Chronic allograft nephropathy (CAN) is a major problem after renal transplantation and chronic inflammation can be one of its promoters. C-reactive protein (CRP) is an important marker of inflammation and atherosclerosis. We retrospectively analyzed the predictive role of serum CRP levels on the development of CAN and graft failure. One hundred and twenty-five renal transplant patients were randomly included into the study. Serum CRP levels were measured at pre-transplant period, first month after transplantation and at yearly intervals throughout follow-up. CAN was diagnosed in 40.8% of patients and 82.4% of them had graft failure in 60.9 +/- 36.7 months. There was no difference at pre-transplant CRP levels of patients with and without CAN, but the first month CRP levels were higher in those who experienced CAN. The initial 3-yr mean CRP levels were higher, but not statistically different between the patients with and without CAN. The simultaneously detected CRP levels when CAN were diagnosed was significantly higher in those with CAN. High post-transplant CRP levels at the first month and at the diagnosis of CAN significantly influenced the allograft failure according to the regression analysis. CRP monitoring gives important information about the risk for CAN and graft failure. Therefore, CRP levels should be included in the follow-up data after renal transplantation.