Zhen Xingshu, Huang Mei, Xu Yangang, Yang Yaping, Zhan Yifei, Li Liuqiang, Du Yuxuan, Chen Jiahui, Guo Yaochuan, Chen Meiling, Bian Jun, Lai Dehui
Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, 621 Gangwan Road, Huangpu District, Guangzhou, 510700, Guangdong, China.
Department of Urology, Huizhou Third People's Hospital, Huizhou, Guangdong, China.
Sci Rep. 2025 Sep 1;15(1):32073. doi: 10.1038/s41598-025-15494-8.
Renal parenchyma thickness and hydronephrosis degree may predict stone-free rate (SFR) after lithotripsy. This study combined these factors and introduced a new index, the ratio of renal parenchymal volume to renal volume (RPRV) to investigate its prediction role of SFR after retrograde intrarenal surgery (RIRS). We collected data from 119 adult patients with upper ureteral or kidney stones who underwent RIRS from March to September 2023. They were divided into stone-free group (n = 85, 71.43%) and residual stone group. Multivariate logistic regression analyzed the relationship between RPRV and SFR. ROC curve analyzed the predictive efficacy of RPRV. Among the 119 patients, there was a difference in RPRV between the two group (P = 0.002). In overall sample, AUC of RPRV for predicting SFR after RIRS is 0.678 (cut-off value: 0.6890, sensitivity: 95.3%; specificity: 41.2%; P = 0.002). In the 2-2.9 cm group multivariate logistic regression analysis is statistically significant (OR 0.847, 95% CI 0.761-0.942, P = 0.002), with an AUC of 0.769 (cut-off value: 0.6887; sensitivity: 97.8%; specificity: 58.8%; P = 0.001). In the 3-4 cm stone group, no significant difference. RPRV is effective in predicting SFR after RIRS and has clinical guiding significance.
肾实质厚度和肾积水程度可能预测碎石术后的无石率（SFR）。本研究综合这些因素，引入了一个新指标，即肾实质体积与肾体积之比（RPRV），以探讨其对逆行性肾内手术（RIRS）后SFR的预测作用。我们收集了2023年3月至9月接受RIRS的119例成年上输尿管或肾结石患者的数据。他们被分为无石组（n = 85，71.43%）和残留结石组。多因素logistic回归分析RPRV与SFR之间的关系。ROC曲线分析RPRV的预测效能。119例患者中，两组间RPRV存在差异（P = 0.002）。在总体样本中，RPRV预测RIRS后SFR的AUC为0.678（临界值：0.6890，灵敏度：95.3%；特异度：41.2%；P = 0.002）。在2 - 2.9 cm组，多因素logistic回归分析具有统计学意义（OR 0.847，95%CI 0.761 - 0.942，P = 0.002），AUC为0.769（临界值：0.6887；灵敏度：97.8%；特异度：58.8%；P = 0.001）。在3 - 4 cm结石组，无显著差异。RPRV对预测RIRS后SFR有效，具有临床指导意义。
