*Purpose: Although early survival after liver transplantation (LT) has improved, late complications such as renal dysfunction have been discussed as a problem. Here, we have investigated the effect of acute kidney injury (AKI) and chronic kidney disease (CKD) on long-term complications after LT.

*Methods: This study included 150 patients who underwent LT in our department between April 2008 and April 2018. We analyzed the relationship between AKI after LT and the relationship between AKI and CKD after LT. AKI 1 and AKI 2 were characterized by an increase in the serum creatinine level of 0.5 and 1.0 mg/dL, respectively, within one week after LT. CKD is defined as renal impairment (kidney morphology, pathology, imaging, blood or urine composition abnormalities) persisting for >3 months with or without eGFR decrease, and/or eGFR<60 ml/min·1.73 m2 for >3 months with or without renal impairment.

*Results: There were 28 cases in the AKI1 group, 21 cases in the AKI2 group and 101 cases in the Non-AKI group and there was no significant difference in patient background. Although there were no significant differences among the three groups in terms of surgical factors, postoperative infections, and the rate of acute rejection, long-term eGFR values ​​were significantly lower in AKI cases (p < 0.005), and prolonged renal dysfunction was observed. The long-term survival was significantly worse in the AKI2 group compared with the Non-AKI group (p = 0.040). Regarding the relationship between AKI1 and CKD, there were significant differences in age, MELD score, and Hepatitis C (p = 0.029, p = 0.002, p = 0.018), and postoperative diabetes and hypertension were associated with the development of CKD (p = 0.049, p = 0.004). There was no significant difference in the patient background regarding the relationship between AKI2 and CKD, but postoperative hyperlipidemia and hypertension were associated with the onset of CKD (p = 0.007, p = 0.038).

*Conclusions: Postoperative diabetes, hypertension, and hyperlipidemia could be involved in the development of CKD. The blood pressure, blood glucose, and serum lipid should be managed shortly after LT.

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