Renal transplantation is the first-line therapy for eligible patients with end-stage kidney disease. However, approximately 20 % of cadaveric graft recipients need to start dialysis at 5 years. The transition period between transplantation and dialysis is at high risk of complications, but data exploring this issue are scarce. In this retrospective study from dialysis centres of the Canton de Vaud, we analysed the clinical data and management of these patients at the beginning of dialysis after graft loss, and up to one year after dialysis start. Our data show that such patients suffer from a high rate of complications, such as urgent start of dialysis, hospitalizations, severe hypertension and depression. We suggest that clinical management in this period should be revisited.