Zhang Yang, Xia Liubing, Luo You, Zhang Jinhua, Tang Zoufu, Chen Xiaorong, Na Ning
Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Organ Transplantation Research Institute, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Ren Fail. 2025 Dec;47(1):2529444. doi: 10.1080/0886022X.2025.2529444. Epub 2025 Jul 23.
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.
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.
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, = 0.005), preoperative serum amylase (OR = 1.01, 95% CI: 1.006 - 1.015, < 0.001), and high perioperative CNIs trough concentration (OR = 2.335, 95% CI: 1.560 - 3.494, < 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).
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.
在我们中心，数名肾移植受者（KTR）围手术期出现高淀粉酶血症。然而，目前尚无关于这一观察结果的发表报告。本研究旨在确定KTR围手术期高淀粉酶血症的相关危险因素。
回顾性分析了我院2020年1月至2023年12月期间540例尸体供肾受者的数据。收集了所有患者的性别、既往病史、相关实验室检查以及血清淀粉酶最高值时钙调神经磷酸酶抑制剂（CNI）的谷浓度等变量。采用单因素和多因素逻辑回归分析来确定围手术期高淀粉酶血症的相关危险因素。
在所有KTR中，153例患者（28.3%）发生围手术期高淀粉酶血症。多因素逻辑回归分析表明，术前血清磷酸盐（比值比[OR]=1.62，95%置信区间[CI]：1.160 - 2.266，P = 0.005）、术前血清淀粉酶（OR = 1.01，95%CI：1.006 - 1.015，P < 0.001）以及围手术期CNI高谷浓度（OR = 2.335，95%CI：1.560 - 3.494，P < 0.001）是围手术期高淀粉酶血症的危险因素。此外，我们将这三者作为一个混合模型来预测围手术期高淀粉酶血症，其显示出良好的预测价值（ROC曲线下面积[AUC]=0.687，95%CI：0.64 - 0.734）。
术前血清磷酸盐水平升高、术前血清淀粉酶水平升高以及围手术期CNI高谷浓度是围手术期高淀粉酶血症的危险因素。本研究可为临床医生识别围手术期高淀粉酶血症的病因并制定防治策略提供有价值的见解。
