title: Prognostic Value of Adrenomedullin and Natriuretic Peptides in Uroseptic Patients Induced by Ureteroscopy.
abstract: The aim of this paper is to investigate whether urosepsis is related to irrigation pressure of ureteroscopy (URS) and evaluate the prognostic value of adrenomedullin (ADM) and atrial and brain natriuretic peptides (ANP and BNP) in URS-induced uroseptic patients. From July 2008 to October 2013, we enrolled 332 patients with untreated unilateral ureteral obstruction (UUO). The UUO group included three subgroups of, respectively, 118, 132, and 82 patients who underwent URS under intermittent stable irrigation pressure of, respectively, 80, 120, and 160 mmHg. The plasma concentrations of ADM, ANP, and BNP were measured in all subjects. URS was performed for all UUO patients; the values of the three peptides were measured again after URS. Irrigation pressure and stone size were independent risk factors of urosepsis. After URS, the plasma concentrations of ADM, ANP, and BNP were significantly higher in uroseptic patients. Moreover, the concentrations were significantly higher depending on the disease severity. Plasma concentrations of the three peptides were correlated with plasma ET concentration in the uroseptic patients. The areas under receiver operating characteristic (ROC) curve of ADM, ANP, and BNP for predicting urosepsis were 0.811, 0.728, and 0.764, respectively. In conclusion, ADM, along with ANP and BNP, is valuable for prognosis in urosepsis secondary to URS which is associated with irrigation pressure.
authors.affiliation: Department of Urology, Renmin Hospital of Wuhan University, No. 238 Liberation Road, Wuhan, Hubei 430060, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, Renmin Hospital of Wuhan University, No. 238 Liberation Road, Wuhan, Hubei 430060, China.
authors.forename: Pang-Hu
authors.initials: PH
authors.lastname: Zhou
authors.affiliation: Department of Urology, Renmin Hospital of Wuhan University, No. 238 Liberation Road, Wuhan, Hubei 430060, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Urology, Renmin Hospital of Wuhan University, No. 238 Liberation Road, Wuhan, Hubei 430060, China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Urology, Renmin Hospital of Wuhan University, No. 238 Liberation Road, Wuhan, Hubei 430060, China.
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D053607:Adrenomedullin / Q000097:blood* / Q000378:metabolism; D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000378:metabolism; D018805:Sepsis / Q000097:blood* / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D018666:Ureteroscopy / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000097:blood* / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
chemical_list: D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor