I am being evaluated at Mayo Clinic Florida for living kidney donation. My question is about how my kidney function will be when I go from two kidneys to one. My first creatinine clearance number was only 77, which the transplant doctor said was lower than she expected but still above the 73 needed for my age (56 years old). With one kidney I am concerned this number could be cut in half, and wouldn’t that put me in the CKD range? The second test result was 90. I am interested in getting an opinion from a non-transplant nephrologist about what might be the effects on my down the road. Thanks in advance.

Your thinking is correct.  By donating a kidney, you will expect to have a reduction in total kidney function as expressed as an estimated glomerular filtration rate (eGFR).  While the eGFR does not commonly decrease by half, after donation of a kidney, the eGFR does decline by 30 to 40%.  Patients who donate kidneys do have a higher incidence of high blood pressure and protein in the urine after kidney donation.  If you have concerns, I recommend that you seek consultation with a nephrologist outside of the transplant center.

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