*Purpose: In kidney transplant recipients, eGFR at 1 year post-transplant has been shown to be associated with graft loss, but it is unclear if this is modified by the occurrence of DGF. We aimed to compare the association of eGFR at 1 year post-transplant with graft loss in recipients who did and did not develop DGF.

*Methods: Using SRTR data, we conducted a mate kidney analysis (where a recipient developed DGF and the recipient of the mate kidney from the same donor did not develop DGF) among 13,295 pairs (n=26,590) of adult kidney-only transplant recipients who were transplanted between 2000-13 and were alive with a functioning graft at 1 year post-transplant. Using Cox multivariable models, we determined the association of eGFR at 1 year with all-cause graft loss (ACGL) after adjusting for recipient age, race, BMI, ESRD cause, prior transplant, HLA mismatch, peak PRA, pre-transplant dialysis exposure, and insurance status.

*Results: Figure 1 plots the unadjusted hazard ratio for ACGL as a function of eGFR at 1 year in recipients with and without DGF, and shows a consistent association of eGFR at 1 year with graft loss irrespective of DGF status (p=0.57). As illustrated in Table 1, eGFR less than 60 ml/min at 1 year in adjusted models was associated with an increased risk of graft loss in recipients with and without DGF, with a greater than 2-fold higher risk of graft loss with an eGFR less than 30 ml/min.

*Conclusions: In a mate kidney analysis, where all donor characteristics were fully accounted for, the association of eGFR at 1 year with graft survival was not modified by the occurrence of DGF, suggesting that eGFR at 1 year may be an important marker of graft survival irrespective of DGF status.

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