Background. Renal dysfunction is a severe complication associated with adverse outcomes after liver transplantation (LT). The aim of our study is to identify the incidence of acute renal injury (ARI) and its relationship to chronic kidney disease (CKD) for intermediate post-transplant periods in this patient population.

Methods. Between September 2005 and December 2012, we included 408 LT recipients in our study and excluded pediatric, retransplant, and multiorgan transplantation cases. A total of 302 patients whose pre-transplant estimated glomerular filtration rates (eGFRs) more than or equal to 60 mL/min/1.73m2 were finally analyzed. The study population was divided into two groups as the Non-ARI group (n=228, 75.5%) and the ARI group (n=74, 24.5%). After 19 patients censored, they were also divided into two groups as the Non-CKD group (n=207, 73.1%) and the CKD group (n=76, 26.9%).

Results. Pre-transplant hypertension (HTN), intraoperative oliguria, and intraoperative hypotensive episodes were significantly associated with the development of ARI during the first week after LT. Pre-transplant HTN, intraoperative oliguria, and high calcineurin inhibitor (CNI) trough levels at 1 week and 1 month post-transplant were significantly associated with the development of CKD after 3 months or more post-transplant. Unless the patients had not developed CKD, the presence of early ARI did not affect the renal function 3 months or more after transplantation.

Conclusions. Remarkable volumes of patients with pre-transplant normal renal function suffered from acute renal dysfunction after LT. Even in patients without ARI, high CNI trough levels were also a risk factor of CKD after transplantation.

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