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Pathogenesis and Negative Impact of Chronic Kidney Disease in Liver Transplant Recipients Chronic kidney disease (CKD) is a major comorbidity after liver transplantation, affecting up to 41.5% of recipients. CKD is defined by a reduction in glomerular filtration rate (GFR) to less than 60 ml/min/1.73 m for over three months or longer. It must be recognized that a small percentage of patients have CKD pre-transplant and meet the national UNOS criteria for simultaneous liver-kidney transplant