Guide for Aviation Medical Examiners

Decision Considerations – Aerospace Medical Dispositions
Item 41. G-U System – General Disorders

Common Conditions and Course of Action
Disease/Condition Class Evaluation Data Disposition
Congenital lesions of the kidney All Submit all pertinent medical information and status report If the applicant has an ectopic, horseshoe kidney, unilateral agenesis, hypoplastic, or dysplastic and is asymptomatic - Issue

Otherwise - Requires FAA Decision
Cystostomy and Neurogenic bladder All Requires evaluation, report must include etiology, clinical manifestation and treatment plan Requires FAA Decision
Renal Dialysis All Submit a current status report, all pertinent medical reports to include etiology, clinical manifestation, BUN, Ca, PO4,Creatinine, electrolytes, and treatment plan Requires FAA Decision
Renal Transplant All See Renal Transplant Protocol Requires FAA Decision
Chronic Kidney Disease (CKD) – All Classes
Disease/Condition Evaluation Data Disposition
A. eGFR 45 to 59 No symptoms or complications and the underlying cause is not disqualifying. ISSUE
Summarize this history in Block 60.
B. eGFR 35 to 44 See CACI worksheet.

Single kidney – DO NOT CACI

Follow the CACI – Chronic Kidney Disease Worksheet (PDF). Annotate Block 60.
C. eGFR 34 or less


Symptoms or complications with any eGFR

Proteinuria 2+ or higher or ACR is 300 or higher


Single kidney with eGFR 44 or less

Submit the following to the FAA review:

☐ Current status report from the treating physician. It should note if the condition is stable or if additional treatment or dialysis is recommended;

☐ List of medications and side effects, if any;

☐ Recent lab (within last 90 days):

  • Renal function studies(creatinine BUN and eGFR);
  • Albumin as dipstick or ACR; and
  • Hemoglobin and hematocrit

☐ Imaging reports (if performed by treating physician); and

☐ Assessment by treating physician if a cardiac evaluation is warranted


Submit the information to the FAA for a possible Special Issuance.

Followup Special Issuance – Will be per the airman's Authorization Letter

ESRD requiring dialysis or kidney transplant See the table above for more information. DEFER

Notes: eGFR is a calculated/estimated value. If additional testing shows the actual renal function is higher than the eGFR, this should be stated in the note from the treating physician.

ACR = albumin creatinine ratio

Last updated: Thursday, March 30, 2023