Predictors of late kidney dysfunction post-liver transplantation

Acute kidney injury (AKI) is common immediately after orthotopic liver transplantation (OLT), whereas chronic kidney disease (CKD) and end-stage renal disease (ESRD) increase in incidence with time. The cumulative risk of developing chronic renal failure post-OLT has been described to be approximately 8%, 14%, and 18% at 12, 36, and 60 months, respectively. Therefore identifying the risk factors for AKI or progressive CKD after OLT and developing strategies to either minimize the risks for AKI or retard the progression of CKD should be an integral part in the management of OLT recipients. Assessment of renal function pre- and post-OLT and an overview of the literature on the risk factors for early postoperative AKI and those affecting progressive CKD in long-term survivors are presented. Suggested therapeutic approaches to prevent, halt, or ameliorate renal dysfunction also are discussed.