Investigating the predictive effect of neutrophil to lymphocyte ratio as an inflammatory marker in the spontaneous excretion of ureteral stones

Authors

  • Hamid Deldadeh-Moghaddam Department of Medicine, Ardabil branch, Islamic Azad University, Ardabil, Iran
  • Tina Cheraghi-Digaleh School of Medicine, Ardabil Branch, Islamic Azad University, Ardabil, Iran

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231596

Keywords:

Neutrophil to lymphocyte ratio, Ureter stone, Spontaneous passage

Abstract

Background: The size and location of the stone have been suggested as the most important predictors of the possibility of spontaneous passage of the stone. The aim of this study was to investigate the predictive effect of neutrophil to lymphocyte ratio as an inflammatory marker in the spontaneous excretion of ureteral stones.

Methods: This descriptive-analytical study was done on 95 patients with ureteral stone during 2020-21. Required data include sex, age, BMI, previous history of stone, previous history of spontaneous passage of stone, side, location and size of stones, spontaneous passage of stone, and neutrophil and lymphocyte ratio were extracted from file of patients. The presence of the stone and its characteristics were confirmed by ultrasound. Patients were followed up for 2 weeks to determine whether or not the stone passed spontaneously.

Results: There was a significant relationship between spontaneous passage of ureteral stone with stone size, location, and neutrophil to lymphocyte ratio. The cut-off points of neutrophil to lymphocyte ratio for predicting spontaneous passage of ureteral stone was 2.52, so that patients with higher values were faced with a 4.2-fold increase in the risk of no spontaneous passage of stones (OR=4.202, 95% CI: 1.563-11.298, Sig.=0.004).

Conclusions: The results of the study showed that the ratio of neutrophils to lymphocytes is a significant predictor of spontaneous passage of ureteral stones, so that if used in addition to the size and location of the stone, the accuracy of predicting patients who benefit from conservative management, increase significantly.

Metrics

Metrics Loading ...

References

Kirkali Z, Rasooly R, Star RA, Rodgers GP. Urinary stone disease: progress, status, and needs. Urology. 2015;86(4):651-3.

Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol. 2010;12:86-96.

Trinchieri A. Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab. 2008;5:101-6.

Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C. Guidelines on urolithiasis. European association of urology. 2011.

Pickard R, Starr K, MacLennan G. Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial. Lancet. 2015;386:341-9.

Matlaga BR, Jansen JP, Meckley LM, Byrne TW, Lingeman JE. Treatment of ureteral and renal stones: a systematic review and meta-analysis of randomized, controlled trials. The Journal of Urology. 2012;188(1):130-7.

Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol. 2016;69(3):468-74.

Singh A, Alter HJ, Littlepage A. A systematic review of medical therapy to facilitate passage of ureteral calculi. Ann Emerg Med. 2017;50:552-63.

Bensalah K, Pearle M, Lotan Y. Cost-effectiveness of medical expulsive therapy using alpha-blockers for the treatment of distal ureteral stones. Eur Urol. 2008;53(2):411-8.

Garcia Morua A, Gutierrez Garcia JD, Martinez Montelongo R, Gomez Guerra LS. Use of alfuzosin for expulsion of stones in the distal third of ureter. Actas Urol Esp. 2009;33(9):1005-10.

Cilesiz NC, Ozkan A, Kalkanli A, Eroglu A, Gezmis CT, Simsek B, et al. Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?. BMC Urology. 2020;20:1-6.

Aldaqadossi HA. Stone expulsion rate of small distal ureteric calculi could be predicted with plasma C-reactive protein. Urolithiasis. 2013;41:235-9.

Park CH, Ha JY, Park CH, Kim CI, Kim KS, Kim BH. Relationship between spontaneous passage rates of ureteral stones less than 8 mm and serum C-reactive protein levels and neutrophil percentages. Korean J Urol. 2013;54:615-8.

Abou Heidar N, Labban M, Bustros G, Nasr R. Inflammatory serum markers predicting spontaneous ureteral stone passage. Clinical and Experimental Nephrology. 2020;24(3):277-83.

Lee KS, Ha JS, Koo KC. Significance of neutrophil-to-lymphocyte ratio as a novel indicator of spontaneous ureter stone passage. Yonsei Medical Journal. 2017;58(5):988-93.

Tzelves L, Türk C, Skolarikos A. European Association of Urology Urolithiasis Guidelines: Where Are We Going?. European Urology Focus. 2021;7(1):34-8.

Quhal F, Seitz C. Guideline of the guidelines: urolithiasis. Current Opinion in Urology. 2021;31(2):125-9.

Morse RM, Resnick MI. Ureteral calculi: natural history and treatment in an era of advanced technology. J Urol. 2009;145:263-5.

Siegel C. Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. J Urol. 2008;168(4 Pt 1):1644-54.

Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M, et al. 2007 Guideline for the management of ureteral calculi. Eur Urol. 2007;52:1610-31.

Hung HY, Chen JS, Yeh CY, Changchien CR, Tang R, Hsieh PS, et al. Effect of preoperative neutrophil-lymphocyte ratio on the surgical outcomes of stage II colon cancer patients who do not receive adjuvant chemotherapy. Int J Colorectal Dis. 2011;26:1059-65.

Proctor MJ, Morrison DS, Talwar D, Balmer SM, Fletcher CD, O’Reilly DS, et al. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer. 2011;47:2633-41.

Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10:12.

Azab B, Camacho-Rivera M, Taioli E. Average values and racial differences of neutrophil lymphocyte ratio among a nationally representative sample of United States subjects. PLoS One. 2014;9:11-23.

López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatric Nephrology. 2010;25(1):49-59.

Arumuham V, Bycroft J. The management of urolithiasis. Surgery (Oxford). 2016;34(7):352-60.

Shah TT, Gao C, Peters M, Manning T, Cashman S, Nambiar A, et al. Factors associated with spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic: results from the multi‐centre cohort study evaluating the role of inflammatory markers in patients presenting with acute ureteric Colic (MIMIC) study. BJU International. 2019;124(3):504-13.

Sfoungaristos S, Kavouras A, Katafigiotis I, Perimenis P. Role of white blood cell and neutrophil counts in predicting spontaneous stone passage in patients with renal colic. BJU International. 2012;110(8b):E339-45.

Liu Y, Chen Y, Liao B, Luo D, Wang K, Li H, Zeng G. Epidemiology of urolithiasis in Asia. Asian Journal of Urology. 2018;5(4):205-14.

Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urological Research. 2011;39(4):309-14.

Özcan C, Aydog˘du O, Senocak C, Damar E, Eraslan A, Oztuna D, et al. Predictive factors for spontaneous stone passage and the potential role of serum C-reactive protein in patients with 4 to 10 mm distal ureteral stones: a prospective clinical study. J Urol. 2015;194:1009-13.

Downloads

Published

2023-05-29

How to Cite

Deldadeh-Moghaddam, H., & Cheraghi-Digaleh, T. (2023). Investigating the predictive effect of neutrophil to lymphocyte ratio as an inflammatory marker in the spontaneous excretion of ureteral stones . International Journal of Research in Medical Sciences, 11(6), 1881–1886. https://doi.org/10.18203/2320-6012.ijrms20231596

Issue

Section

Original Research Articles