The 64-year-old patient was diagnosed with end-stage renal disease (ESRD) due to type 2 diabetes in February 2001 and initiated hemodialysis treatment. In September 2013, the patient underwent a kidney transplant from a deceased donor with a 6/6 human leukocyte antigen (HLA) match. Six years post-transplant, in June 2019, the patient was hospitalized with pneumonia and septicemia. Laboratory tests showed impaired kidney function (BUN 79.9 mg/dl, creatinine 3.18 mg/dl, FENa 0.82%) with positive blood culture for Coagulase-negative Staphylococcus. Due to the patient's unstable condition, a kidney biopsy was not performed and peritoneal dialysis was initiated concurrently with treatment (June 2019). Even after recovery, the patient's creatinine level remained elevated at 3.9 mg/dl, and urine output was consistently below 500 cc per day. We considered the possibility of acute kidney injury (AKI) and continued immunosuppressive therapy while closely monitoring the patient with peritoneal dialysis. Starting seven months after peritoneal dialysis, we gradually reduced the frequency of dialysis sessions to assess renal function recovery. Four months after discontinuing peritoneal dialysis, the patient's creatinine level decreased to 1.9 mg/dl. Subsequently, the patient maintained creatinine levels between 1.6 and 1.9 mg/dl without the need for dialysis. In December 2022, nine years post-transplant, the patient presented with generalized edema. Laboratory tests indicated renal dysfunction (creatinine 3.29 mg/dl, BUN 50.1 mg/dl, FENa 0.82%), and 24-hour urine volume was less than 400 cc. Despite previous severe renal insufficiency, graft kidney biopsy revealed no significant damage to glomeruli or tubules but showed inflammation in the glomerular vascular compartment and arteriolar hyaloinosis (Banff score: cv2, ah2, aah2). The patient underwent coronary angiography and received stent placement in the RCA. Diuretics were administered to manage edema, and renal function stabilized at 1.67 mg/dl one week after the procedure.