1
|
Shi C, Cao H, Zeng G, Yang L, Wang Y. The relationship between complete blood cell count-derived inflammatory biomarkers and benign prostatic hyperplasia in middle-aged and elderly individuals in the United States: Evidence from NHANES 2001-2008. PLoS One 2024; 19:e0306860. [PMID: 38980876 PMCID: PMC11233019 DOI: 10.1371/journal.pone.0306860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/25/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is a common health disorder of the male genitourinary system with a high prevalence, especially among middle-aged and older adults, which seriously affects men's quality of life. Inflammatory markers derived from complete blood cell count (CBC) have previously been considered a prognostic indicator for various diseases, but little is known about their relationship with BPH. This study evaluated the relationship between complete blood cell count (CBC)-derived inflammatory biomarkers and BPH. METHODS Data for this cross-sectional study were gathered from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2008. Using multiple logistic regressions, the study examined the association between benign prostatic hyperplasia(BPH) and Inflammatory biomarkers derived from blood cell counts such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Systemic Inflammatory Response Index (SIRI) and Systemic Immunoinflammatory Index (SII). RESULTS 3,919 participants were included, with a median age of 61.00 (52.00-71.00) years old. Among them, 609 participants had benign prostatic hyperplasia, with a prevalence of 15.54%. Upon accounting for confounding factors, the study revealed a positive correlation between the plurality of BPH PLR and SII. However, MLR, NLR, and SIRI did not significantly correlate with the prevalence of BPH (p>0.05). In contrast to the lowest quartile, higher quartiles of PLR (OR = 1.93[1.38-2.69]) and SII (OR = 1.71[1.22-2.40]) were linked to an elevated risk of BPH. Interaction tests showed that age, body mass index, hypertension, diabetes, smoking, and drinking had no significant effect on this positive correlation (p for interaction>0.05). In addition, we found a roughly linear association between SII, PLR, and BPH using smoothed curve fitting. CONCLUSIONS According to our research, high levels of PLR and SII are positively linked with an increased risk of BPH in middle-aged and elderly individuals in the United States. The results compensate for previous studies that still need to be validated with larger prospective cohorts.
Collapse
Affiliation(s)
- Chengdong Shi
- Department of Urology II, The First Hospital of Jilin University, Changchun, China
| | - Hongliang Cao
- Department of Urology II, The First Hospital of Jilin University, Changchun, China
| | - Guoqiang Zeng
- Department of Urology II, The First Hospital of Jilin University, Changchun, China
| | - Lei Yang
- Department of Urology II, The First Hospital of Jilin University, Changchun, China
| | - Yuantao Wang
- Department of Urology II, The First Hospital of Jilin University, Changchun, China
| |
Collapse
|
2
|
Bapir R, Fakhralddin SS, Aghaways I, Muhammed BO, Rahim HM, Fattah FH, Ismael BO, Ali RE, Hamahussein KF, Kakamad FH, Salih RQ, Mohammed SH, Abdalla BA. Predictive value of inflammatory markers for the spontaneous passage of Ureteral stones: a comprehensive systematic review with meta analysis. Urolithiasis 2024; 52:98. [PMID: 38907797 DOI: 10.1007/s00240-024-01590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/06/2024] [Indexed: 06/24/2024]
Abstract
Urolithiasis is a common disease that affects approximately one-fifth of the global population. This systematic review explores the predictive role of inflammatory markers for the spontaneous passage of ureteral stones. The literature was systematically searched via Google Scholar, PubMed/MEDLINE, the Cochrane Library, Science Direct, CINAHL, Web of Science, and EMBASE databases to identify papers published until 2023. Overall, 26 articles were identified, of which 10 were excluded. The remaining 16 papers reported 2,695 patients (1,723 males and 972 females), with 1,654 (61.37%) experiencing spontaneous stone passage (SSP) and 1,041 (38.63%) not experiencing it (non-SSP). Stones located in the upper part of the ureter were less likely to pass spontaneously (152/959, 15.94% in the SSP group vs. 180/546, 32.48% in the non-SSP group; p < 0.001). Mid-ureteral stones were present in 180/959 (18.75%) of the SSP group compared to 84/546 (14.52%) of the non-SSP group (p = 0.0974). Lower ureteral stones were more likely to pass spontaneously, with 627/959 (63.31%) in the SSP group compared to 282/546 (49.36%) in the non-SSP group (p < 0.001). No significant correlation was found between most inflammatory markers and SSP (p > 0.05). However, procalcitonin levels were lower in the SSP group compared to the non-SSP group (132.7 ± 28.1 vs. 207 ± 145.1, respectively) (p < 0.001). This systematic review has revealed that except procalcitonin, most inflammatory markers do not offer significant predictive capability for ureteral SSP.
