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This prospective observational study evaluates serum and urine Growth Differentiation Factor-15 (GDF-15) for diagnostic and predictive use in patients with ureteral-stone-induced renal colic. Seventy-six patients were studied, with ELISA-based biomarker measurement alongside CT characterization and inflammatory laboratory tests, using statistical comparisons, correlations, and ROC analysis.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/evaluation-of-serum-and-urine-gdf-15-levels-in-patients-with-ureteral-stones/465121/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/evaluation-of-serum-and-urine-gdf-15-levels-in-patients-with-ureteral-stones/465121.png","ImageObject",300,407,{"name":92,"@type":93},"Rowan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"Why is CT limited for diagnosing ureteral stones in acute renal colic?","Question",{"text":112,"@type":113},"Non-contrast CT is the diagnostic gold standard, but its use is restricted by radiation exposure, cost, and accessibility. Identifying alternative biomarkers could reduce unnecessary CT scans.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were serum and urine GDF-15 levels measured and compared?",{"text":117,"@type":113},"Serum and urine GDF-15 were measured using ELISA. 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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Urology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize 53000, Türkiye; [erdem.orman@erdogan.edu.tr](erdem.orman@erdogan.edu.tr) (E.O.); [eyup.dil@erdogan.edu.tr](eyup.dil@erdogan.edu.tr) (E.D.); [hakki.uzun@erdogan.edu.tr](hakki.uzun@erdogan.edu.tr) (H.U.)  \n2 Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Türkiye; [ertugrulyigit@ktu.edu.tr](ertugrulyigit@ktu.edu.tr)  \n3 Department of Medical Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize 53000, Türkiye; [merve.huner@erdogan.edu.tr](merve.huner@erdogan.edu.tr)  \n* Correspondence: [gorkem.akca@erdogan.edu.tr](gorkem.akca@erdogan.edu.tr); Tel.: +90-5346163280  \nAbstract  \nBackground: Acute renal colic, most often caused by ureteral stones, is a common cause of emergency admissions. While non-contrast computed tomography (CT) is the diagnostic gold standard, its use is limited by radiation exposure, cost, and accessibility. Growth Differentiation Factor-15 (GDF-15) is a stress-induced cytokine elevated in various acute pathologies. This study investigated the diagnostic and predictive value of serum and urine GDF-15 in patients with acute renal colic due to ureteral stones. Methods: In this prospective observational study (January 2024–March 2025), 76 patients presenting with sudden-onset flank pain were enrolled. A total of 41 patients with radiologically confirmed ureteral stones formed the stone-positive group, and 35 patients without urinary pathology served as controls. Serum and urine GDF-15 levels were measured by ELISA, along with routine laboratory tests. CT was used to assess stone characteristics, hydronephrosis grade, and ureteral wall thickness. Group comparisons were performed using the Mann–Whitney U test, correlations with Spearman’s test, and diagnostic performance with ROC analysis. Results: Both serum and urine GDF-15 levels were significantly higher in stone-positive patients (p \u003C 0.001) . Urine GDF-15 demonstrated excellent diagnostic accuracy (AUC = 0.986; sensitivity = 92.7%; specificity = 91.4), while serum GDF-15 showed moderate performance (AUC = 0.767) . GDF-15 levels showed modest positive correlations with CRP and were numerically higher in patients with ureteral wall thickness > 1 mm and proximal stones. No significant association was found with spontaneous stone passage (p > 0.05) . Conclusions: Urine GDF-15 shows promising diagnostic accuracy for ureteral stones and may serve as anon-invasive adjunctive tool when imaging is limited. While associated with inflammation and stone location, it did not predict spontaneous stone passage. These findings support its potential as a clinical biomarker, though further large-scale validation is required.  \nKeywords: ureteral stone; GDF-15; urinary biomarker; renal colic; inflammation  \n1. Introduction  \nFlank pain is among the most common reasons for emergency department visits, with acute renal colic representing one of the most critical differential diagnoses. Acute renal colic typically presents as a sudden-onset flank pain originating from the costovertebral angle and radiating anteriorly and inferiorly toward the groin or testes, often accompanied by nausea and vomiting [1] . This severe pain is most commonly secondary to ureteral calculi  \nand results from stone-induced obstruction of the ureter, leading to impaired urinary flow, ureteral spasm, and dist","cbCaic9teaAdex75","https://ap.wps.com/l/cbCaic9teaAdex75","pdf",6020370,16,"English","# Abstract\n# 1. Introduction\n## Background and clinical challenge\n## Diagnostic approach and limitations\n## Rationale for GDF-15","[{\"question\":\"Why is CT limited for diagnosing ureteral stones in acute renal colic?\",\"answer\":\"Non-contrast CT is the diagnostic gold standard, but its use is restricted by radiation exposure, cost, and accessibility. Identifying alternative biomarkers could reduce unnecessary CT scans.\"},{\"question\":\"How were serum and urine GDF-15 levels measured and compared?\",\"answer\":\"Serum and urine GDF-15 were measured using ELISA. Group differences were assessed with Mann–Whitney U testing, correlations were examined with Spearman’s method, and diagnostic performance used ROC analysis.\"},{\"question\":\"What diagnostic performance did urine and serum GDF-15 show?\",\"answer\":\"Urine GDF-15 showed excellent diagnostic accuracy (AUC 0.986) with high sensitivity and specificity, whereas serum GDF-15 demonstrated moderate performance (AUC 0.767).\"},{\"question\":\"Did GDF-15 predict spontaneous stone passage?\",\"answer\":\"No significant association was found between GDF-15 levels and spontaneous stone passage, despite observed links with inflammation markers and stone-related features.\"}]","Evaluation of Serum and Urine GDF-15 Levels in Patients with Ureteral Stones | PDF",1790769203]