OBJECTIVES: Little data is available describing the relationship between quality of life and  levels of kidney function in renal transplant patients. We sought to assess the relationship between health utility and renal impairment in US and UK kidney transplant (KTX) recipients. METHODS: Data was obtained from KTX patients enrolled at the kidney transplant facilities of the Renal Unit at the Cardiff and Wales NHS Trust in Cardiff, UK (n=209) and Saint Louis University Hospital, St. Louis, MO (n=233). General linear models were used to estimate adjusted EQ-5D means across CKD stages (K/DOQI classification).  Partial Spearman’s correlation was used to evaluate trend across CKD classes. We adjusted all models for age, gender, time since transplant and diagnosis of diabetes. We adjusted for center effect by including the variable indicating the center of enrollment and the appropriate interaction term in the model. RESULTS: Mean age of KTX recipients was 52.7 and 49.1 years and mean time since transplant was 5.6 and 3.3 years in the UK and US cohorts respectively.  After adjustment, EQ-5D scores resulted as follows in UK and US samples  respectively: CKD 1-2, 0.74 and 0.87; CKD 3, 0.69 and 0.88 , CKD 4, 0.61 and 0.82; CKD 5, 0.39 and 0.79. The trend across CKD classes was statistically significant in both samples (UK: ρ= -0.24, p<0.01;  US: ρ= -0.19, p=0.03). Center effect was statistically significant and mainly explained by inclusion of recipients with failed graft on dialysis in the UK sample. CONCLUSIONS: This study demonstrates a significant and independent relationship between levels of post transplant renal impairment and health utility.  Management strategies that maximize post transplant renal function will have important implications for patients’ quality of life.