressed.
Note: some of the more common causes of CKD are diabetes, high blood pressure, infections and lupus.
- We will use the abbreviation CKD throughout this summary to refer to chronic kidney disease.
- This patient summary focuses on evaluating a patient’s suitability for kidney transplantation.
- Evaluation should begin when a test of kidney function called the glomerular filtration rate (GFR) falls below 30 ml/min/1.73 m2.
- This should be 6–12 months before dialysis is expected to begin.
- Transplantation should be done before it is necessary.
- The preferred kidney is from a living donor.
- Factors that, by themselves, do not exclude transplantation:
- Factors to be considered:
- Cognitive function before the age of 5 years
- Psychiatric or psychological condition, substance use disorder or non-adherence
- Ability to cooperate with ongoing medical management
- Ability to abstain from tobacco
- Conditions that raise surgical risk:
- Blood clotting disorders
- Blood vessel problems
- The primary or additional kidney diseases
- Bone and mineral metabolism
- Conditions that usually exclude transplant:
- Deposition diseases like amyloid
- Active infections
- Almost all active cancers
- Severe diseases of lungs, heart, arteries, nervous system, digestive organs, blood or immune system
- Potential transplant recipients should be fully vaccinated.
- CKD: Chronic Kidney Disease
- GFR: Glomerular Filtration Rate
- KDIGO: Kidney Disease: Improving Global Outcomes
Chadban SJ, Ahn C, Axelrod DA, Foster BJ, Kasiske BL, Kher V, Kumar D, Oberbauer R, Pascual J, Pilmore HL, Rodrigue JR, Segev DL, Sheerin NS, Tinckam KJ, Wong G, Knoll GA. KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation. Transplantation. 2020 Apr;104(4S1 Suppl 1):S11-S103. doi: 10.1097/TP.0000000000003136. PMID: 32301874.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.