ORIGINAL RESEARCH article
Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1675844
Construction and validation of a risk prediction model for hyperamylasemia after kidney transplantation
Provisionally accepted
- The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Kidney transplantation (KT) is the preferred treatment for patients with end-stage renal disease (ESRD); however, postoperative hyperamylasemia (HA) remains common and has been associated with acute rejection (AR), infection, and impaired graft function. Early identification of HA risk factors is essential to improve outcomes of kidney transplant recipients (KTR). This study aimed to develop and internally validate a novel nomogram for predicting the risk of HA after KT, thereby supporting personalized monitoring, prevention and intervention strategies. Methods: We retrospectively analyzed KTR treated at the Transplant Medicine Institution of the Second Affiliated Hospital of Guangxi Medical University from July 2021 to June 2022. Based on admission dates, patients were assigned to a training cohort (n=243, July 2021 to March 2022) and a validation cohort (n=107, April 2022 to June 2022). In the training cohort, risk factors of HA were identified using logistic regression, Lasso regression and clinical consideration. Subsequently, a nomogram was developed to predict HA risk in patients who underwent KT based on the identified variables. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results: A total of 350 KTR and their corresponding 182 donors were enrolled in this study. The nomogram incorporated six predictive factors: recipient preoperative white blood cell (WBC) count, induction, tacrolimus (FK506) trough concentration, AR, donor age, and donor total bilirubin (TBIL) level according to results of logistic regression, Lasso regression and clinical consideration. The nomogram showed moderate predictive performance, with an area under the ROC curve (AUC) of 0.730 (Youden index = 0.683) in the training cohort and 0.731 (Youden index = 0.767) in the validation cohort. Furthermore, calibration plots indicated close agreement between predicted and actual outcomes, and DCA confirmed net clinical benefit across a range of threshold probabilities. Conclusions: A novel nomogram was established to predict HA after KT, which may support early risk stratification and personalized management of KTRs. External multicenter validation is needed before clinical implementation.
Keywords: Kidney Transplantation, Hyperamylasemia, nomogram, Internal validation, prediction
Received: 29 Jul 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Li, Du, Dang, Li, Ma, Wen, Wen, Dong and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuyong Sun, sunxuyong@gxmu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.