What is the role of inflammatory markers in predicting spontaneous ureteral stone passage?

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.

Zusammenfassung

Zusammenfassung Es geht um eine Analyse, ob Entzündungsmarker geeignet sind, den Spontanabgang eines Harnleitersteines vorhersagen zu können.

Methode Es erfolgte eine retrospektive Analyse von 279 konservativ behandelten Patienten mit einem Harnleiterstein von 4–10mm Größe. Dazu wurden die Patienten in 2 Gruppen unterteilt. Gruppe 1 bestand aus 137 Patienten, bei denen ein Spontanabgang des Uretersteines erfolgte, während bei den 142 Patienten der Gruppe 2 nicht stattfand. Der statistische Vergleich erfolgte mit dem Mann-Whitney U und dem Chi-Quadrat-Verfahren, wobei sowohl die einzelnen Parameter als auch eine multivariable Analyse angewendet wurde.

Ergebnisse Das Durchschnittsalter der Patienten betrug 41,2 Jahre. Die Patienten der Gruppe 1 hatten alle einen kleineren Stein und die Leukozyten und Granulozyten waren vermindert. Außerdem unterschieden sich beide Gruppen hinsichtlich der Steinlokalisation und der Ausprägung der Stauungsniere. Obwohl bei den Patienten in Gruppe 1 die Anzahl der Neutrophilen genauso vermindert war wie das Verhältnis von Neutrophilen zu Lymphozyten und das Verhältnis von Thrombozyten zu Neutrophilen, ergab sich für beide Gruppen kein statistischer Unterschied.In einer multivarianten Analyse waren zur Vorhersage eines Spontanabganges sowohl die Steingröße als auch die Steinlokalisation und Ausprägung der Hydronephrose signifikant. Entzündungsmarker wie eine Leukozytose oder die Anzahl der Neutrophilen oder die Ratio von Neutrophilen zu Lymphozyten ermöglichten keine Erhöhung der Zuverlässigkeit der Vorhersage, ob der Spontanabgang eines Uretersteines möglich ist.

Schlussfolgerung Unsere Ergebnisse zeigen, dass serologische Entzündungsmarker keine zuverlässige Aussage ermöglichen, ob der Spontanabgang eines Uretersteines stattfinden könnte.

Schlüsselwörter

Harnleiterstein - Entzündungsmarker - Spontane Steinpassage - Prognose

Keywords

ureteral stone - inflammatory markers - spontaneous stone passage - prognosis

Publication History

Received: 27 July 2021

Accepted after revision: 15 November 2021

Article published online:
10 January 2022

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