The utility of amylase and lipase as reliable predictive markers for functioning renal graft

The aim of this study was to evaluate the utility of amylase and lipase as reliable predictive markers for functioning renal grafts, either short- or long-term.

Serum amylase (Amyl), lipase, creatinine (Cr), creatinine clearance (Cr Cl) and 24-hr proteinuria (Prot) were studied in 190 kidney recipients. The correlation of these outcomes for each parameter was tested. Sensitivity and specificity of the variables were obtained in patients with graft failure (GF) and acute cellular rejection (ACR).

Mean follow-up was 66.7 month. Amyl and lipase were elevated 67% vs. 45% in GF (N=23); 60% vs. 44% in ACR (N=42) patients and were inversely correlated with Cr Cl (p>.05). Lipase was notably superior to amylase and creatinine; the specificity of lipase (Amyl, Cr) was 87% (59%, 28%). Increases in amylase were more predictive in the presence of mild or moderate kidney failure (33% and 52%, respectively). However, the highest intensity of lipase elevation (39%) was in advanced kidney failure (Cr Cl <30 ml/min).

Serum amylase and lipase should be used as markers monitoring graft function. For early detection of graft dysfunction, amylase seems to be superior to lipase.