Donating a kidney is a step with lifetime implications for the donor. Of the many outcomes, one needs to consider after kidney donation, the major one following the donation of one kidney is the long term risk of developing kidney failure, dialysis or transplantation requirements. Donor candidates often have a good understanding of the health effects of kidney failure, as their reason to donate is to treat the kidney failure of their intended recipient. Each donor candidate has a cumulative incidence of developing kidney failure that is influenced by the combination of risks conferred by their demographic and clinical characteristics at the time of evaluation plus risk attributable to donation. Demographic characteristics include age, sex and, race. Clinical characteristics include glomerular filtration rate, albuminuria, BMI, blood pressure, diabetes status, smoking history, and family history of kidney disease, and other factors. The risk attributable to donation also varies according to demographic and clinical characteristics. Minimizing the lifetime risk of kidney failure in accepted donors is important to safeguard the practice, regardless of the degree to which it can be established that donation contributed to the risk of kidney failure.
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