Abstract: Objective: To explore the influence of serum creatinine level and creatinine reduction ratio in one month after kidney transplantation as predictors of long-term graft survival. Methods: The clinical data of 166 patients who received cadaveric renal transplantation were analyzed retrospectively.All patients were divided into different groups by their serum creatinine levels and creatinine reduction ratio in one month after transplantation.The long-term graft survival in 1,3,and 5 years after transplantation and the incidence of acute rejection and delayed graft function among different groups were observed. Results: There were no difference between cold and warm ischemia times,CDC and immunosuppressive therapy;there was significant difference between long-term graft survival,incidence of acute rejection and delayed graft function among different groups. Conclusion: Both serum creatinine levels and creatinine reduction ratio in one month after transplantation can be used to predict long-term graft survival.However,creatinine reduction ratio was more reliable in predicting graft survival.