We performed a retrospective study to identify the risk factors for cytomegalovirus (CMV) disease among 570 renal transplant recipients. By means of a multivariate analysis we identified antilymphocyte antibody therapy (odds ratio [OR]: 4.6; 95% confidence interval [CI]: 2.0 to 10.6), high doses of corticosteroids (OR: 3.4; 95% CI: 1.2 to 10.1), and double renal transplant (OR: 4.1; 95% CI: 1.5 to 11.5). To the best of our knowledge, this is the first study to suggest that in addition to other well-known risk factors for CMV disease (ie, therapy with anti-lymphocyte antibodies or high doses of corticosteroids), the use of double renal transplantation appears to increase the risk of CMV disease in this population. © 2005 by Elsevier Inc. All rights reserved.