In this study we aimed to determine whether the effects of early onset proteinuria after renal transplantation have an influence on long-term allograft survival. One hundred thirty patients (105 male, 25 female; mean age 29.6 +/- 9.6 years; 105 living-related, 25 cadaveric) were included. Proteinuria was defined as protein in urine was more than 300 mg/day at the third month after transplantation. Donor and recipient age at transplantation, pretransplant dialysis duration, donor status (living-related or cadaveric), presence of delayed graft function and acute rejection, panel reactive antibodies, number of human leucocyte antigen mismatches, and systolic blood pressure were retrospectively recorded. Cox regression analysis was used to estimate allograft survival. Patients with proteinuria showed significantly lower graft survival rates than did those without proteinuria (54.17% vs. 82.62%, P<.002). Proteinuria at the third month posttransplantation (P<.004; OR=3.26; CI, 1.46-7.29), donor age (>40 years; P<.001; OR=1.06; CI, 1.02-109), and panel reactive antibodies (>13%, P<.041; O=1.06; CI, 1.00-1.12) were significantly associated with decreased allograft survival. Early onset proteinuria after renal transplantation is indicative of a high risk for allograft dysfunction. A reduction of proteinuria may be associated with improved graft survival.