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Estimation of Renal Function Using Unenhanced Computed Tomography in Upper Urinary Tract Stones Patients.

ABSTRACT: Objectives: The aim of this study was to determine whether unenhanced computed tomography (CT) imaging can estimate differential renal function (DRF) in patients with chronic unilateral obstructive upper urinary tract stones. Materials and Methods: This was a single-center retrospective study of 76 patients. All the patients underwent unenhanced CT and nuclear renography (RG) at an interval of 4 to 6 weeks due to chronic unilateral obstructive urinary stones. Renal CT measurements (RCMs), including residual parenchymal volume (RPV) and volumetric CT texture analysis parameters, were obtained through a semiautomatic method. Percent RCMs were calculated and compared with renal function determined by RG. Results: The strongest Pearson coefficient between percent RCM and DRF was reflected by RPV (r = 0.957, P < 0.001). Combinations of RPV and other parameters did not significantly improve the correlation compared with RPV alone (r = 0.957 vs. r = 0.957, 0.957, 0.887, 0.815, and 0.956 for combination with Hounsfield unit, parenchymal voxel, skewness, kurtosis, and entropy, respectively; all P < 0.001). Percent RPV was subsequently introduced into linear regression, and the equation y = -2.66 + 1.07* × (P < 0.001) was derived to calculate predicted DRF. No statistically difference was found between predicted DRF using the equation and observed DRF according to RG (P = 0.959). Conclusion: Unenhanced CT imaging can estimate DRF in patients with chronic unilateral obstructive upper urinary tract stones, and RG might not be necessary as a conventional method in clinical.

SUBMITTER: Li J

PROVIDER: S-EPMC7347744 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Estimation of Renal Function Using Unenhanced Computed Tomography in Upper Urinary Tract Stones Patients.

Li Jiali J Xun Yang Y Li Cong C Han Yunfeng Y Shen Yaqi Y Hu Xuemei X Hu Daoyu D Liu Zheng Z Wang Shaogang S Li Zhen Z

Frontiers in medicine 20200703

<b>Objectives:</b> The aim of this study was to determine whether unenhanced computed tomography (CT) imaging can estimate differential renal function (DRF) in patients with chronic unilateral obstructive upper urinary tract stones. <b>Materials and Methods:</b> This was a single-center retrospective study of 76 patients. All the patients underwent unenhanced CT and nuclear renography (RG) at an interval of 4 to 6 weeks due to chronic unilateral obstructive urinary stones. Renal CT measurements ...[more]

PMID: 32719802

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Project description:To study the relationship between preoperative urine culture, bacterial species and infection after percutaneous nephrolithotomy in patients with upper urinary tract stones, and summarize the clinical characteristics of different bacterial infections. From January 2014 and January 2020, 963 patients with upper urinary tract stones who underwent PCNL in the department of urology of Fujian provincial hospital were included in the study. Information included the patient's age, gender, weight, diabetes, chronic disease history, urine routine, preoperative urine culture results, stone size, number of stones, hydronephrosis level, operation time, body temperature, heart rate, blood pressure, breathing rate, hemoglobin, serum creatinine, bilirubin, platelets and whether there was preoperative infection were recorded. 141 patients (14.6%) had a positive urine culture before surgery, and 7 of them had multiple bacterial infections. The most common pathogenic bacteria was Escherichia coli, followed by Enterococcus and Klebsiella pneumoniae. A total of 74 cases (7.7%) of 963 patients with infection after PCNL occurred, 24 cases (32.4%) of infected patients progressed to urinary septic shock. Univariate analysis shown that the probability of infection in patients with long operation time and positive urine culture was significantly higher, and the difference was statistically significant. Further multivariate logistic regression analysis shown that positive urine culture before operation and long operation time were independent risk factors for infection after PCNL. Among the 29 patients with septic shock, 18 cases (62.1%) had a positive urine culture before surgery. The incidence (43.9%) of postoperative infection in Escherichia coli positive patients was significantly higher than that in the negative group, and the difference was statistically significant. The rate of patients with Escherichia coli infection progressing to septic shock was 9 cases (60%). 2 patients with Enterococcus faecium infection and 2 patients with Klebsiella pneumoniae infection all progressed to septic shock. The age of patients with post-PCNL infection caused by Escherichia Coli, Enterococcus faecium and Klebsiella pneumoniae were 58.53 ± 11.73 years, 76.5 years and 74 years.The body temperature of patients with post-PCNL infection caused by Escherichia Coli, Enterococcus faecium and Klebsiella pneumoniae were 39.10 ± 0.25 °C, 39.45 °C and 38.65 °C. The highest pct value of patients with post-PCNL infection caused by Escherichia Coli, Enterococcus faecium and Klebsiella pneumoniae were 80.62 ± 31.45 ng/mL, 24.32 ng/mL and 8.45 ng/mL. The nitrite positive rate of patients with post-PCNL infection caused by Escherichia Coli, Enterococcus faecium and Klebsiella pneumoniae were 64.51%, 16.6% and 0. Postoperative infection of PCNL is significantly correlated with positive preoperative urine culture, and positive preoperative urine culture is an independent risk factor for postoperative infection. The most common pathogen of postoperative infection of PCNL is Escherichia coli, followed by Enterococcus and Klebsiella pneumoniae. Patients with Escherichia coli infection are often positive for nitrite before surgery, mainly manifested by high fever, and PCT is significantly increased (often exceeded 100 ng/ml). Enterococcus faecium and Klebsiella pneumoniae infections mostly occur in elderly patients and often progress to septic shock. Patients with Enterococcus faecium infection have a high fever, and the PCT value is significantly higher (often exceeded 20 ng/ml). Patients with Klebsiella pneumoniae infection have a moderate fever, and the PCT value generally does not exceeded 10 ng/ml. Long operation time is another independent risk factor for PCNL infection.

Dataset Information

Estimation of Renal Function Using Unenhanced Computed Tomography in Upper Urinary Tract Stones Patients.

Publications

Estimation of Renal Function Using Unenhanced Computed Tomography in Upper Urinary Tract Stones Patients.

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