Correlation of volume, position of stone, and hydronephrosis with microhematuria in patients with solitary urolithiasis

Okumuş, Mehmet

doi:10.12659/msm.889077

Cited by 14 publications

(7 citation statements)

References 24 publications

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“…Our sample size may have been too small to detect one, although previous studies have also failed to demonstrate a significant correlation between stone size and the presence of hematuria 10. We did find, however, a significant difference in the mean size of ureteral stones resulting in minimal-to-mild hydronephrosis (4.1mm) versus those resulting in moderate-to-severe hydronephrosis (6.9 mm, p < 0.0001).…”

Section: Discussioncontrasting

confidence: 72%

“…One hypothesis is that larger ureteral stones may obstruct bleeding resulting in the absence of hematuria on UA; however, no studies have proven this. Additional factors that may influence or confound the presence or absence of microscopic hematuria on UA in patients with suspected urolithiasis include dehydration, females on their menstrual period, stone position,10 and the time interval between pain onset and urine collection 12. A recent study by Sahin et al examined the value of several parameters for predicting successful medical expulsion therapy in urolithiasis and found stone size, localization, degree of hydronephrosis, proximal ureteral diameter and ureteral wall thickness to be highly predictive, and patient age, BMI and stone density not predictive 13.…”

Section: Discussionmentioning

confidence: 99%

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A Comparison of Urolithiasis in the Presence and Absence of Microscopic Hematuria in the Emergency Department

Mefford¹,

Tungate²,

Amini³

et al. 2017

WestJEM

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IntroductionUrolithiasis is a common medical condition that accounts for a large number of emergency department (ED) visits each year and contributes significantly to annual healthcare costs. Urinalysis is an important screening test for patients presenting with symptoms suspicious for urolithiasis. At present there is a paucity of medical literature examining the characteristics of ureteral stones in patients who have microscopic hematuria on urinalysis versus those who do not. The purpose of this study was to examine mean ureteral stone size and its relationship to the incidence of clinically significant hydronephrosis in patients with and without microscopic hematuria.MethodsThis is a retrospective chart review of patient visits to a single, tertiary academic medical center ED between July 1, 2008, and August 1, 2013, of patients who underwent non-contrast computed tomography of the abdomen and pelvis and urinalysis. For patient visits meeting inclusion criteria, we compared mean stone size and the rate of moderate-to-severe hydronephrosis found on imaging in patients with and without microscopic hematuria on urinalysis.ResultsOut of a total of 2,370 patient visits 393 (16.6%) met inclusion criteria. Of those, 321 (82%) had microscopic hematuria present on urinalysis. Patient visits without microscopic hematuria had a higher rate of moderate-to-severe hydronephrosis (42%), when compared to patients with microscopic hematuria present (25%, p=.005). Mean ureteral stone size among patient visits without microscopic hematuria was 5.7 mm; it was 4.7 mm for those patients with microscopic hematuria (p=.09). For ureteral stones 5 mm or larger, the incidence of moderate-to-severe hydronephrosis was 49%, whereas for ureteral calculi less than 5 mm in size, the incidence of moderate-to-severe hydronephrosis was 14% (p < 0.0001).ConclusionPatients visiting the ED with single-stone ureterolithiasis without microscopic hematuria on urinalysis could be at increased risk of having moderate-to-severe hydronephrosis compared to similar patients presenting with microscopic hematuria on urinalysis. Although the presence of hematuria on urinalysis is a moderately sensitive screening test for urolithiasis, these results suggest patients without hematuria tend to have more clinically significant ureteral calculi, making their detection more important. Clinicians should maintain a high index of suspicion for urolithiasis, even in the absence of hematuria, since ureteral stones in these patients were found to be associated with a higher incidence of obstructive uropathy.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

A Comparison of Urolithiasis in the Presence and Absence of Microscopic Hematuria in the Emergency Department

Mefford¹,

Tungate²,

Amini³

et al. 2017

WestJEM

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“…Within the selected articles, screening of the reference lists allowed to add 3 additional records. Finally, 49 studies [ 7 – 9 , 13 – 58 ] including 15′860 patients were identified as potentially relevant and were selected for the systematic review and meta-analysis. All of the included studies except two [ 30 , 50 ] were published in English.…”

