Almost one-third of transplanted kidneys come from living donors, who sacrifice approximately 30% of their pre-donation glomerular filtration rate (GFR) after they experience compensatory hypertrophy and hyperfiltration in their remaining kidney. Although hyperfiltration can cause glomerular injury, many studies have suggested that donor nephrectomy itself does not cause long-term loss of GFR at a higher rate than what is seen in the normal aging population. However, when post-donation kidney diseases occur in an unfortunate few, recent studies suggest that GFR loss at donor nephrectomy increases the risk of eventual end-stage renal disease (ESRD). In this issue of the
Roland C. Blantz, Robert W. Steiner
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