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Chronic liver disease is one of the most common causes of premature death in Americans. My career goal is to improve the outcome of individuals with chronic liver disease by identifying the optimal means for diagnosis, monitoring, treatment and prevention. The path I have chosen to achieve this goal is through engagement in clinical epidemiology and patient-oriented, effectiveness research.Since the development of the MELD score which recognizes the importance of renal function in the prognosis of patients with end stage liver disease, one of the areas that we have had intense interest has been acute and chronic renal injury in patients undergoing liver transplantation. Liver transplantation represents a unique opportunity for research, because of the potential for reversal of the renal injury as well as access to biological materials.