C-reactive protein (CRP) is a reliable marker of inflammation in renal transplant recipients. We analyzed the predictive value of posttransplant CRP surges on renal allograft survival. Totaly, 141 ESRD patients (115 men and 26 women; age, 29.3+/-9.4 years, ESRD duration = 18.9±19.9 months; 27 cadaveric and 114 living donation) who underwent renal transplantation included. The demographic, clinical, and laboratory data were recorded. Recipients were assigned to three 3 groups regarding 5-year serum CRP surges: group N = normal serum CRP concentrations group IH: intermittently high serum CRP concentrations group CH: consistently high serum CRP concentrations (n=9). In recipients with normal, intermittently high, and consistently high CRP concentrations, allograft survival rates were 90.0%, 72.6%, and 11.1% respectively (P<.0001). Acute rejection (P=.004; OR:1.701; CI:1.188-2.434), advanced age of the recipient (P=.04; OR: 1.041; CI: 1.002-1.081), and consistently high serum CRP concentrations (P<.0001; OR: 14.973; CI: 4.029-55.646) were associated with a high risk of renal allograft loss. Consistently high serum CRP concentrations have a high predictive value for renal allograft survival. Efforts may be necessary to manage inflammation and therefore prolong renal allograft survival.