Renal pelvis density on preoperative ct: a novel predictor of infectious complications after percutaneous nephrolithotomy.

IF 2.2 2区医学 Q2 UROLOGY & NEPHROLOGY

Urolithiasis Pub Date : 2025-08-04 DOI:10.1007/s00240-025-01823-z

Erdinç Dinçer, Orkunt Özkaptan, Cengiz Çanakçı, Osman Murat Ipek, Utku Can, Murat Can

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Abstract

To investigate the association between infectious complications following percutaneous nephrolithotomy (PCNL) and renal pelvis urine density (RPUD) measured on preoperative non-contrast-enhanced computed tomography scans.This retrospective cohort study was conducted on patients who underwent PCNL between January 2020 and December 2024. Preoperative non-contrast-enhanced computed tomography was used to assess stone characteristics and RPUD measurement. Patients were categorized into infectious and non-infectious groups based on postoperative infectious complications. The groups were compared in terms of demographic data, stone characteristics (stone burden, localization, stone density), length of stay and RPUD.The study included 273 patients (76% male; 24% female). The median RPUD value was 13.1 ± 4.9 in the non-infectious group and 17.2 ± 4.6 in the infectious group (p < 0.001). Age, sex, BMI, ASA score, diabetes mellitus, stone side and localization were similar in both groups. In the multivariate analysis, stone density and RPUD were found to be associated with postoperative infectious complications (p = 0.034, p = 0.001, respectively). Postoperative infection risk increased 1.13-fold with each unit (HU) increase in RPUD. The cut-off value of RPUD value was 15.15 for predicting postoperative infection, with 66.6% sensitivity and 65.8% specificity (AUC: 0.702, 95% CI = 0.615-0.79, p < 0.001).This study demonstrated a significant association between higher preoperative RPUD values and the development of infectious complications following PCNL. RPUD-a simple measurement obtained from preoperative CT scans-may serve as an early indicator of infection risk and support prophylactic antibiotic planning or drainage decision-making.

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术前ct肾盂密度：经皮肾镜取石术后感染并发症的新预测指标。

探讨经皮肾镜取石术（PCNL）后感染并发症与术前非增强计算机断层扫描测量的肾盂尿密度（RPUD）之间的关系。这项回顾性队列研究是对2020年1月至2024年12月期间接受PCNL的患者进行的。术前使用非对比增强计算机断层扫描评估结石特征和RPUD测量。根据术后感染并发症将患者分为感染组和非感染组。比较两组患者的人口学数据、结石特征（结石负担、定位、结石密度）、住院时间和RPUD。该研究纳入273例患者(76%为男性；24%的女性)。非感染组RPUD中位值为13.1±4.9，感染组为17.2±4.6 （p < 0.05）

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来源期刊

Urolithiasis UROLOGY & NEPHROLOGY-

CiteScore

4.50

自引率

6.50%

发文量

期刊介绍： Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.