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. 2025 Dec;47(1):2529444.
doi: 10.1080/0886022X.2025.2529444. Epub 2025 Jul 23.

Analysis of risk factors for perioperative hyperamylasemia in kidney transplant recipients

Yang Zhang  1   2 , Liubing Xia  1   2 , You Luo  1   2 , Jinhua Zhang  1   2 , Zoufu Tang  1   2 , Xiaorong Chen  1   2 , Ning Na  1   2
Affiliations

Analysis of risk factors for perioperative hyperamylasemia in kidney transplant recipients

Yang Zhang et al. Ren Fail. 2025 Dec.

Abstract

Background: Perioperative hyperamylasemia has been observed in several kidney transplant recipients (KTRs) at our center. However, there are currently no published reports on this observation. This study aimed to identify the risk factors associated with perioperative hyperamylasemia in KTRs.

Methods: The data from 540 deceased-donor kidney recipients in our hospital from January 2020 to December 2023 were retrospectively analyzed. Variables such as gender, past medical history, relevant laboratory tests, and trough concentration of calcineurin inhibitors (CNIs) at the time of serum amylase maximum were collected for all patients. Univariate and multivariate logistic regression analyses were used to determine the risk factors associated with perioperative hyperamylasemia.

Results: Among all KTRs, 153 patients (28.3%) developed perioperative hyperamylasemia. Multivariate logistic regression analysis indicated that preoperative serum phosphate (odds ratio [OR] = 1.62, 95% confidence interval [CI]: 1.160 - 2.266, p = 0.005), preoperative serum amylase (OR = 1.01, 95% CI: 1.006 - 1.015, p < 0.001), and high perioperative CNIs trough concentration (OR = 2.335, 95% CI: 1.560 - 3.494, p < 0.001) were risk factors associated with perioperative hyperamylasemia. In addition, we used all three as a hybrid model to predict perioperative hyperamylasemia, which demonstrated good predictive value (area under the ROC curve [AUC] = 0.687, 95% CI: 0.64-0.734).

Conclusion: Elevated preoperative serum phosphate levels, preoperative serum amylase levels, and high perioperative CNIs trough concentrations are risk factors for perioperative hyperamylasemia. This study may provide valuable insights for clinicians to identify the causes of perioperative hyperamylasemia and formulate prevention and treatment strategies.

Keywords: Renal transplantation; calcineurin inhibitors; hyperamylasemia; perioperative hyperamylasemia; phosphate.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1.
Figure 1.
Study design and cohort build-up.
Figure 2.
Figure 2.
ROC Curves for relevant indicators.
See this image and copyright information in PMC

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