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. 2017 Sep;58(5):988-993.
doi: 10.3349/ymj.2017.58.5.988.

Significance of Neutrophil-to-Lymphocyte Ratio as a Novel Indicator of Spontaneous Ureter Stone Passage

Kwang Suk Lee  1 , Jee Soo Ha  1 , Kyo Chul Koo  2
Affiliations

Significance of Neutrophil-to-Lymphocyte Ratio as a Novel Indicator of Spontaneous Ureter Stone Passage

Kwang Suk Lee et al. Yonsei Med J. 2017 Sep.

Abstract

Purpose: Stone size and location are generally considered the most important factors associated with spontaneous ureter stone passage (SSP). Several parameters related to inflammatory changes have been identified as predictors associated with SSP. Our aim was to investigate the predictive role of neutrophil-to-lymphocyte ratio (NLR) for SSP.

Materials and methods: A retrospective review was performed on 131 patients who were referred to the urology outpatient clinic and diagnosed with unilateral ureteral stones at our emergency department between July 2016 and December 2016. The presence of ureteral stones was confirmed with non-contrast-enhanced computed tomography (NCCT) for all patients. SSP was confirmed with either the patient collecting the stone during urination or by NCCT performed at 3 weeks from the first stone episode. Physical examination, urinalysis, complete blood count, serum chemistry and inflammatory markers, plain radiographs, and NCCT at initial presentation were reviewed to analyze predictors of future SSP.

Results: Of 113 patients included for analysis, 90 (79.6%) passed their stones spontaneously. The SSP rates within 3 weeks according to the stone's size (5-10 mm and ≤5 mm) were 62.2% and 88.2%, respectively. A lower stone location [odds ratio (OR), 11.54; p=0.001], smaller stone size (≤5 mm) (OR, 8.16; p=0.001), and NLR (<2.3) (OR, 9.03; p=0.003) were independent predictors of SSP.

Conclusion: Low NLR (<2.3) may predict SSP in patients with ureter stones ×1.0 cm in size. Our results suggest that ureteral inflammation plays an important role in SSP. Early intervention may be considered for patients presenting with high NLR (≥2.3).

Keywords: Calculi; inflammation; prognosis; ureter; urinary calculi.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Flowchart of study selection process. ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; NCCT, non-contrast-enhanced computed tomography.
See this image and copyright information in PMC

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References

    1. Dellabella M, Milanese G, Muzzonigro G. Efficacy of tamsulosin in the medical management of juxtavesical ureteral stones. J Urol. 2003;170(6 Pt 1):2202–2205. - PubMed
    1. Aldaqadossi HA. Stone expulsion rate of small distal ureteric calculi could be predicted with plasma C-reactive protein. Urolithiasis. 2013;41:235–239. - PubMed
    1. 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 Int. 2012;110(8 Pt B):E339–E345. - PubMed
    1. 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;54:615–618. - PMC - PubMed
    1. Özcan C, Aydogğdu 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;194:1009–1013. - PubMed

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