Glucose-6-phosphatase was tested histochemically as a gluconeogenesis marker of ischemia-reperfusion injury of proximal tubular cells in human renal transplants. Histochemical enzyme activity, histology and transplantation conditions (preservation solution, cold and warm ischemia time, donor age), were compared to renal transplant evolution. Neither histology nor transplantation conditions were correlated with renal transplant evolution. Only glucose-6-phosphatase activity was significantly correlated with transplant evolution and could be used as a more sensitive marker than histology for the detection of ischemia-reperfusion injury of proximal tubules.