The Relationship Between Inflammation Levels and The Degree of Obstruction in Urinary Tract Stones Based on Platelet-Lymphocyte Ratio (PLR) and Computed Tomography Stonography
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This study aimed to analyze the relationship between the platelet-to-lymphocyte ratio (PLR) and the degree of urinary tract obstruction in patients with urinary tract stones, as assessed by computed tomography (CT) stone protocol imaging. This analytical observational study employed a cross-sectional design using secondary data from patients with urinary tract stones who underwent CT imaging at Dr. Moewardi General Hospital, Surakarta, between March and August 2025. A total of 51 patients met the inclusion criteria, comprising 36 men (70.6%) and 15 women (29.4%). The most common stone location was the lower renal calyx (21.6%), while the most frequent stone size category was 11–20 mm (39.2%). Stone location differed significantly between the mild and significant obstruction groups (p = 0.046), whereas stone size categories showed no statistically significant difference (p = 0.059). The median PLR increased from 109.7 in grade 0 to 236.6 in grade 4, with a statistically significant difference across obstruction grades (Kruskal–Wallis H = 18.884; p = 0.001). Post hoc analysis revealed a significant difference between grades 0 and 4 (Bonferroni-adjusted p = 0.001). The median PLR was significantly higher in the significant obstruction group than in the mild obstruction group (226.8 vs. 112.3; p < 0.001). Spearman's rank correlation analysis demonstrated a strong positive association between PLR and obstruction severity (? = 0.609; p < 0.001). Logistic regression analysis indicated that each 10-unit increase in PLR was associated with 1.262-fold higher odds of significant obstruction (odds ratio = 1.262; 95% confidence interval: 1.101–1.447; p = 0.001). These findings demonstrated a statistically significant, strong positive association between PLR and the degree of urinary tract obstruction assessed by CT imaging in patients with urinary tract stones.
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