Collapse
Affiliation(s)
- Rawa Bapir
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, 46001, Iraq
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
- Kscien Organization for Scientific Research, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan, 46001, Iraq
| | - Saman S Fakhralddin
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, 46001, Iraq
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Bryar O Muhammed
- Scientific Affairs Department, Smart Health Tower/Raparin, Sarkapkan Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Hawbash M Rahim
- Kscien Organization for Scientific Research, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan, 46001, Iraq
- Medical Laboratory Science Department, College of Health Sciences, University of Human Development, Sulaymaniyah, Kurdistan Region, 46001, Iraq
| | - Fattah H Fattah
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Barzan O Ismael
- Scientific Affairs Department, Smart Health Tower/Raparin, Sarkapkan Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Rebaz E Ali
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Karokh F Hamahussein
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
| | - Fahmi Hussein Kakamad
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq.
- Doctors City, Building 11, Apartment 50, Sulaimani, Iraq.
| | - Rawezh Q Salih
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
- Kscien Organization for Scientific Research, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan, 46001, Iraq
- Biology Department, College of Science, University of Sulaimani, Kurdistan, 46001, Iraq
| | - Shvan H Mohammed
- Kscien Organization for Scientific Research, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan, 46001, Iraq
| | - Berun A Abdalla
- Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, 46001, Iraq
- Kscien Organization for Scientific Research, Hamdi Street, Azadi Mall, Sulaimani, Kurdistan, 46001, Iraq
| |
Collapse
|
3
|
Wang Z, Zhao G, Cao Y, Gu T, Yang Q. Association between monocyte to high-density lipoprotein cholesterol ratio and kidney stone: insights from NHANES. Front Endocrinol (Lausanne) 2024; 15:1374376. [PMID: 38894743 PMCID: PMC11183274 DOI: 10.3389/fendo.2024.1374376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Purpose The ratio of monocyte to high-density lipoprotein cholesterol (MHR) has surfaced as a novel biomarker indicative of inflammation and oxidative stress. The aim of our study was to evaluate the association between MHR and the risk of kidney stones. Methods This study analyzed data from individuals aged 20-79 who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The MHR was assessed as the exposure variable, while a self-reported history of kidney stones was used as the outcome variable. The independent relationship between MHR and the risk of kidney stones was thoroughly evaluated. Results This study included 28,878 participants, and as the quartile range of the MHR increased, the proportion of kidney stones also rose progressively (7.20% to 8.89% to 10.88% to 12.05%, P<0.001). After adjusting for confounding factors, MHR was independently associated with an increased risk of kidney stones (OR=1.31, 95%CI=1.11-1.54, P=0.001), also independent of some common inflammatory indices. Subgroup analysis suggested that the relationship between MHR and kidney stones was more pronounced in female and individuals aged 20-49. Further restricted cubic spline (RCS) analysis indicated a nonlinear relationship between MHR and the risk of kidney stones. Conclusion Our results indicate a positive correlation between MHR and an increased risk of kidney stones in US adults, underscoring the need for further large-scale prospective cohort studies to validate these findings.
