Objective: Microscopic examination of urine sediment is necessary for evaluation of renal and urinary tract diseases. In this study, we evaluated and compared analytic and diagnostic performances of DIRUI FUS-200 and a new image-based automated urine sediment analyzer Urised 3. Method: A total of 440 urine samples, submitted to our laboratory, were evaluated by two automated urine sediment analyzers and a standardized manual microscopy. Precision, linearity and method comparison studies were performed according to CLSI guidelines. Results: Considering the red blood cell (RBC) and white blood cell (WBC) counts, strong correlations existed between FUS-200 and manual microscopy (r=0.993 vs 0.861), Urised 3 and manual microscopy (r=0.962 vs 0.818), FUS200 and Urised 3 (r=0.961 vs 0.961). Clinical nonconcordance ranged from 7% to 14.16% among all methods. Conclusions: The concordance between the analyzers and manual microscopy for WBC was better than that of RBC. The concordance between the two analyzers was better for WBC and RBC, with respect to the manual microscopy. Although the Urised 3, FUS-200 and manual microscopy counts were in agreement; confirmation of the results of automated analyzers with manual microscopy is particularly helpful, for pathological samples with near cutoff values.

Fundamento: O receptor fraco indutor de apoptose semelhante a fator de necrose tumoral solúvel (sTWEAK) é um membro da superfamília de TNF que tem um papel crítico na proliferação e inflamação na circulação arterial. Objetivos: Este estudo prospectivo tem o objetivo de mostrar a relação entre os níveis de sTWEAK e calcificação da artéria coronária (CAC) em pacientes com doença renal crônica (DRC). Métodos: Este estudo prospectivo incluiu 139 pacientes consecutivos que passaram por angiografia coronariana por tomografia computadorizada, por qualquer motivo, para síndromes coronarianas agudas, de agosto de 2020 a fevereiro de 2021. Um total de 12 pacientes foi excluído do estudo devido aos critérios de exclusão. Os pacientes foram divididos em dois grupos com base em terem um escore CAC menor que 400 (n=84) ou um escore de 400 ou mais (n=43). A significância foi presumida em p-valor bilateral <0,05. Resultados: À medida que o escore CAC aumentou, os níveis de sTWEAK diminuíram de forma estatisticamente significativa e detectou-se uma relação forte entre níveis de sTWEAK e escore CAC (r: -0,779, p<0,001). A análise ROC revelou que o nível de corte ideal de sTWEAK para prever o escore CAC de 400 era 761 pg/mL com uma sensibilidade de 71% e especificidade de 73% (AUC: 0,78; IC 95%: 0,70-0,85; p <0,001). Conclusões: Embora os estudos em larga escala tenham demonstrado uma correlação positiva entre os níveis de TFGe e sTWEAK, alguns estudos detectaram que o aumento nos níveis de sTWEAK estão associados a mortalidade e gravidade do sistema da artéria coronária em pacientes com DRC. Nossos resultados comprovam nossa hipótese de que os níveis de sTWEAK mostram calcificação coronária em vez de outros tipos de placas ateroscleróticas.

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Introduction: The tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is one of the inflammatory mediators contributing to the atherosclerotic process. TWEAK has been studied in chronic kidney disease (CKD) patients and it has been shown that its level declines as eGFR decreases. Most studies have found that the decreased level of TWEAK was seen in atherosclerosis and was also associated with calcification of the plaque. This prospective study was designed to clarify any relationship between coronary slow flow (CSF) and TWEAK levels. Hypothesis: Our hypothesis was to show that the higher level of TWEAK might be seen in the setting of CSF due to lack of calcium deposits and TWEAK is not a reflection of healthy vessels. Methods: This prospective study included 93 consecutive patients undergoing invasive coronary angiography (ICA) for any reason except for acute coronary syndromes from May 2019 to March 2020 (Table 1). A total of 93 patients were divided into two groups with regard to having CSF (n=35) or no-CSF (n=58). Results: Patients with CSF had higher TWEAK levels than those without CSF (695.2± 225.2 vs 465.8±157.6, p<0.001). As the number of coronary arteries with slow flow increased, the TWEAK level was increased statistically significant (r:0.635/ p<0.001). The TWEAK level of 516 pg/mL was found for the prediction of CSF in ROC analysis. Conclusions: Our study has shown that plasma TWEAK level is an independent predictor for the CSF in patients with CKD (Table 2). Our study have found that elevated TWEAK levels may not reflect the healthy vessels as it was hypothesized in the past.