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Inflammatory serum markers predicting spontaneous ureteral stone passage

  • Nassib Abou Heidar
  • Muhieddine Labban
  • Gerges Bustros
  • Rami NasrEmail author
Original article
  • 32 Downloads

Abstract

Introduction

Ureteral stones pose a high economic and medical burden among Emergency Department (ED) admissions. Management strategies vary from expectant therapy to surgical interventions. However, predictors of spontaneous ureteral stone passage are still not well understood. We aim to explore the role of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios in the spontaneous ureteral stone passage (SSP).

Methods

Chart review was done for 619 patients who presented to our institution’s ED with non-febrile renal colic and received a radiological diagnosis of ureteral stone of less than 10 mm. Demographic, clinical, laboratory, and radiological data were collected. The Linear-by-Linear Association test was used to look at the trend among the NLR and PLR quartiles and other demographic variables. Univariate analysis was run for the collected variables. Then, a hierarchal backward multivariate logistic regression was run for each of NLR and PLR variables. To validate the results, bootstrapping was undertaken for each model.

Results

NLR between 2.87 and 4.87 had odds ratio (OR) 2.96 (95% CI 1.80–5.49) and an NLR > 4.87 had 3.63 (2.04–6.69) the odds of retained ureteral stone. A PLR between 10.42 and 15.25 and a PLR > 15.25 had 3.28 (1.79–6.19) and 3.84 (2.28–7.12) the odds of failed SSP, respectively. Other significant variables in the two models are diabetes, urine leukocyte esterase > 10 white blood cell/μl, moderate-to-severe hydronephrosis, and stone size.

Conclusion

NLR and PLR are inversely associated with SSP of ureteral stones. In adjunct with other indicators, NLR and PLR are inflammatory markers that could be used in the clinical decision of ureteral stone management.

Keywords

Urinary calculi Ureteral stone Renal colic Spontaneous stone passage Inflammatory marker Prognosis 

Notes

Supplementary material

10157_2019_1807_MOESM1_ESM.xlsx (139 kb)
Supplementary material 1 (XLSX 139 kb)

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Copyright information

© Japanese Society of Nephrology 2019

Authors and Affiliations

  1. 1.Division of Urology, Department of SurgeryAmerican University of Beirut Medical CenterBeirutLebanon

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