{"id":"a3f34978b064","type":"article","url":"https://hartvaat.nl/2016/02/04/risicoprojectie-voor-nierfalen-bij-levende-nierdonorkandidaten/","title":"Risicoprojectie voor nierfalen bij levende nierdonorkandidaten","title_en":"Kidney-Failure Risk Projection for the Living Kidney-Donor Candidate.","category":"hypertensie","category_label":"Hypertensie","professions":["internist"],"tags":[],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1510491","source_url":"https://doi.org/10.1056/NEJMoa1510491","authors":["Morgan E Grams","Yingying Sang","Andrew S Levey","Kunihiro Matsushita","Shoshana Ballew","Alex R Chang","Eric K H Chow","Bertram L Kasiske","Csaba P Kovesdy","Girish N Nadkarni","Varda Shalev","Dorry L Segev","Josef Coresh","Krista L Lentine","Amit X Garg"],"significance":8,"published":"2016-02-04","source_date":"2016-02-04","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/"],"congress":"","summary_en":"This NEJM study developed and validated a kidney-failure risk projection tool for living kidney donor candidates, enabling simultaneous assessment of multiple risk factors for end-stage renal disease. The tool supports evidence-based evaluation of donor candidacy beyond individual risk factor screening.","created":"2026-07-03T10:25:56Z","updated":"2026-07-03T13:25:18Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"NEJM-studie die een empirisch instrument ontwikkelde voor het simultaan beoordelen van risicofactoren voor eindstadium nierziekte bij potentiële levende nierdonoren. Ondersteunt evidence-based donorselectie.","abstract_original":"BACKGROUND: Evaluation of candidates to serve as living kidney donors relies on screening for individual risk factors for end-stage renal disease (ESRD). To support an empirical approach to donor selection, we developed a tool that simultaneously incorporates multiple health characteristics to estimate a person's probable long-term risk of ESRD if that person does not donate a kidney. METHODS: We used risk associations from a meta-analysis of seven general population cohorts, calibrated to the population-level incidence of ESRD and mortality in the United States, to project the estimated long-term incidence of ESRD among persons who do not donate a kidney, according to 10 demographic and health characteristics. We then compared 15-year projections with the observed risk among 52,998 living kidney donors in the United States. RESULTS: A total of 4,933,314 participants from seven cohorts were followed for a median of 4 to 16 years. For a 40-year-old person with health characteristics that were similar to those of age-matched kidney donors, the 15-year projections of the risk of ESRD in the absence of donation varied according to race and sex; the risk was 0.24% among black men, 0.15% among black women, 0.06% among white men, and 0.04% among white women. Risk projections were higher in the presence of a lower estimated glomerular filtration rate, higher albuminuria, hypertension, current or former smoking, diabetes, and obesity. In the model-based lifetime projections, the risk of ESRD was highest among persons in the youngest age group, particularly among young blacks. The 15-year observed risks after donation among kidney donors in the United States were 3.5 to 5.3 times as high as the projected risks in the absence of donation. CONCLUSIONS: Multiple demographic and health characteristics may be used together to estimate the projected long-term risk of ESRD among living kidney-donor candidates and to inform acceptance criteria for kidney donors. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.)."}