Primum non Nocere: is chronic kidney disease staging appropriate in living kidney transplant donors?

The aphorism of Primum non Nocere ('first do no harm') was introduced to guide physicians in making difficult and potentially hazardous decisions. The application of estimating equations for glomerular filtration rate (GFR) and classification schema for chronic kidney disease (CKD) has inadvertently led to 'labeling' of many living donors as having CKD postdonation. This review examines this issue and its possible consequences. Although complete long-term studies are lacking, it appears that the 'labeling' of such donors as having CKD postdonation is common but not associated with a major effect on morbidity or mortality.