Kidney transplantation is currently the best treatment for end-stage renal disease, but many kidney patients will have some problems after kidney transplantation, such as elevated blood creatinine (common cause of elevated blood creatinine after kidney transplantation). Some kidney patients will have abnormal urine test, such as proteinuria and hematuria. At this time, patients will be very nervous, because many kidney patients cause uremia is also proteinuria, hematuria, they will worry whether proteinuria, hematuria after kidney transplantation will cause uremia, causing the failure of transplanted kidney. This worry is understandable, but do not be overly anxious, there are many causes of proteinuria and hematuria after kidney transplantation, including the following: chronic rejection after kidney transplantation, especially chronic humoral rejection, recurrence of nephropathy in the transplanted kidney, new glomerulonephritis in the transplanted kidney, and kidney damage caused by hepatitis. The difference between surgical hematuria and medical hematuria is that surgical hematuria is a homogeneous hematuria. Internal hematuria has a polymorphic hematuria sediment. Surgical hematuria is noted to exclude original renal, ureteral and bladder tumors and inflammation. Inflammation and tumors of the transplanted kidney and transplanted ureter, as well as prostate (male) and urethra problems also need to be ruled out. If the hematuria is medical in nature, a recurrent or new onset of nephritis needs to be considered. The best way to diagnose the cause of proteinuria and hematuria is to perform a biopsy of the transplanted kidney. A biopsy of the transplanted kidney and pathological examination can clarify the cause and guide the treatment plan. If it is a relapse of transplanted kidney nephropathy, the most common is IgA nephropathy, followed by focal segmental sclerosis, membrane nephropathy, membrane proliferative nephritis, and some systemic diseases can also relapse, such as systemic lupus erythematosus, vasculitis, purpura nephritis, anti-GBM nephritis, etc. The clinical manifestations of these disease relapses are consistent with the original disease, but the clinical manifestations and pathological changes will be lighter, because kidney transplant patients are taking immunosuppressants, these immunosuppressants can inhibit the development of these diseases, so even if the kidney disease relapses, the impact on the transplanted kidney will be less, kidney patients do not need to worry too much, unless some relapsed nephritis manifests as a large amount of hematuria, proteinuria, elevated blood creatinine. These people often need to be hospitalized for active treatment to stop the disease progression. Most relapsing nephritis can be controlled with treatment, but only a very few types of relapsing nephropathy are difficult to control. There are also some renal patients who present with proteinuria, the cause of which is chronic rejection, especially chronic humoral rejection. These rejection reactions can cause glomerular damage, resulting in proteinuria, and the main cause of the damage is the production of PRA in the body, which causes transplant kidney damage against the transplanted kidney. The significance of group reactive antibody (PRA) testing in blood after kidney transplantation, these conditions require adjustment of immunosuppression and treatment with some specific drugs. Does everyone who develops proteinuria and hematuria need to have a transplant kidney biopsy? If the 24-hour protein quantification is below 0.8g, the RBC in blood and urine is below 500,000, and the blood creatinine is normal, you can take medication according to your experience and observe for 1-3 months, and if the proteinuria and hematuria improve, these conditions can continue to be observed. However, if there is no improvement after taking medication, a transplanted kidney biopsy must be performed to clarify the diagnosis and guide the treatment according to the situation. In addition, some people worry that proteinuria and hematuria after kidney transplantation may cause the transplanted kidney to lose its function soon and return to dialysis if it is not treated well. This worry is superfluous, as already mentioned, due to the use of immunosuppressive drugs, the clinical and pathological manifestations of proteinuria and hematuria after kidney transplantation are mild and the prognosis is relatively good, therefore, it will not lead to transplant kidney failure soon, unless the condition is serious and will threaten more. With correct diagnosis and timely treatment, the transplanted kidney can continue to work normally and obtain a better quality of life, or in the case of severe disease, active treatment is required. Proteinuria and hematuria may not always turn completely negative after treatment, while a small amount of long-term proteinuria and hematuria will not have much effect on the long-term survival of the transplanted kidney, and do not force the indexes to turn negative for sure. Therefore, if proteinuria and hematuria appear in kidney transplant recipients after surgery, do not be alarmed and overly worried, actively cope with them, promptly diagnose and adjust the treatment, the vast majority of them can be better controlled. For some serious and complicated cases, it is necessary to go to a hospital with better conditions to perform transplant kidney biopsy in time to make a clear diagnosis and timely treatment, so as not to miss the best time for treatment.