Collapse
Affiliation(s)
- Zhaoxiang Wang
- Department of Endocrinology, First People’s Hospital of Kunshan, Kunshan, Jiangsu, China
| | - Guang Zhao
- Department of Emergency Medicine, First People’s Hospital of Kunshan, Kunshan, Jiangsu, China
| | - Yuanfei Cao
- Department of Urology, First People’s Hospital of Kunshan, Kunshan, Jiangsu, China
| | - Tian Gu
- Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China
- Department of Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Qichao Yang
- Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu, China
- Department of Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| |
Collapse
|
4
|
Mutlu H, Sert ET, Kokulu K, Kankılıç NA. Role of the systemic immune-inflammation index in predicting spontaneous stone passage in patients with renal colic. Postgrad Med 2024; 136:325-330. [PMID: 38669143 DOI: 10.1080/00325481.2024.2347198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/22/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Renal colic (RC) is one of the most frequent reasons for presentation to the emergency department (ED) and creates a high economic and medical burden. Management strategies for RC range from waiting for spontaneous passage to surgical intervention. However, factors determining spontaneous stone passage (SSP) are still poorly understood. Therefore, in this study, we aimed to investigate the role of the systemic immune-inflammatory index (SII) in predicting SSP. METHODS We retrospectively analyzed the data of 924 patients aged over 18 years, who were diagnosed with RC in our clinic between 1 January 2019, and 30 May 2022, and had ureteral stones of ≤ 10 mm. The patients were divided into two groups according to whether they had SSP. The clinical and laboratory characteristics of the patients in the ED were evaluated. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (neutrophil count x platelet count/lymphocyte count) values of the patients were calculated. Stone size and location were also recorded. RESULTS In the univariate analysis of SSP, a ureteral stone size of ≤ 5 mm (p < 0.001), distal ureteral location (p < 0.001), SII (p < 0.001), NLR (p < 0.001), and PLR (p = 0.036) were significantly correlated with SSP. ROC analysis showed that an SII level < 721.8 (Sensitivity %82.6, Specificity %74.7, p < 0.001) was an independent predictor of SSP. CONCLUSION Our findings showed that a low SII level was associated with SSP and could be used as a predictive marker of SSP as a more valuable parameter than NLR. SII and NLR, together with other indicators, are inflammatory markers that can be used in the clinical decision-making process for ureteral stone treatment.
Collapse
Affiliation(s)
- Hüseyin Mutlu
- Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey
| | - Ekrem Taha Sert
- Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey
| | - Kamil Kokulu
- Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey
| | | |
Collapse
|
5
|
Uzun E, Arabaci HB, Ceviz K, Koudonas A, Germiyanoglu RC, Senel S. Development of a new scoring system predicting medical expulsive therapy success on 4-10 mm distal ureteral stones: medical expulsive therapy stone score (METSS). Urolithiasis 2023; 52:8. [PMID: 38015235 DOI: 10.1007/s00240-023-01504-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/04/2023] [Indexed: 11/29/2023]
Abstract
Ureteral stone passage by using medical expulsive therapy (MET) are affected by numerous radiological and clinical parameters. We aimed to construct a scoring system, which would be based on clinical and computed tomography (CT)-derived data, to predict the success of the MET approach. 186 patients presenting to urology clinic or emergency department with unilateral single 4-10 mm distal ureteral stone and who had MET were included. All patients were divided into two groups as the MET-successful group and the MET-unsuccessful group. The success rate of MET was 67.2%. Stone size ≥ 6.5 mm, stone density > 1078 HU, ureteral wall thickness (UWT) > 2.31 mm, ureteral diameter (UD) > 9.24 mm, presence of periureteral stranding (PUS) and presence of diabetes mellitus (DM) were stated as the independent risk factors. Based on the regression coefficients on multivariate logistic regression analysis, 1 point for stone size > 6.5 mm, 2 points for stone density > 1078 HU, 2 points for UWT > 2.31 mm, 3 points for UD > 9.24 mm, 1 point for presence of PUS and 1 point for presence of DM were assigned to patients for each risk factor. Higher medical expulsive therapy stone score (METSS) indicated lower MET success. All patients were classified into three risk groups according to METSS: low risk (0-3 points; success percentage: 92.8%); intermediate risk (4-5 points; success percentage: 60.4%) and high risk (6-10 points; success percentage: 8.3%). The METSS seems to separate successfully the patients with a favorable or adverse constellation of factors.
