Early detection of infected ureteral obstruction after SWL employing C-reactive protein.
Infection of the obstructed upper urinary tract is a severe complication of stone disease. Early detection and therapy is crucial to prevent septicemia. The authors investigated prospectively whether C-reactive protein (CRP) might act as a marker for the early detection of infected upper urinary tract obstruction. The serum concentration of CRP was compared with the classic markers of inflammation--white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and temperature--in the follow-up of 85 patients undergoing 173 extracorporeal shockwave lithotripsy (SWL) treatments. Post-SWL, 69% of the patients showed dilation of the upper tract on ultrasonography and 16.5% became symptomatic and required intervention. In this group, the mean CRP value was increased 18-fold, whereas the WBC count, ESR, and temperature were not markedly raised. In contrast, patients with no need for additional treatment showed no more than a 2-fold increase in CRP. C-Reactive protein seems to be a useful indicator for the early detection of infected upper urinary tract obstruction.
Wolff
J M
JM
Boeckmann
W
W
Mattelaer
P
P
Krämer
U
U
Jakse
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D001831:Body Temperature; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria; D006094:Gram-Positive Bacteria; D006801:Humans; D007958:Leukocyte Count; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014514:Ureteral Calculi / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D014517:Ureteral Obstruction / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D014552:Urinary Tract Infections / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D014556:Urine / Q000382:microbiology
D015415:Biomarkers; D002097:C-Reactive Protein