{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:43:46Z","timestamp":1792478626133,"version":"4.5.0"},"reference-count":59,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":291,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) in liver transplant patients is associated with increased morbidity, mortality, and reduced graft survival. However, the impact of the timing of dialysis initiation\u2014before versus after transplantation\u2014remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize liver transplant recipients with Kidney Disease: Improving Global Outcomes (KDIGO) Stage 3 AKI\u2013requiring dialysis (AKI\u2010D) according to the timing of kidney replacement therapy (KRT) initiation (pre\u2010 versus posttransplant) and to evaluate 90\u2010day mortality. Secondary objectives included identifying independent predictors of dialysis dependence and assessing liver graft function at 90\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, single\u2010center cohort study included all consecutive adult liver transplant recipients who received dialysis in a Brazilian intensive care unit (ICU) between 1999 and 2015. The study was approved by the Research Ethics Committee of the Federal University of Sao Paulo (UNIFESP), with a waiver of informed consent. Patients were grouped according to the timing of dialysis initiation: pre\u2010 or postliver transplantation. Multiple logistic regression was used to identify predictors of 90\u2010day mortality and dialysis dependence. Ninety\u2010day liver graft survival was analyzed using a multivariate Cox model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 356 liver transplant patients with AKI\u2010D were included. Of these, 109 (30.6%) initiated dialysis within 4\u2009weeks before transplantation and 247 (69.4%) within 4\u2009weeks after transplantation. The timing of dialysis initiation was not associated with 90\u2010day mortality or dialysis dependence. Independent predictors of 90\u2010day mortality included graft dysfunction and use of continuous KRT as the initial modality. Impaired pretransplant renal function and a history of diabetes mellitus were predictors of 90\u2010day dialysis dependence. Posttransplant dialysis was associated with a twofold increased risk of liver graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The timing of dialysis initiation (pre\u2010 versus posttransplantation) was not associated with 90\u2010day mortality or dialysis dependence. However, initiation of dialysis after transplantation was associated with an increased risk of liver graft dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/joot\/6880648","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:36:26Z","timestamp":1792478186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beginning Kidney Replacement Therapy Before or After Liver Transplantation: Does the Timing of Dialysis Matter? 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