Evaluation of Serum Amylase and Lipase Levels in Pediatric Kidney Transplant Recipients

Objective: Conventional markers such as serum creatinine and eGFR may lack sensitivity for detecting early graft dysfunction. Since pancreatic enzymes are primarily eliminated via the kidneys, this study aimed to evaluate serum amylase and lipase levels in pediatric kidney transplant recipients and investigate their relationship with graft function.Materials and Methods: This retrospective, dual-center study included 52 pediatric kidney transplant recipients (2011–2021) and 50 age- and sex-matched healthy controls. eGFR was calculated using the modified Schwartz formula. The correlation between pancreatic enzymes and clinical/laboratory variables was statistically analyzed.Results: Serum amylase and lipase levels were significantly higher in the transplant group compared to the control group (p < 0.05). A significant negative correlation was found between eGFR and both amylase (r = −0.689, p < 0.01) and lipase (r = −0.443, p < 0.01). After multivariable adjustment, eGFR was the only independent correlate of serum amylase (β = −1.16, p < 0.001), whereas body mass index was the only independent correlate of lipase (β = 1.56, p = 0.006). On ROC analysis, amylase discriminated transplant recipients from controls with an area under the curve of 0.90. Obesity, hypertension, and dyslipidemia were more prevalent among recipients but showed no independent association with enzyme levels. No significant correlation was observed between immunosuppressive therapy and enzyme levels.Conclusions: Elevated amylase primarily reflected reduced eGFR and thus graft function, whereas lipase reflected adiposity. Whether these enzymes add clinical value beyond conventional graft function markers remains to be determined in prospective longitudinal studies.