Perinephric Fat Stranding Is Associated with Elevated Creatinine Among Patients with Acutely Obstructing Ureterolithiasis

Farrell, M. Ryan; Papagiannopoulos, Dimitri; Ebersole, John H.; White, Gregory M.; Deane, Leslie A.

doi:10.1089/end.2018.0252

Cited by 12 publications

(12 citation statements)

References 11 publications

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“…Generally, the severity of obstruction depends on the degree and duration. The collecting system becomes dilated within 42 h of obstruction, with edematous changes to the renal parenchyma occurring after seven days (4). Poor ureteral status readily leads to more severe obstruction due to the ureteral calculi, and the urine above the calculi cannot flow smoothly, which results in greater pressure and causes renal pelvic and calyx expansion, renal unit cell degeneration, atrophy, and necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…The exclusion criteria were pediatric patients and patients with preoperative double-J stent placement and ureteral obstruction that did not result from the stone. Stone size, preoperative hydronephrosis and hydroureter, renal parenchyma thickness, ureteral wall thickening on imaging, stone location, computed tomography (CT) values and perinephric fat stranding (3,4) were evaluated with CT. A total of 101 patients from the archives of the Department of Urology at the XXXX were initially recruited for the present study according to a protocol that was approved by the Institutional Review Board.…”

Section: Methodsmentioning

confidence: 99%

“…The following factors were recorded: age; sex; stone side (right/left); hydronephrosis (the largest transverse diameter of the renal pelvis at the level of the renal vein); hydroureter (the largest diameter of the ureter at the level of the ureteropelvic junction); renal parenchyma thickness (the ventral middle calyces were measured at the level of the renal vein) (Fig. 1a); perinephric fat stranding score as reported previously (3,4); stone diameter; Hounsfield units of the stones; ureteral wall thickening on imaging (yes/no) (Fig. 1b); stone location (proximal, middle, or distal); time between diagnosis and the day of surgery; white blood cell count; leukocyte count in the urine; and history of ipsilateral operation (yes/no).…”

Section: Data Collectionmentioning

confidence: 99%

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Predicting ureteral status below the ureteral calculi in patients undergoing ureteroscopic lithotomy

Qin

Yin

et al. 2021

Acta Radiol

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Background During ureteroscopy, severe ureter straightness or contortion may occur before the stone is passed. Purpose To identify clinical factors associated with distal ureteral status below the ureteral calculi in patients before surgery. Material and Methods From October 2016 to March 2017, 101 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients who lacked clinical data and underwent preoperative indwelling ureteral stent placement were excluded. Univariate and multivariate analyses were performed to determine the clinical factors associated with intraoperative findings. Results A total of 101 patients were enrolled in the study (mean age = 54 years; mean stone size = 7.9 ± 4.5 mm). Overall, 25 of the 101 patients (24.7%) were diagnosed with poor distal ureteral status defined as intraoperative ureterostenosis or contortion resulting in a ureteroscope being unable to pass during the initial attempt. Univariate analysis showed significant differences in renal parenchyma thickness, ureteral wall thickening on imaging, and stone location (all, P < 0.05) with and without poor distal ureteral status. On multivariable analysis, renal parenchyma thickness (adjusted odds ratio [aOR] 0.288; 95% confidence interval [CI] 0.099–0.838; P = 0.022) and ureteral wall thickening on imaging (aOR 6.114; 95% CI 2.015–18.548; P = 0.001) independently predicted poor distal ureteral status. However, only renal parenchyma thickness was associated with severe ureter straightness or tortuosity that resulted in conversion. Conclusion In conclusion, renal parenchyma thickness and ureteral wall thickening on imaging were associated with poor distal ureteral status. Therefore, patients with these predictive factors should undergo more intensive preparation before surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

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Predicting ureteral status below the ureteral calculi in patients undergoing ureteroscopic lithotomy

Qin

Yin

et al. 2021

Acta Radiol

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“…All images were evaluated at a soft tissue setting with window width of 300 Hounsfield units (HU) and window level of 20 HU [ 21 ]. PFS was defined as thin or thick soft tissue attenuation strands extending radially or parallelly to renal capsule which can be short or long, and/or any coalescent perirenal fluid [ 22 ]. For some severe patients, the stranding may extend to perirenal fascia/Gerota's fascia and lead to focal or diffuse thickening of the fascia.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 associated kidney impairment in adult: Qualitative and quantitative analyses with non-enhanced CT on admission

Huang

Lyu

et al. 2020

European Journal of Radiology

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Highlights Renal parenchyma attenuation on non-enhanced CT decreases in COVID-19. Renal parenchyma attenuation is negatively correlated with serum creatinine levels. Perinephric fat stranding suggests more severe renal impairment in COVID-19. Non-enhanced CT could be used in evaluation of COVID-19 associated renal impairment on admission.

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“…In recent years, the application of multi-slice spiral CT in kidney diseases has been increasing. CT imaging has not only improved the image resolution, showing more three-dimensional images of kidney anatomy and morphological changes, but also has a marked effect on the detection rate and qualitative diagnosis of kidney diseases [7,8]. The main advantages of CT are signi cant improvement of soft tissue contrast, which may directly and accurately show stones and clearly show tiny stones [9,10].…”

Section: Introductionmentioning

confidence: 99%

CT Grading in Upper Urinary Tract Calculi with Kidney Infection

Zhang

Lin

Deng

et al. 2020

Preprint

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Background This study is to establish a CT imaging grading system and to explore its value in evaluating upper urinary tract calculi with kidney infection. Methods CT images of 126 patients with kidney infection caused by upper urinary tract calculi were retrospectively analyzed. CT grading system was developed based on CT images. General information, clinical symptoms and examination data of patients in different CT grades were analyzed. With the occurrence of systemic inflammatory response syndrome (SIRS) as the end point, univariate and multivariate analysis was conducted to analyze the risk factors of SIRS. Results CT images were classified into 4 grades. For patients with different CT grades, the factors of fever, diabetes, blood white blood cell counts, urine leucocytes, CT1 (ratios of renal cortex CT values on the affected side and those on the healthy side), CT2 (ratios of renal pelvis CT values on the affected side and those on the healthy side), maximum body temperature, disease time, proportion of blood neutrophils, C-reactive protein, procalcitonin, and the size of stones had statistical significance (P<0.05). Only CT grading was statistically significant by multivariate analysis. The higher the CT grading, the greater the risk of SIRS, with 4.472 times higher of SIRS risk for each increasement of the CT grade. Conclusions CT images may reflect the involvement extent and scope of upper urinary tract calculi with kidney infection. The higher the CT grade is, the more severe the clinical symptoms are and the greater the risk of SIRS is.

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Perinephric Fat Stranding Is Associated with Elevated Creatinine Among Patients with Acutely Obstructing Ureterolithiasis

Cited by 12 publications

References 11 publications

Predicting ureteral status below the ureteral calculi in patients undergoing ureteroscopic lithotomy

Predicting ureteral status below the ureteral calculi in patients undergoing ureteroscopic lithotomy

COVID-19 associated kidney impairment in adult: Qualitative and quantitative analyses with non-enhanced CT on admission

CT Grading in Upper Urinary Tract Calculi with Kidney Infection

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