Collapse
Affiliation(s)
- Emre Uzun
- Department of Urology, Ankara City Hospital, Üniversiteler Mahallesi, 1604. Cadde No: 9, Çankaya, Ankara, Turkey
| | - Hasan Batuhan Arabaci
- Department of Urology, Ankara City Hospital, Üniversiteler Mahallesi, 1604. Cadde No: 9, Çankaya, Ankara, Turkey
| | - Kazim Ceviz
- Department of Urology, Ankara City Hospital, Üniversiteler Mahallesi, 1604. Cadde No: 9, Çankaya, Ankara, Turkey
| | - Antonios Koudonas
- First Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Rustu Cankon Germiyanoglu
- Department of Urology, Ankara City Hospital, Üniversiteler Mahallesi, 1604. Cadde No: 9, Çankaya, Ankara, Turkey.
| | - Samet Senel
- Department of Urology, Ankara City Hospital, Üniversiteler Mahallesi, 1604. Cadde No: 9, Çankaya, Ankara, Turkey
| |
Collapse
|
6
|
Biomarkers in Urolithiasis. Urol Clin North Am 2023; 50:19-29. [DOI: 10.1016/j.ucl.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
7
|
Savin Z, Mintz I, Lifshitz K, Achiam L, Aviram G, Bar-Yosef Y, Yossepowitch O, Sofer M. The role of serum and urinary markers in predicting obstructing ureteral stones and reducing unjustified non-contrast computerized tomographic scans in emergency departments. Emerg Radiol 2023; 30:167-174. [PMID: 36680669 DOI: 10.1007/s10140-023-02114-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The reported yield of non-contrast computed tomography (NCCT) in assessing flank pain and obstructive urolithiasis (OU) in emergency departments (EDs) is only ~ 50%. We investigated the potential capability of serum and urinary markers to predict OU and improve the yield of NCCT in EDs. METHODS All consecutive ED patients with acute flank pain suggestive of OU and assessed by NCCT between December 2019 and February 2020 were enrolled. Serum white blood cells (WBC), C-reactive protein (CRP) and creatinine (Cr) levels, and urine dipstick results were analyzed for association with OU, and unjustified NCCT scan rates were calculated. RESULTS NCCTs diagnosed OU in 108 of the 200 study patients (54%). The median WBC, CRP, and Cr values were 9,100/µL, 4.3 mg/L, and 1 mg/dL, respectively. Using ROC curves, WBC = 10,000/µL and Cr = 0.95 mg/dl were the most accurate thresholds to predict OU. Only WBC ≥ 10,000/µL (OR = 3.7, 95% CI 1.6-8.3, p = 0.002) and Cr ≥ 0.95 mg/dl (OR = 5, 95% CI 2.3-11, p < 0.001) were associated with OU. Positive predictive value and specificity for detecting OU among patients with combined WBC ≥ 10,000 and Cr ≥ 0.95 were 83% and 89%, respectively. Patients negative to the serum markers criteria underwent significantly more unjustified NCCTs (p = 0.03). The negative predictive value of the serum criteria for justified NCCT scanning was 81%. CONCLUSIONS WBC and Cr may be valuable serum markers in predicting OU among patients presenting to EDs with acute flank pain. They may potentially reduce the number of unjustified NCCT scans in the ED setting.
Collapse
Affiliation(s)
- Ziv Savin
- Department of Urology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel.
