Living Kidney Donor Annual Physical Examination.

Have a copy of the donation records sent to the primary care physician. Discuss the potential risks, complications and issues at the next appointment. Not all physicians are savvy in terms of single-kidneyed persons, especially living donors. It is possible the living donor will have more extensive knowledge.

Follow-up lab tests should include:

• Urinalysis - macro, micro and culture. This detects and measures protein and potential bacteria in the urine.

• Urine albumin: creatinine ratio - Excretion of even small amounts of albumin in the urine may portend serious future events, such as Chronic Kidney Disease and progressive renal dysfunction (95)  Albuminuria is the hallmark of hyperfiltration damage (173)

• Microalbumin can be a precursor to protein in the urine (proteinuria). Protein are large molecules which can damage the kidney. Conversely, malfunctioning kidneys can themselves be the cause of the secreted protein.

•  Serum creatinine or full basic metabolic profile - This evaluates the current status of the kidneys (including BUN/Blood Urea Nitrogen and Creatinine levels), electrolyte, blood sugar and calcium levels.

• Fasting blood glucose or Hemoglobin A1C.

• Lipid profile - in other words, watch your cholesterol!

• CBC (Complete Blood Count) – Kidneys produce a hormone that signals the body to produce red blood cells. This test, among other things, will monitor for anemia.

If the 'estimated' GFR is below 60, request a true measured GFR through a 24-hour urine collection and concurrent blood draw for creatinine. A GFR below 60 is considered Stage 3 Chronic Kidney Disease.