Value of Acute-Phase Proteins in the URS Surgery and Complications

Background: URS and ESWL are the most preferred first-line treatment options in cases where the stone needs to be removed. URS is recommended as priority to patients who want to get rid of stones quickly with a single treatment application. Aim: In this study we tried to elucidate the preoperative and postoperative hematological, biochemical and acute phase protein changes in patients who underwent ureteroscopy and its complications. Materials & Method: A total of 115 patients who have been run via URS due to kidney stones in our institution between 2019 and 2021 and patients who underwent ESWL as a control group were included in this study. Hemogram, blood biochemistry, C-Reactive Protein, Haptoglobin, transferrin values were analyzed in all patients before and at 1,3 and 30 days after surgery. The acute phase protein changes in case of complications in 15 patients who developed complications in URS surgery were analyzed. Results: A statistically significant difference was seen in Bk, BUN, Cr, Na, CRP, HPT and TRF and Bk, Na, and Ca values measured in the first month (p<0.05). The development of complications were 8 times more common if the stone was located on the left side. One-unit decrease in Cl reduced complication rate 0.6-fold decrease in the pre-operative period and 0.8-fold on the first day. One-unit decrease in TRF reduced complication rate 0.7-fold decrease in the pre-operative period and 0.02-fold on the third day. The CRP cut-off value of 63.95, HPT cut-off value of over 5.84 and TRF cut-off value of below 2.04 increased complication rate. Conclusion: Regarding the results of this study one can say that acute phase reactants can be used as convenient predictive biomarkers of complications in patients who underwent ureteroscopy. As far as we know this was the first study to elaborate their importance in the literature.