Does the development of chronic kidney disease and acute kidney injury affect the prognosis after living donor liver transplantation?

Background and aims Chronic kidney disease ( CKD ) and acute kidney injury ( AKI ) have been discussed as complications following living donor liver transplantation ( LDLT ). The aim of this study was to clarify the relationships among CKD , AKI , and the prognosis after LDLT . Methods This study included 118 patients who underwent LDLT in our department. A low eGFR (<60 mL/min/1.73 m 2 ) was regarded to indicate CKD . 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 wk after LDLT . We investigated the risk factors for and the relevance of CKD and AKI on the prognosis. Results AKI 1 was associated with sepsis and intra‐operative bleeding (p = 0.0032, p = 0.001). AKI 2 was associated with sepsis and hepatitis C infection (p < 0.001, p = 0.027). A pre‐operative eGFR of 60–89 and diabetes were the risk factors for the development of CKD in POY 2 (p = 0.018, p = 0.002). AKI 2, sepsis, and diabetes were the risk factors for the patient death within one yr after LDLT (p = 0.010, p = 0.002, p = 0.022). AKI 2 and sepsis were the risk factors for death within two yr after LDLT (p = 0.005, p = 0.018). Conclusions Recognizing the risk factors and careful management for preventing both AKI and CKD may improve the prognosis of patients following LDLT .