*Purpose: Our goal was to examine the association of eGFR in the first year on long term outcomes following kidney transplant.

*Methods: The sample included kidney transplant patients (excluding multiple transplant) > 18 years who received a deceased donor kidney between 1/1/13 and 12/31/18 in the US. We assessed the association of eGFR at discharge, at 6 months and 12 months post-transplant on death censored allograft survival in 3 separate multivariable Cox models. All predictors were constant across models except eGFR. Variables were force entered sequentially by block (Patient, Donor, Transplant and eGFR).

*Results: Donor diabetes, hypertension, cold ischemia time, DR mismatch and DGF and discharge eGFR were all significant in the model of graft survival post-discharge. However, in the models of graft survival after 6 and 12 months, neither DGF nor the cold ischemia time remained significantly associated with death censored allograft failure; eGFR became the dominant predictor in the model (see table).

*Conclusions: Multivariable models that include eGFR at 6 or 12 months post-transplant demonstrate a lack of association between DGF & cold ischemia time and subsequent allograft failure. This suggests that the observed association between DGF & cold ischemia and graft failure is being driven by the early failures that occur within the first 6 months posttransplant, while proximal graft function is the best predictor of subsequent failure.

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