Living Kidney Donor Prediabetes Risk Platform
This platform was created to help transplant professionals identify prediabetes in living kidney donor candidates, characterize its severity, and estimate future risk for type 2 diabetes mellitus.
A clinician-facing web calculator to support evaluation of living kidney donor candidates with prediabetes. The platform integrates OGTT glucose and insulin timepoints (0–120 min) to compute insulin secretion and sensitivity indices (e.g., IGI, Matsuda, DI), and combines these with ATP III metabolic syndrome criteria to inform risk stratification and counseling.
Keywords: living kidney donor prediabetes, OGTT calculator, insulinogenic index, Matsuda index, disposition index, transplant donor diabetes risk.
It complements the publication of our article in the American Journal of Transplantation, Personal Viewpoint: Risk Stratification and Counseling of Living Kidney Donor Candidates with Prediabetes.
Traditional biomarkers such as hemoglobin A1c lack sensitivity for early detection of impaired glucose homeostasis. Many individuals with normal hemoglobin A1c and fasting blood glucose levels may still be at elevated risk for progression to diabetes.
Risk estimates generated by this tool are based on OGTT-derived glucose and insulin values, from which validated indices of insulin secretion and insulin sensitivity are calculated, and are integrated with metabolic syndrome classification using Adult Treatment Panel III (ATP III) criteria, and hemoglobin A1c.
Kidney Donor Prediabetes Risk Assessment Tool
Calculator subpage
Use the tool to enter OGTT glucose and insulin values and generate OGTT-derived indices used in the risk stratifier.
Open the Calculator View Stepwise Approach For healthcare professionalsOGTT Protocol Summary
- The WHO recommends an OGTT after 10–16 hours of overnight fasting (water only).
- For ≥3 days before testing, candidates should ingest ≥150 g/day of carbohydrates, with the final pre-fast meal including ≥50 g (carbohydrate restriction may impair post-load glucose disposal).1
- After fasting glucose and insulin are obtained, a 75 g oral glucose load is administered, and glucose and insulin are measured at 30, 60, 90, and 120 minutes.
Authorship and Acknowledgments
Designed and developed by:
Katafan Achkar, MD, FASN
Living Kidney Donor Program Director, Houston Methodist Hospital
Development assistance: ChatGPT (OpenAI) — used to support code development, structure, and content refinement. All medical content was reviewed and approved by the author.
Special thanks: Omar Achkar and Ahmad Achkar — for technical assistance and support.
Disclaimer: This platform is intended for healthcare professionals and is designed to support risk stratification and counseling. It does not replace clinical judgment.
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