*Purpose: High estimated glomerular filtration rate (eGFR) as well as low eGFR is associated with cardiovascular morbidity and mortality. The transplanted kidney in the recipient is exposed to hyperfiltration-mediated injury. Such nonimmunological injuries as well as immunological injuries further accelerate poor graft outcome in transplant recipients. The present study examined whether the high eGFR levels of post-transplantation at the first year is an important risk factor for long-term graft survival of kidney transplantation (KT) patients.

*Methods: We included 1,692 adult recipients who underwent KT in single center with more than one-year follow-up period. The level of serum creatinine was obtained throughout study period. Covariates in cox-regression model included dialysis duration before KT, recipient age and sex, related status, acute rejection status, diabetes status, and GFR at 1 year after KT. Participants were divided into four groups according to their eGFR level (60∼75, 76∼90, 91∼105 and 106∼maximum mL/min/1.73 m²). The participants who had eGFR less than 60 mL/min/1.73 m² were excluded.

*Results: Graft survival rate estimated by Kaplan-Meier estimator was significantly lower in the participants who had eGFR more than 106~maximum mL/min/1.73 m² (log-rank test p=.016). The multivariable Cox regression adjusting covariates including recipient age and sex, related status, acute rejection status and diabetes status, showed that the highest GFR group had the significant association with higher graft failure (HR=1.629, p=.014).

*Conclusions: Our data support that the higher eGFR at 1 year after KT is associated with poor outcome for long-term kidney graft survival in KT recipients.

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