What condition in a potential living kidney donor should be identified as a contraindication?

The identification of chronic kidney disease as a contraindication for living kidney donation is based on the fundamental principle that potential donors must have healthy kidney function. Chronic kidney disease indicates that a person’s kidneys are already compromised and not functioning optimally. This condition could increase the risk of further kidney deterioration after donation, exposing both the donor and the recipient to significant health risks. A living donor must possess two healthy kidneys because the remaining kidney assumes the complete responsibility for filtering blood after one is removed.

On the other hand, conditions such as hypertension or osteoarthritis can often be managed and may not preclude someone from donating a kidney, provided the severity is controlled and does not adversely affect overall health. Similarly, controlled diabetes may also be acceptable, assuming the individual maintains blood sugar levels within recommended limits and has no signs of kidney damage. Therefore, chronic kidney disease is the only condition listed that unequivocally limits a person's ability to donate a kidney safely.