OBJECTIVES: The aim of this study was to characterize Brazilian-specific immunosuppressant (IS) treatment patterns among kidney transplant patients. METHODS: Non-interventional, multicenter, medical chart review of patients undergoing kidney transplant. Five year follow-up data on IS medication use from adult (≥ 18 years old at time of transplantation), single kidney only transplants from Jan/2004 to Jan/2005 were collected from 7 transplant center in Brazilian hospitals. Patients  were censored on graft loss or loss of follow-up. RESULTS: Data on 498 patients were included; 51.2% were female, the , average age was 38.9±13.9 years, and 55.4% was recipients of kidneys from deceased donors.  Of the 498 patients, 61.2% were treated with tacrolimus (TAC)-based IS regimens as the initial calcineurin inhibitor (CNI), while 38.8% were treated with cyclosporine (CyC). CNI switching  from TAC to CyC occurred in 4.6%, versus 5.6% that switched from CyC to TAC. There was a decreasing trend in average CNI dose by year: at the end of the first year, the mean dose of TAC was 9.3±5.4 mg/day and 282.1±118.3 mg/day for CYC, decreasing to 5.2±3.6 and 158.7±57.8 mg/day in the third year, and 4.8±7.3 and 144.2±58.4 mg/day in the fifth year. At the end of the first (n=455) and second year (n=408) post-transplant, the most common IS regimens were TAC/prednisone/mycophenolate mophetil (MMF) (19.1% in both years), TAC/prednisone/azathioprine (15.6% at first year and 14.7% at second year) and CyC/prednisone/azathioprine (13.2% at first year and 14.0% at second year). By the end of the fifth year (n=141), however, the most common IS regimen was TAC/prednisone/mycophenolate sodium (MFS; 31.9%), followed by CyC/prednisone/MFS (7.8%) and TAC/prednisone/MMF (7.1%). CONCLUSIONS: Tacrolimus was the CNI of choice for the majority of de novo kidney transplant patients in 2004. The main IS therapy regimens during the first post-transplant years was tacrolimus/prednisone/mycophenolate mophetil.