| | - Ishai Mintz
- Department of Urology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel
| | - Karin Lifshitz
- Department of Urology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel
| | - Lauren Achiam
- Department of Emergency Medicine, Tel-Aviv Sourasky Medical Center, Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Galit Aviram
- Department of Radiology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yuval Bar-Yosef
- Department of Urology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel
| | - Ofer Yossepowitch
- Department of Urology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel
| | - Mario Sofer
- Department of Urology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel.,Department of Endourology Unit, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
8
|
Di X, Liu S, Xiang L, Jin X. Association between the systemic immune-inflammation index and kidney stone: A cross-sectional study of NHANES 2007-2018. Front Immunol 2023; 14:1116224. [PMID: 36895572 PMCID: PMC9989007 DOI: 10.3389/fimmu.2023.1116224] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/08/2023] [Indexed: 02/23/2023] Open
Abstract
Background The incidence rate of kidney stones increased over the past decades globally, which brought medical expenditure and social burden. The systemic immune-inflammatory index (SII) was initially identified as a prognosis of multiple diseases. We performed an updated analysis on the impact of SII on kidney stones. Methods This compensatory cross-sectional study enrolled participants from the National Health and Nutrition Examination Survey 2007-2018. Univariate and multivariate logistic regression analyses were performed to investigate the association between SII and kidney stones. Results Of the 22220 participants, the mean (SD) age was 49.45 ± 17.36 years old, with a 9.87% incidence rate of kidney stones. A fully adjusted model showed that SII higher than 330 x 109/L was parallel associated with kidney stones (Odds ratio [OR] = 1.282, 95% Confidence interval [CI] = 1.023 to 1.608, P = 0.034) in adults aged 20-50. However, no difference was found in the elderly subgroup. Multiple imputation analyses confirmed the robustness of our results. Conclusions Our findings suggested SII was positively associated with a high risk of kidney stones in US adults aged less than 50. The outcome compensated for previous studies that still needed more large-scale prospective cohorts for validation.
Collapse
Affiliation(s)
- Xingpeng Di
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shaozhuang Liu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Liyuan Xiang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xi Jin
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
9
|
Aghaways I, Ibrahim R, Bapir R, Salih RQ, Salih KM, Abdulla BA. The role of inflammatory serum markers and ureteral wall thickness on spontaneous passage of ureteral stone < 10 mm: A prospective cohort study. Ann Med Surg (Lond) 2022; 80:104198. [PMID: 36045783 PMCID: PMC9422225 DOI: 10.1016/j.amsu.2022.104198] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. There is a widespread discussion on the preferred initial treatment method, whether medical or surgical, and each has its pros and cons. In this study, we aimed to assess the role of both ureteral wall thickness around the stone and inflammatory markers in guiding the decision-making process. Methods In this prospective study, 161 patients who presented with ureteric colic and were diagnosed with ureteral stone with NCCT were included. UWT around the stone was measured, and the NLR and PLR were calculated. The patients were given a single daily dose of tamsulosin 0.4 mg for 4 weeks with weekly follow-up to determine SSP or failure. Results Of the 161 patients with a mean age 40.12 ± 12.36 SD, 55.9% had a spontaneous stone passage. Receiver operating characteristics showed a cut off value of 2.45 mm UWT of non SSP patients with an 83% sensitivity and 86% specificity. Moreover, there was a significant correlation between higher NLR, PLR and increased UWT (Pearson correlation of 0.314 and 0.426 respectively). The combined higher NLR, PLR and increased UWT were associated with failure of SSP (p-value <0.001). Conclusion Many factors play a role in decision making for management of ureteral stones. Our study concludes that patients with high NLR, PLR, and UWT around the stone have lesser chance of SSP using MET. Their rise can be used as predictors to decide early intervention. Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. Impacted ureteral stones occupy the majority of emergency department visits due to urolithiasis. The role of inflammatory serum markers and UWT around the stone on spontaneous passage are controversial.
Collapse
Affiliation(s)
- Ismaeel Aghaways
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
| | - Rebaz Ibrahim
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
| | - Rawa Bapir
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- U-merge Ltd. (Urology in Emerging Countries), London, UK
- Corresponding author. Doctor city, building 4, apartment 23, Sulaymaniyah, Iraq.
