C-Reactive Protein as a Predictor for Early Intervention in Patients with Ureteric Calculus- A Prospective Study

Abstract

Introduction: Inflammation of ureteric wall may impede the passage of calculus which reduces the chances of spontaneous expulsion. C-Reactive Protein (CRP) being an acute phase reactant elevates in almost all inflammatory conditions. Aim: To determine whether CRP levels can predict the need for early intervention in symptomatic ureteric calculus. Materials and Methods: The sample was estimated to be 140 patients over the age of 18 years during the study duration of six months. Ureteric calculus measuring 5-10 mm were subjected to Medical Expulsion Therapy (MET) (Silodosin 8 mg at night). CRP levels were estimated on day 1 and day 7 from the presentation. CRP less than 6 mg/L was considered normal, represented as ‘negative’ in the present study; more than or equal to 6 mg/L was taken as ‘positive’. Patients who demonstrated rising/elevated CRP were considered for early endoscopic/surgical intervention. Data was analysed by Statistical Package for the Social Sciences (SPSS) v19.00. Results: Out of the 140 patients, 56 patients had positive CRP on day 7, of which only nine patients had expelled the stone at the end of two weeks (16.07%). Out of 84 negative CRP group patients, 56 showed evidence of spontaneous calculus expulsion within one week and 18 patients at the end of two weeks and 10 patients did not demonstrate spontaneous expulsion at the end of two weeks and required intervention. The present study showed a statistically significant correlation between the positive CRP levels and the rates of spontaneous expulsion of ureteric calculus (p=0.0001). Conclusion: CRP can be used as a predictor for an early intervention of symptomatic ureteric calculus.