This study evaluates the association between immunological markers and infection risk after ureteroscopic lithotripsy in patients with upper urinary tract calculi, providing evidence for risk stratification and clinical decision support.
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Research Article
* These authors contributed equally
This study evaluates the association between immunological markers and infection risk after ureteroscopic lithotripsy in patients with upper urinary tract calculi, providing evidence for risk stratification and clinical decision support.
Postoperative infection is a severe complication of ureteroscopic lithotripsy for upper urinary tract calculi. This study aimed to analyze the association of immunological markers, including C-reactive protein (CRP), albumin (ALB), and heparin-binding protein (HBP), with postoperative infection. A total of 177 patients who underwent surgery between June 2020 and June 2024 were enrolled. Patients were classified into an infection group (41 cases) and a non-infection group (136 cases) based on postoperative infection status. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results showed that postoperative HBP, CRP, and ALB levels were independent factors associated with postoperative infection (p < 0.05). The optimal cutoff values were 19.56 mg/L for CRP, 40.7 g/L for ALB, and 79.05 ng/mL for HBP, with area under the curve (AUC) values of 0.684, 0.654, and 0.733, respectively. Combined detection of the three indicators yielded an AUC of 0.803 (p < 0.05). In conclusion, postoperative CRP, ALB, and HBP are associated with postoperative infection after ureteroscopic lithotripsy and may aid in risk assessment. Further validation is needed before clinical application.
Calculus of the upper urinary tract is a common urological disease, primarily referring to stone lesions occurring in the kidneys and ureters. Statistics show that the global incidence of upper urinary tract calculi ranges from 2% to 20%, with rates of up to 12% in American men and 6% in women, and this incidence is on the rise year by year1,2,3. China is one of the three major global regions with a high incidence of urinary stones. A recent systematic review and meta-analysis including 46 studies from 22 provinces reported a pooled prevalence of urolithiasis of 8.1% in China....
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Study design and ethics statement
This retrospective study was conducted in accordance with the Declaration of Helsinki. Approval was obtained from the Ethics Committee of The Second Hospital of Nanjing (Approval No. [2026-LS-ky054]) before data collection and analysis.
Patient selection
The electronic medical records of consecutive patients diagnosed with upper urinary tract calculi who underwent ureteroscopic lithotripsy at the Department of Urology of The Second Hospital of Nanjing between June 2020 and June 2024 were reviewed. The inclusion criteria were as follows: diagnosis of upper urinary tr....
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Incidence of postoperative infection and univariate analysis
Among the 177 patients who underwent ureteroscopic lithotripsy, 41 (23.16%) developed postoperative infection and formed the infection group, while the remaining 136 patients (76.84%) constituted the non-infection group. Univariate statistical analysis showed significant differences in postoperative CRP, ALB, and HBP levels between the infection and non-infection groups (p < 0.05). No statistically significant differences were f.......
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In recent years, amid changes in lifestyle and dietary habits, the incidence of upper urinary tract calculi has been on the rise. Patients with upper urinary tract calculi often experience symptoms such as flank pain and abdominal pain. Without timely and effective intervention, the disease can progress to obstruction and infection, leading to renal insufficiency and severely compromising the patient's quality of life11,12. Although there are various treatmen.......
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The authors declare that they have no financial conflicts of interest.
This study received no external funding. The authors thank the medical staff of the Department of Urology at The Second Hospital of Nanjing for their assistance in collecting clinical data.
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| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| Automated biochemical analyzer | Beckman Coulter | AU5800 | For serum albumin (ALB) and C-reactive protein (CRP) measurement |
| Centrifuge | Eppendorf | 5810R | For plasma separation, 1,500 × g, 10 min, 4 °C |
| EDTA blood collection tubes | BD | 367861 | For peripheral venous blood collection |
| ELISA plate washer | Bio-Rad | 157510 | For automated washing of ELISA plates |
| Heparin-binding protein (HBP) ELISA kit | Hycult Biotech | HK330 | For quantitative detection of HBP in plasma |
| Micropipettes | Eppendorf | 3120000020 | For precise liquid handling (10 µL, 100 µL, 1000 µL) |
| Microplate reader | Bio-Rad | iMark | For absorbance measurement at 450 nm |
| Refrigerator | Haier | DW-86L486 | For sample storage at −80 °C |
| SPSS software | IBM | N/A | Version 24.0, for statistical analysis |
| Vortex mixer | IKA | MS 3 Basic | For mixing samples and reagents |