Fig. 1

The serum levels of creatinine (Cr) and proteinuria after renal transplantation. The dosages of mycophenolate mofetil (MMF), prednisolone (PSL), and tacrolimus (TAC) are indicated by bars. Trough blood concentration of tacrolimus (TAC) is indicated by a line graph. After transplantation, his serum Cr level was maintained at 1.2 to 1.5 mg/dl and proteinuria and hematuria were negative. The first protocol biopsy was performed 1 year after the transplant when his serum Cr level was maintained at 1.3 to 1.4 mg/dl and neither proteinuria nor hematuria was detected. From the second year after transplantation, transient hematuria and proteinuria started to be detected, and at POY 1.6, urinary abnormality became constant. When the second protocol biopsy was performed at POY 3, his serum Cr was maintained at 1.3 to 1.4 mg/dl, but proteinuria around 150 mg/gCr and hematuria 1+ with dysmorphic red blood cells were observed. His serum Cr increased gradually to around 1.5 to 1.6 mg/dl, and when an episode biopsy was performed after a herpes zoster virus infection in post-operative year 4, the serum Cr had elevated rapidly to 2.0 mg/dl. Proteinuria was around 400 mg/gCr and hematuria was 3+