The effect of pretransplantation dialysis treatment was examined retrospectively in 70 children less than 6 years old receiving a primary renal transplant at the University of Minnesota. Patient and graft survivals were compared at 1, 2 and 3 years and there were no significant differences between patients who received only hemodialysis (group 1), only peritoneal dialysis (group 2), or no prior dialysis (group 3). All patients received deliberate blood transfusions before transplantation and children at risk for recurrent diseases were excluded from the analyses. No grafts were lost due to perioperative thrombosis. Also, treatment with cyclosporine A did not significantly influence the outcomes. In this series, the choice to proceed directly to renal transplantation without an interposed interval of dialysis imposes no penalty in terms of patient or graft survival. Likewise, when dialysis was required, the dialysis mode selected exerted no clear effect on the outcome of transplantation.