In addition to sub-clinical immunology mediated damage, non immunological factors may play an important role in development of chronic allograft dysfunction. In the setting of live related renal transplantation with good HLA matching the relative contribution of non immunological factors may be easier to analyse. A rejection free population of 50 live related renal transplant recipients who developed chronic allograft dysfunction defines as persistent elevation of serum creatinine exceeding 2mg/dl beyond one month post transplant were compared with well functioning grafts (serum creatnine ≤2mgdl) who were similarly rejection free and had comparable HLA matching. In a logistic regression model with donor age, donor sex, donor GFR, delayed graft function, early cyclosporine exposure, occurrence of urinary tract infection and cytomegalovirus as independent variables, female donors (female vs. male, OR=5.4, 95% CI=1.95–19.8) and high Cyclosporine AUC in first week (>6000 vs ≤6000 ng/ml, OR=6.2, 95% CI=1.6–24.1) was significantly associated with risk of chronic dysfunction. Though proteinuria and hypertension were highly prevalent in patients with dysfunctional grafts, cause and effect relationship was not possible to analyse. Highest cyclosporine exposure in early transplant period may lead to irreversible damage especially if kidney is from female donor.