We evaluated the influence of dialysis requiring acute tubular necrosis on patient survival, and kidney survival and function in all 182 patients who needed dialysis immediately after transplantation at the University of Minnesota Hospitals. When compared to matched control patients not requiring dialysis, there was no difference at any point in patient survival. At 1 month there were more kidneys lost in the patients who developed acute tubular necrosis, but this difference was not present at 3 months or later. Acute tubular necrosis is a relatively innocent complication of renal transplantation and, if one avoids assaulting patients with invasive diagnostic procedures, does not give rise to an increased mortality nor, in the long run, to an increased loss of kidneys. Therefore, kidneys should not be discarded because of fear they might develop this complication.