| | - Rawezh Q. Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq
| | - Karzan M. Salih
- Iraqi Board for Medical Specialties, Department of Surgery, Sulaymaniyah Center, Sulaymaniyah, Iraq
| | - Berwn A. Abdulla
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq
| |
Collapse
|
10
|
Senel C, Aykanat IC, Asfuroglu A, Keten T, Balci M, Aslan Y, Tuncel A. What is the role of inflammatory markers in predicting spontaneous ureteral stone passage? Aktuelle Urol 2022; 53:448-453. [PMID: 35008109 DOI: 10.1055/a-1703-3099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the role of inflammatory markers in predicting the spontaneous passage of ureteral stones. METHODS We retrospectively reviewed 279 patients with ureteral stones sized 4-10 mm that were managed conservatively. The patients were divided into two groups: Group 1 consisted of 137 patients who passed the stone spontaneously; Group 2 comprised 142 patients without spontaneous stone passage. The groups were compared using the Mann-Whitney U and chi-square tests. In addition, univariate and multivariate analyses were performed to identify the significance of the parameters. RESULTS The mean age of the patients was 41.2 years. The patients in Group 1 had a significantly lower mean stone size, white blood cell count and neutrophil count. In addition, stone location, presence of hydronephrosis and history of urolithiasis were significantly different between the groups. Neutrophil percentage, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were insignificantly lower in Group 1. In a multivariate analysis, stone size, distal location and hydronephrosis status significantly predicted the spontaneous stone passage. However, inflammatory markers including white blood cell count, neutrophil count and neutrophil-to-lymphocyte ratio could not determine the likelihood of spontaneous stone passage. CONCLUSION Our results suggest that inflammatory markers are no meaningful parameters for the prediction of spontaneous stone passage.
Collapse
Affiliation(s)
- Cagdas Senel
- Urology, Balikesir Universitesi, Balikesir, Turkey
| | | | | | - Tanju Keten
- Urology, Etimesgut State Hospital, Etimesgut, Turkey
| | - Melih Balci
- Urology, Etimesgut State Hospital, Etimesgut, Turkey
| | - Yilmaz Aslan
- Urology, Etimesgut State Hospital, Etimesgut, Turkey
| | - Altug Tuncel
- Urology, University of Health Sciences, School of Medicine, Ankara State Hospital, Ankara, Turkey
| |
Collapse
|
11
|
KARSLI O, ÜSTÜNER M, HALAT AÖ, ÖZCAN L, GOKALP F, KORAŞ Ö, VOYVODA B, MEMİK Ö. Do Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio Predict the Hardness of Kidney Stone. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2021. [DOI: 10.17944/mkutfd.873615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
12
|
Abou Heidar N, Labban M, Najdi J, Al Shami A, Nasrallah O, Nasr R. Spontaneous ureteral stone passage: a novel and comprehensive nomogram. Minerva Urol Nephrol 2021; 74:102-109. [PMID: 33439574 DOI: 10.23736/s2724-6051.20.04125-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ureteral stones pose a high economic and medical burden among Emergency Department (ED) admissions. Management strategies vary from expectant therapy to surgical interventions. Since predictors of ureteral spontaneous stone passage (SSP) are still not well understood, we sought to create a novel nomogram to guide management decisions. METHODS Charts were retrospectively reviewed for patients who presented to our institution's ED with non-febrile renal colic and received a radiological diagnosis of ureteral stone ≤10 mm. Demographic, clinical, laboratory, and non-contrast CT data were collected. This novel nomogram incorporates the serum neutrophil-to-lymphocyte ratio (NLR) as a potential predictor of SSP. The model was derived from a multivariate logistic regression and was validated on a different cohort. A receiver operator characteristic (ROC) curve was constructed and the area under the curve (AUC) was computed. RESULTS A total of 1186 patients presented to our ED between January 2010 and October 2018. We randomly divided our population into a derivation and validation cohort in one to five ratio. A stone size ≥7 mm was the strongest predictor of SSP failure; OR=9.47; 95% CI: 6.03-14.88. Similarly, a NLR≥3.14 had 2.17; (1.58-2.98) the odds of retained stone. SSP failure was also correlated with proximal position, severe hydronephrosis, and leukocyte esterase ≥75, P=0.02, P=0.05, and P=0.006, respectively. The model had an AUC of 0.804 (0.776-0.832). The nomogram was also used to compute the risk of SSP failure (AUC 0.769 [0.709-0.829]). CONCLUSIONS Our novel nomogram can be used as a predictor for SSP and can be used clinically in decision making.
Collapse
Affiliation(s)
- Nassib Abou Heidar
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Muhieddine Labban
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jad Najdi
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anwar Al Shami
- Nature Conservation Center, American University of Beirut, Beirut, Lebanon
| | | | - Rami Nasr
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon -
| |
Collapse
|