Risk factors for urinary tract infection after ureteroscopic holmium laser lithotripsy and its impacts on the FGF23/Klotho pathway
Guo Fanfan
Ren Huifang
Ma Lin
Yang Guodong
Ma Wenbo
Abstract：Objective:To investigate the influencing factors of urinary tract infection(UTI)following uretero-scopic holmium laser lithotripsy(UHLL)and its impact on the fibroblast growth factor(FGF)23/Klotho pathway.Methods:A retrospective analysis was conducted on 120 patients with ureteral calculi who underwent Ureteroscopic Holmium Laser Lithotripsy(UHLL)treatment at the Department of Urology in our hospital between August 2021 and August 2023.The patients were categorized into two groups based on the presence or absence of urinary tract in-fection(UTI):a non-UTI group(n=101)and a UTI group(n=19).ELISA was applied to detect serum FGF23 and Klotho levels;Multivariate logistic regression analysis was applied to analyze the influencing factors of UTI after UHLL.Results:The incidence of UTI after UHLL in patients with ureteral calculi was 15.83%(19/120).The pro-portions of diabetes,stone diameter≥2 cm,no use of antibiotics before operation,hydronephrosis and operation time≥60 min in UTI group were obviously higher than those in non UTI group(χ2=5.003,11.027,5.885,6.564,6.621,P<0.05).Multivariate logistic regression analysis showed that stone diameter(OR=2.518),preoperative use of antibiotics(OR=1.835),hydronephrosis(OR=2.026),and operative time(OR=2.104)were the influenc-ing factors for TUI after UHLL(P<0.05).The serum levels of FGF23,PCT,and IL-6 in postoperative UTI group were higher than those in the non UTI group(t=7.617,31.489,11.053,P<0.05),and Klotho was lower than that in the non UTI group(t=9.483,P<0.05).The serum levels of FGF23,PCT,and IL-6 in the UTI group after operation were higher than those before operation(t=5.590,14.555,6.660,P<0.05),while Klotho was lower than that before operation(t=6.950,P<0.05).Conclusion:The diameter of stones,preoperative use of antibiotics,hy-dronephrosis,and operative time are the influencing factors for the occurrence of TUI after UHLL,Moreover,the oc-currence of UTI after UHLL is accompanied by changes in the FGF23/Klotho pathway.
Keywords：ureteroscopy holmium laser lithotripsyurinary tract infectionrisk factorsfibroblast growth factor 23Klotho
Publication Date：2024-06-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 171-175 )