*Purpose: Kidney transplant recipients (KTR) suffer many complications and are hospitalized frequently. Specific reasons for hospital admission with detailed information are scarce.

*Methods: We retrieved data of 1.526 KTR from our transplant database monitored routinely at our center from 2009 to 2018. We analyzed indications/causes and frequency of hospitalizations.

*Results: Over the 10-year-period, we found a mean of 746±58 hospitalizations/year (Table 1), which are 47%-49% over the years of all KTR of our aftercare and, of which 47%-48% over years were hospitalized via the emergency department. We found a mean hospitalization rate of 0.71±0.09 per patient/year. Further analysis of KTR, with the longest available follow-up (82 cases in 2009 and 105 cases in 2010) demonstrated that the hospitalization rates (HR)/patient and year were highest in the first two years after transplantation (1.38-1.7 HR/patient) and declined thereafter (Figure 2). Within 3-4 years post-transplant, we had 0.48-0.7 HR/patient and we found low and stable HRs of 0.26-0.49/patient/year by the 4th year following kidney transplantation.. The difference of HR/patient within the first two years and the fifth to tenth year is significant with p=0.001 (2-tailed). In 2015 and 2016, KTRs had 362 and 349 different main diagnoses coded for admission. The most frequent reason for admission were acute kidney injury (AKI)/suspected rejection/rejection (2015: 26.43%, 2016: 29.73%), which are uniformly coded in our health care system, followed by infections (2015: 18.86%, 2016: 15.41 %), cardiac (2015: 7.36%, 2016: 6.59%) and gastroenterological complications (2015: 6.98%, 2016: 7.84%).

*Conclusions: KTR have a high rate of hospitalizations particularly within the first years after transplantation. Numerous reasons are leading to admission with main etiologies being AKI/suspected rejection/rejection, infections, and cardiac as well as gastroenterologic complications.

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