Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases
Abstract Hematuria, either glomerular or extraglomerular, is defined as 3 or more red blood cells (RBCs)/high power field. Currently, urinalyses are commonly performed using automated urine sediment analyzers. To assess whether RBC counting by automated urine sediment analyzers is reliable for defin...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-00457-6 |
| _version_ | 1819024909571981312 |
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| author | Won Seok Yang |
| author_facet | Won Seok Yang |
| author_sort | Won Seok Yang |
| collection | DOAJ |
| description | Abstract Hematuria, either glomerular or extraglomerular, is defined as 3 or more red blood cells (RBCs)/high power field. Currently, urinalyses are commonly performed using automated urine sediment analyzers. To assess whether RBC counting by automated urine sediment analyzers is reliable for defining hematuria in glomerular disease, random specimen urinalyses of men with nephritic glomerular disease (7674 urinalyses) and bladder cancer (12,510 urinalyses) were retrospectively reviewed. Urine RBCs were counted by an automated urine sediment analyzer based on flow cytometry (UF-1000i, Sysmex Corporation) or digital image analysis (Cobas 6500, Roche Diagnostics GmbH). In about 20% of urine specimens, the specific gravity was less than 1.010, making the RBC counts unreliable. In the urine specimens with specific gravity ≥ 1.010, RBC counts measured using either UF-1000i or Cobas 6500 were well correlated with the positive grades in the dipstick blood test. However, at a trace, 1+, or higher positive dipstick tests for blood, RBC counts were graded significantly lower in glomerular disease than in bladder cancer. The findings suggest that RBC counting by UF-1000i or Cobas 6500 underestimates the severity of hematuria in glomerular disease, possibly because dysmorphic RBCs in glomerular disease are susceptible to hemolysis and/or fail to be properly recognized. |
| first_indexed | 2024-12-21T05:02:17Z |
| format | Article |
| id | doaj.art-9d6a88e199904083a133048161f9924a |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-21T05:02:17Z |
| publishDate | 2021-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-9d6a88e199904083a133048161f9924a2022-12-21T19:15:13ZengNature PortfolioScientific Reports2045-23222021-10-011111810.1038/s41598-021-00457-6Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseasesWon Seok Yang0Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of MedicineAbstract Hematuria, either glomerular or extraglomerular, is defined as 3 or more red blood cells (RBCs)/high power field. Currently, urinalyses are commonly performed using automated urine sediment analyzers. To assess whether RBC counting by automated urine sediment analyzers is reliable for defining hematuria in glomerular disease, random specimen urinalyses of men with nephritic glomerular disease (7674 urinalyses) and bladder cancer (12,510 urinalyses) were retrospectively reviewed. Urine RBCs were counted by an automated urine sediment analyzer based on flow cytometry (UF-1000i, Sysmex Corporation) or digital image analysis (Cobas 6500, Roche Diagnostics GmbH). In about 20% of urine specimens, the specific gravity was less than 1.010, making the RBC counts unreliable. In the urine specimens with specific gravity ≥ 1.010, RBC counts measured using either UF-1000i or Cobas 6500 were well correlated with the positive grades in the dipstick blood test. However, at a trace, 1+, or higher positive dipstick tests for blood, RBC counts were graded significantly lower in glomerular disease than in bladder cancer. The findings suggest that RBC counting by UF-1000i or Cobas 6500 underestimates the severity of hematuria in glomerular disease, possibly because dysmorphic RBCs in glomerular disease are susceptible to hemolysis and/or fail to be properly recognized.https://doi.org/10.1038/s41598-021-00457-6 |
| spellingShingle | Won Seok Yang Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases Scientific Reports |
| title | Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases |
| title_full | Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases |
| title_fullStr | Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases |
| title_full_unstemmed | Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases |
| title_short | Automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases |
| title_sort | automated urine sediment analyzers underestimate the severity of hematuria in glomerular diseases |
| url | https://doi.org/10.1038/s41598-021-00457-6 |
| work_keys_str_mv | AT wonseokyang automatedurinesedimentanalyzersunderestimatetheseverityofhematuriainglomerulardiseases |