Transplant from solid nonrenal organ has experienced an important increase in the last decades. It is due to the increasing improvement of the results obtained with the above mentioned transplants. Parallel, many nonrenal transplanted patients have developed a chronic renal failure that has determined, in some cases, the need of beginning the substitution of renal function by means of dialysis and/or transplant. The origin of the same one is multifactorial and the consequences derived from it are very important so much in morbimortality as of economic nature for the set of the system. The present review tries to help to the identification of risk factors of renal insufficiency in the nonrenal transplanted patient and to determine which might be the basic concepts of prevention, early diagnosis and of derivation to the nephrologist expert in transplants and renal dysfunction. Finally, we check the possibilities of managing of the immunosuppressive treatment and substitution of renal function by means of dialysis and/or simple or double transplant.