Valor predictivo de proteína C reactiva y albúmina en la expulsión de litos ureterales de 6-10 mm del tercio inferior

Resumen

Introducción La litiasis ureteral es responsable del 20% de casos de urolitiasis, el cólico renal afecta negativamente la calidad de vida, el mayor dilema es el elegir entre medidas conservadoras y cirugía. La mayoría de los litos ureterales de tercio distal menor de 6mm, pueden pasar espontáneamente con terapia conservadora. Sin embargo, ella se asocia a incomodidad, infecciones y ausencia laboral. La proteína C Reactiva (PCR) se ha utilizado como predictor en la expulsión de esos litos, además se introduce el uso de la albúmina como nuevo marcador de predicción.

Objetivo El objetivo es analizar el valor predictivo de PCR y albúmina para la expulsión de litos ureterales de tercio inferior de 6–10 mm.

Métodos Se realizó un estudio prospectivo en pacientes que presentaron cólico renal secundario a litiasis ureteral distal 6–10 Mm, los cuales recibieron tratamiento médico expulsivo durante 4 semanas, hasta la expulsión del lito o la necesidad de tratamiento quirúrgico en que se determinó punto de corte de PCR y albúmina por medio de una curva COR.

Resultados 78 pacientes se enrolaron en el estudio, el paso espontáneo fue de 55,1% y el restante requirió de intervención quirúrgica, el punto de corte para PCR fue 5,95 mg/L y de 2,75 g/dl para albúmina.

Conclusión El PCR es un parámetro predictivo en la expulsión de litos ureterales de tercio inferior en pacientes muy seleccionados. Se obtiene el siguiente punto de corte para predecir la eliminación del lito (5,95 mg/L) y se propone la albúmina como un nuevo parámetro bioquímico.

Abstract

Introduction Ureteral stones is responsible for 20% of cases of urolithiasis, renal colic negatively affects quality of life, the main dilemma is choosing between conservative measures and surgery. Most ureteral stones of the distal third smaller than 6 mm can pass spontaneously with conservative therapy. However, this is associated with discomfort, infections. C Reactive protein (CRP) has been used as a predictor in the expulsion of these stones, and the use of albumin as a new marker of prediction is also introduced.

Objective The objective is to analyze the predictive value of CRP and albumin for the expulsion of ureteral stones of the lower third of 6–10 mm

Methods A prospective study was performed in patients who presented renal colic secondary to distal ureteral lithiasis 6–10 mm and who received medical expulsive treatment for 4 weeks, until the expulsion of the stone or the need for surgical treatment, PCR cut off point was determined and albumin by means of a ROC curve.

Results 78 patients enrolled in the study, spontaneous passage was 55.1% and the remaining required surgical intervention, the cut-off point for PCR was 5.95 mg/L and 2.75 g/dl for albumin.

Conclusion CRP is a predictive parameter in the expulsion of lower third ureteral stones in highly selected patients. The following cut off point is obtained to predict the elimination of lithium (5.95 mg/L) and albumin is proposed as a new biochemical parameter.

Palabras clave

litiasis ureteral - ureter inferior - proteína C reactiva - albúmina - tratamiento médico expulsivo - tamsulosina

Keywords

ureteral stones - ureter lower third - C reactive protein - albumin - medical expulsive therapy - tamsolusin

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