Massie AB, Holscher CM, Henderson ML, et al. - Given the correlation of living kidney donation with elevated long-term risk of end-stage renal disease (ESRD), researchers here examined if renal function in the first 6 months postdonation associates to subsequent risk of ESRD in kidney donors. In this secondary analysis, they used data of a prospective national cohort of all living kidney donors from a population-based registry in the United States between October 26, 1999, and January 1, 2018, with follow-up through December 31, 2018. They included a total of 71,468 living kidney donors (of 109 065 total donors over this period) in this registry-based cohort study. The outcomes revealed a significant correlation of a 10-unit difference in early postdonation estimated glomerular filtration rate with a 28% raised risk of subsequent ESRD. This emphasizes the utility of procuring glomerular filtration rate measurement at 6 months postdonation in donors to recognize donors with low renal function. Increased surveillance or early intervention to reduce end-stage renal disease risk may benefit these donors.