Revista da Associacao Medica Brasileira (1992) · 2026
The role of hematological parameters and systemic immune-inflammation index in the management of symptomatic gestational hydronephrosis.
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Sungur Ubeyd, Toksal Kağan, Sungur Gül Şüheda, Özlü Deniz Noyan, Ekşi Mithat, Fakir Ali Emre, Bitkin Alper
Аннотация
OBJECTIVE: The aim of this study was to investigate the clinical, imaging, and hematological parameters predicting the necessity of surgical intervention in pregnant women presenting with symptomatic gestational hydronephrosis.
METHODS: We retrospectively evaluated 192 pregnant women diagnosed with symptomatic hydronephrosis between January 2015 and September 2024. Patients were divided into Group 1 (conservative management, n=138) and Group 2 (surgical intervention via double-J stent or percutaneous nephrostomy, n=54). Demographic data, clinical findings, degree of hydronephrosis, urinalysis, and complete blood count parameters-including C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index-were compared. Logistic regression analysis was performed to identify predictors for surgery.
RESULTS: A history of urolithiasis, prolonged pain, fever, severe hydronephrosis, pyuria, and elevated creatinine were significantly higher in Group 2 (p<0.05). White blood cell, neutrophil-to-lymphocyte ratio, and C-reactive protein levels did not differ significantly between the groups. However, platelet counts (p=0.020), platelet-to-lymphocyte ratio (p=0.038), and systemic immune-inflammation index (p=0.015) were significantly elevated in the surgical cohort. Univariate logistic regression analysis revealed that an elevated platelet count (p=0.039) and a higher systemic immune-inflammation index (p=0.004) were significant predictors. In the multivariate analysis, the systemic immune-inflammation index remained an independent predictor (p=0.009), whereas platelet count did not.
CONCLUSION: While clinical presentation and the severity of hydronephrosis primarily indicate the need for surgical intervention, the systemic immune-inflammation index serves as a valuable, cost-effective auxiliary predictor among the hematological parameters.
METHODS: We retrospectively evaluated 192 pregnant women diagnosed with symptomatic hydronephrosis between January 2015 and September 2024. Patients were divided into Group 1 (conservative management, n=138) and Group 2 (surgical intervention via double-J stent or percutaneous nephrostomy, n=54). Demographic data, clinical findings, degree of hydronephrosis, urinalysis, and complete blood count parameters-including C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index-were compared. Logistic regression analysis was performed to identify predictors for surgery.
RESULTS: A history of urolithiasis, prolonged pain, fever, severe hydronephrosis, pyuria, and elevated creatinine were significantly higher in Group 2 (p<0.05). White blood cell, neutrophil-to-lymphocyte ratio, and C-reactive protein levels did not differ significantly between the groups. However, platelet counts (p=0.020), platelet-to-lymphocyte ratio (p=0.038), and systemic immune-inflammation index (p=0.015) were significantly elevated in the surgical cohort. Univariate logistic regression analysis revealed that an elevated platelet count (p=0.039) and a higher systemic immune-inflammation index (p=0.004) were significant predictors. In the multivariate analysis, the systemic immune-inflammation index remained an independent predictor (p=0.009), whereas platelet count did not.
CONCLUSION: While clinical presentation and the severity of hydronephrosis primarily indicate the need for surgical intervention, the systemic immune-inflammation index serves as a valuable, cost-effective auxiliary predictor among the hematological parameters.