Objective To explore the value of urine retinol-binding protein 4 (RBP4)detected by colloidal gold immunochromatography assay in evaluating the renal dysfunction state in kidney transplant patients. Methods A total of 141 kidney transplant patients followed-up by our urology center were included in this study. The RBP4 levels in the urine of the participants were measured by both enzyme-linked immunosorbent assay (ELISA) and colloidal gold immunochromatography assay. The consistency of the two methods was evaluated by kappa test. The patients were divided into three groups according to the results of colloidal gold immunochromatography assay, in which dark red, light red and colorless representing the low, medium and high levels of RBP4, respectively. The relationship between patient clinical manifestations and RBP4 results was analyzed. Results The two methods of ELISA and colloidal gold immunochromatography assay showed high consistency in detecting RBP4 concentration in the urine of kidney transplant patients (kappa=0.813, 95%CI: 0.763-0.933). According to the results of colloidal gold immunochromatography assay, the low, medium and high levels RBP4 groups had significantly different fasting glucose (P=0.028), serum creatinine (P=0.021), blood urea nitrogen (P=0.012), albumin (P=0.014), hemoglobin (P=0.026) and proteinuria (P=0.015). Conclusion Colloidal gold immunochromatography assay detecting urine retinol binding protein 4 can achieve semi-quantitative results via reaction color of the strip. It is reliable, sensitive and easy to perform, making it easy for the early diagnosis of renal tubular injury after kidney transplantation during follow-up.