Panel reactive antibody (PRA) monitoring is essential in kidney transplant candidates to assess immunologic risk and guide transplant strategy. Despite its importance, there is no established guideline on how frequently PRA should be measured according to sensitization status. This study aims to analyze PRA kinetics in real-world data and propose stratified monitoring intervals based on sensitization risk. We retrospectively analyzed 147 kidney transplant candidates who underwent at least two PRA tests at Jeonbuk National University Hospital (JBUH) from 2013 to 2024. Patients were classified into 3 groups based on initial PRA levels: Group 1 (Class I and II = 0%), Group 2 (any PRA <80%), Group 3 (any PRA ≥80%). Statistical analysis included Mann-Whitney U test and logistic regression. Group sizes were: Group 1 (n=83), Group 2 (n=54), Group 3 (n=10). Mean PRA follow-up intervals were 70.4, 65.5, and 57.9 months in Groups 1, 2, and 3, respectively. Despite overall infrequent monitoring, the relative trend showed that sensitized patients were monitored slightly more frequently, suggesting clinician awareness but lack of standardization. Group 2 showed the highest increase in PRA (ΔClass I: +10.4%, Class II: +11.0%), with a high sensitization rate of 39% (any ≥80%) and 9% (both ≥80%). Group 1 had minimal changes (6% and 1% high sensitization), and Group 3 remained sensitized. Prior transplantation was significantly associated with PRA Class I increase (p=0.0478) and high sensitization (OR=3.9, p=0.032) Although PRA monitoring was performed infrequently in real-world practice, our findings support more proactive follow-up in partially sensitized patients. We propose the following monitoring intervals: Group 1 (every 12–24 months), Group 2 (every 6–9 months), and Group 3 (case-specific evaluation focusing on antibody specificity rather than frequency).