Recurrence of primary IgA nephropathy after renal transplantation is clearly a time-dependent event, justifying the use of Kaplan-Meier and Cox regression analyses to sort the significant risk factors. In this retrospective study, we focused on the potential role of induction immunosuppressive therapy. We studied 116 renal transplantation (84 males, 112 cadaveric donors, 95 first grafts, mean age at Tx=46.1 years) who received, as induction, antithymocyte globulin (ATG) in 29, anti-CD25 in 35, and none in 52, associated with different maintenance therapy overtime. The 10-year cumulative recurrence rate was overall 36%, but only 9% after ATG induction when compared with 41% without induction (P=0.001). Multivariate Cox regression confirmed that ATG was protective with a 80% reduction in relative risk (P=0.01). In conclusion, this important finding needs to be confirmed in a prospective trial and if so will have major implication.