Perinephric fat stranding is associated with increased age and stone size but not with serum creatinine in patients with obstructing ureterolithiasis

• Published in: Urolithiasis 2024-06, Vol.52 (1), p.87
• Main Authors: Van Horn, Christine M., Iovanel, Gregory, Atwater, Britney, Engelberg, Rachel, Sobieh, Ahmed, Sorokin, Igor
• Format: Article
• Language: English
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Adult; Age Factors; Aged; Creatinine; Creatinine - blood; Female; Humans; Kidney - diagnostic imaging; Kidney - pathology; Male; Medical Biochemistry; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Nephrology; Patients; Retrospective Studies; Severity of Illness Index; Tomography, X-Ray Computed; Ureteral Obstruction - blood; Ureteral Obstruction - complications; Ureteral Obstruction - etiology; Ureterolithiasis - blood; Ureterolithiasis - complications; Urology
• ISSN: 2194-7228; 2194-7236; 2194-7236
• DOI: 10.1007/s00240-024-01583-2

Previous reports show increased severity of perinephric fat stranding (PFS) with elevated serum creatinine in obstructing ureterolithiasis. We sought to investigate this association with our institution’s patient population. We reviewed charts of patients diagnosed with obstructive ureterolithiasis or nephrolithiasis in our emergency department between January and October 2018. Patient demographics, lab results, and computed tomography (CT) imaging were reviewed. A blinded radiologist reviewed all CTs and graded hydronephrosis and PFS. Subjects were stratified by degree of PFS and compared via paired t-test, chi-squared test, univariate analysis, and multivariate analysis. We identified 141 patients; 114 had no-mild (Group 1) PFS, while 27 had moderate-severe (Group 2) PFS. Group 1 had a mean age of 56 (SD = 16.1) and mean stone size of 7.3 mm (SD = 4.22); 77% of the cohort had symptoms under 24 h. Group 2 was older with a mean age of 65 (SD = 16.2, p  = 0.01) and mean stone size of 10.1 mm (SD = 6.07, p