JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Kidney and Bladder Disease

1. Acute Nephritis (to include Pyelonephritis, Acute tubular interstitial nephritis and Glomerulonephritis)
Definitions

Pyelonephritis: acute nephritis due to ascending infection.

Acute tubular interstitial nephritis: acute nephritis caused by an  'allergic reaction' to medication, rarely as part of a systemic often autoimmune disease.

Glomerulonephritis: May be primary intrinsic to the kidney or secondary, associated with certain infections, drugs, systemic disorders (SLE, vasculitis), or diabetes.

Obligatory

Must not donate if:
If under active investigation, treatment or specialist follow-up by a specialist.

Discretionary

If well, on no treatment and is discharged from follow-up, accept. 

See if Relevant

Autoimmune Disease

Additional Information

Self-limiting renal disease e.g. single attacks of glomerulonephritis or pyelitis, from which recovery has been complete, do not necessarily disqualify the donor.

If there is doubt about the diagnosis refer to a 'Designated Clinical Support Officer'.

2. Chronic Nephritis
Obligatory

Must not donate.

3. Infection
Obligatory

Must not donate if:
a) Has active infection
b) Under investigation
c) On antibiotics to prevent urinary tract infection

Discretionary

If the donor has taken a single dose of an antibiotic after sexual intercourse to prevent urinary tract infection, is symptom-free on the day of donation, and does not have an underlying condition that prevents donation, accept.

See

Infection - General

See if Relevant

Antibiotic Therapy

Additional Information

Donors may be taking prophylactic antibiotics long-term or as single post-coital doses. Anatomical anomalies within the urinary tract can make individuals more prone to recurrent infections. If a donor is accepted in accordance with the Discretionary guidance above, the importance of informing the relevant blood service of symptoms suggestive of urinary tract infection occurring within 14 days of donation must be emphasised with the donor. 


Donors on long-term antibiotics may have ongoing urinary tract infection without having any symptoms. As an active infection at the time of donation cannot be ruled out, these donors must not be accepted. 

4. Kidney Failure
Obligatory

Must not donate if:
a) Has renal impairment requiring dialysis.

b) Using erythropoietin or similar drugs to increase the haemoglobin concentration.

c) Is either under active investigation, or continued follow up by a specialist for renal impairment, or has any associated cardiovascular complications.

d) Has had a kidney transplant.

Discretionary

If a kidney transplant was of a non stored autologous organ, accept.

See if Relevant

Autoimmune Disease
Blood Pressure - High
Diabetes Mellitus
Immunosuppression
Tissue and Organ Recipients

If treated with blood or blood products, immunoglobulin, plasma exchange or filtration:
Transfusion

Additional Information

People with significant kidney failure usually have a high risk of anaemia. This, together with other factors, make them unsuitable as donors.

Information

This is a requirement of the Blood Safety and Quality Regulations 2005.

5. Polycystic Kidney Disease
Discretionary

A diagnosis of polycystic kidney disease does not necessarily prevent donation. If otherwise well, accept.

See if Relevant

Blood Pressure - High
Infection - General
Kidney Failure above.

Additional Information

Polycystic kidney disease is usually genetic. It varies markedly in its severity and many people will not run into problems until later in their lives. Before this happens, provided they are otherwise well, there is no reason why affected individuals should not donate. Often they will have higher haemoglobin concentrations than normal.

6. Renal Colic, Kidney and Bladder Stones
Obligatory

Must not donate if:
a) Symptomatic.

b) Under investigation.

See if Relevant

Infection - General

Additional Information

Renal colic is most commonly caused by solid material (crystals or a stone) passing through the tube that connects the kidney to the bladder (the ureter). It is commonly associated with infection.

It is important to wait until the donor is fully recovered and any investigations have been completed. This should avoid a donation being taken from an individual with infection. Infection can lead to bacteria contaminating any donated material. This can be dangerous because bacteria can multiply to dangerous levels in the stored donation.

Kidney and bladder stones have many causes and may be associated with infection. It is important to ensure that there is not an underlying cause that would prevent donation.

7. Interstitial Cystitis
Obligatory

Must not donate if:
a) Under investigation

b) Has an associated condition which would prevent donation

c) Has required catheterisation within the last 7 days.

d) On treatment with Pentosan polysulfate sodium (Elmiron)

Discretionary

If investigations are complete, there are no associated conditions or treatments which would prevent donation, symptoms are controlled even if on medication other than Pentosan polysulfate sodium (Elmiron), the potential donor has not required catheterisation within the last 7 days and any treatment with Pentosan polysulfate sodium was completed more than seven days ago, accept.

See if Relevant

Autoimmune Disease
Chronic Fatigue Syndrome
Endoscopy
Infection -General
Surgery
Urinary Catheterisation

Additional Information

Interstitial Cystitis or Painful Bladder Syndrome is a condition which causes chronic or recurrent pain in the bladder and in the pelvic region due to damaged bladder lining or urothelium.

The cause is unknown but may be associated with other conditions such as Irritable Bowel Syndrome, Fibromyalgia, Chronic Fatigue Syndrome, Autoimmune Disease and Anxiety Disorder
It may also be caused by traumatic injury to the bladder and precipitated by infection.

The diagnosis of IC or PBS is one of exclusion.

Treatment can be through diet modification, bladder training techniques, exercise and stress management. It can include oral medication with analgesics, antidepressants, and Cimetidine. Treatment can also be with Pentosan polysulfate sodium (Elmiron) which can be associated with increased bleeding and bruising. The condition can also be treated by interventional methods including catheterisation, surgery and botulinum toxin injections.
Investigation and treatment can involve cystoscopy. Use of neuromodulation techniques with a transcutaneous electrical nerve stimulation (TENS) machine does not prevent donation.

Update Information

This entry was last updated in:
DSG-WB Edition 203, Release 61.

Reason for change

Obligatory and discretionary guidance has been added for Infection, including for donors taking antibiotics to prevent urinary tract infection. Relevant links have been included.
For Interstitial Cystitis, Obligatory and Discretionary have been amended to avoid repetition, the relevant links have been updated, and reference to the use of cystoscopy has been added to Additional Information.

See if Relevant

Indwelling Shunts and Stents and Implanted Devices 

Reason for change

Obligatory and discretionary guidance has been added for Infection, including for donors taking antibiotics to prevent urinary tract infection. Relevant links have been included.
For Interstitial Cystitis, Obligatory and Discretionary have been amended to avoid repetition, the relevant links have been updated, and reference to the use of cystoscopy has been added to Additional Information.

Donor Information

If you wish to obtain more information regarding a personal medical issue please contact your National Help Line.

Please do not contact this web site for personal medical queries, as we are not in a position to provide individual answers.

Update Information

This entry was last updated in:
DSG-WB Edition 203, Release 61.