Section: Resultsmentioning

confidence: 99%

“…As diagnostic tool the STONE Score was developed and validated; this score includes parameters as sex, duration of pain prior to presentation, race, nausea, vomiting and microhematuria [ 6 ]. Microhematuria prevalence in suspected renal colic has been studied in several trials, ranging from 55% [ 7 ] to 93% [ 8 , 9 ]. In order to better understand the difference existing in prevalence range, we performed a meta-analysis of studies dealing with microhematuria by suspected acute renal colic and/or confirmed urolithiasis.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis

et al. 2020

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Background: This systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department. Methods: A comprehensive literature search was conducted to find relevant data on prevalence of microhematuria in patients with suspected acute renal colic and/or confirmed urolithiasis. Data from each study regarding study design, patient characteristics and prevalence of microhematuria were retrieved. A random effect-model was used for the pooled analyses. Results: Forty-nine articles including 15′860 patients were selected through the literature search. The pooled microhematuria prevalence was 77% (95%CI: 73-80%) and 84% (95%CI: 80-87%) for suspected acute renal colic and confirmed urolithiasis, respectively. This proportion was much higher when the dipstick was used as diagnostic test (80 and 90% for acute renal colic and urolithiasis, respectively) compared to the microscopic urinalysis (74 and 78% for acute renal colic and urolithiasis, respectively). Conclusions: This meta-analysis revealed a high prevalence of microhematuria in patients with acute renal colic (77%), including those with confirmed urolithiasis (84%). Intending this prevalence as sensitivity, we reached moderate values, which make microhematuria alone a poor diagnostic test for acute renal colic or urolithiasis. Microhematuria could possibly still important to assess the risk in patients with renal colic.

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“…The clear expression of VEGF in the mesangial region could promote the protein extravasation outside this region. Thus, increase in the vascular extracellular matrix would result in a subsequent increase in glomerular volume [ 21 ]. The repair of capillaries is necessary for glomerulonephritis healing [ 22 ], and VEGF is the essential factor that affects the growth and proliferation of glomeruli and peritubular endothelial cells.…”

Section: Discussionmentioning

confidence: 99%

Relationships of Urinary VEGF/CR and IL-6/CR with Glomerular Pathological Injury in Asymptomatic Hematuria Patients

Song¹

2015

Med Sci Monit

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BackgroundInterleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) have important functions in injury and repair processes of glomerular intrinsic cells. A study was conducted to analyze the urinary VEGF/creatinine (CR) and IL-6/CR levels in simple hematuria patients after excluding the interference of creatinine. We aimed to investigate the function and relationships of the above indices in the glomerular pathological injury process, and to elaborate the values of urinary VEGF and IL-6 changes in the diagnosis of asymptomatic hematuria or hematuria with proteinuria.Material/MethodsA total of 121 renal hematuria patients diagnosed by clinical and laboratory tests were included as research subjects. The midstream fresh morning urine was collected on the day renal biopsy was performed.ResultsThe IL-6/CR value of the group III was significantly greater than in group I (Z=−2.478, P<0.05), with a statistically significant difference between these 2 groups. The VEGF/CR value of group III was significantly greater than in group II (P<0.01). Compared with group I, the VEGF/CR of group III was significantly greater (Z=−4.65, P<0.01), with a statistically significant difference.ConclusionsThe VEGF/CR and IL-6/CR values in simple hematuria patients were positively correlated with glomerular pathological injury scores. VEGF/CR and IL-6/CR might be used as biological diagnostic indicators in determining the extent of simple hematuria glomerular injury.

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Correlation of volume, position of stone, and hydronephrosis with microhematuria in patients with solitary urolithiasis

Cited by 14 publications

References 24 publications

A Comparison of Urolithiasis in the Presence and Absence of Microscopic Hematuria in the Emergency Department

A Comparison of Urolithiasis in the Presence and Absence of Microscopic Hematuria in the Emergency Department

Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis

Relationships of Urinary VEGF/CR and IL-6/CR with Glomerular Pathological Injury in Asymptomatic Hematuria Patients

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