The Value of Comparative Volumetric Analysis of Urinary and Blood Erythrocytes to Localize the Source of Hematuria

Angulo, Javier C.; López-Rubio, Montserrat; Guil, M; Herrero, B.; Burgaleta, Carmen; Sánchez‐Chapado, Manuel

doi:10.1097/00005392-199907000-00028

Cited by 12 publications

(3 citation statements)

References 35 publications

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“…To standardize measurements and to reduce the workload of conventional microscopic examination, automated systems using computer-assisted light microscopy [31,32], immunocytochemical staining, flow cytometric analysis of erythrocytes [33] or measurement of size or mean corpuscular volume of erythrocytes [34] have been used in the laboratories. These methods, however, are still not qualified to detect and quantify urinary dRBC.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Urinary Dysmorphic Erythrocytes in Clinical Practice

Crop

Rijke²,

Verhagen³

et al. 2010

Nephron Clin Pract

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Background: In clinical practice, discriminating between glomerular and nonglomerular causes of hematuria is often difficult. Dysmorphic red blood cells (dRBC) in the urinary sediment are claimed to be effective, but the cutoff points in the literature vary. This follow-up study aimed to determine the diagnostic value of dRBC. Methods: We investigated 134 hematuria patients in the departments of nephrology and urology. To diagnose the origin of hematuria, urological and/or nephrological examination was performed and the %dRBC identified by microscopy. Follow-up was performed after 3.5 years. Results: The cause of hematuria was proven in 68 patients (35% glomerular; 65% nonglomerular). Patients with glomerular disease had significantly more albuminuria and dRBC than patients with nonglomerular disease, but the %dRBC ranged from 1 to 50% and no optimal cutoff could be identified. Logistic regression analysis showed that %dRBC had a predicted probability to diagnose glomerular disease of 77.9% (area under the curve, AUC, 0.85). When %dRBC was combined with other risk factors such as serum creatinine, sex, age, dipstick erythrocyte or proteinuria score and number of casts, the predictive probability increased to 90.6% (AUC 0.97). Follow-up of the included patients showed no benefit of dRBC to identify patients at risk for glomerular disease. Conclusions: The diagnostic value of routinely collected urinary dRBC to diagnose glomerular disease in patients presenting with hematuria is modest. However, including dRBC with other variables, such as age and erythrocyte score on dipstick testing may increase the sensitivity, but needs to be confirmed in another, preferably larger, population.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Urinary Dysmorphic Erythrocytes in Clinical Practice

Crop

Rijke²,

Verhagen³

et al. 2010

Nephron Clin Pract

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“…Auch die Volumenbestimmung der im Urin gefundenen Erythrozyten [26], die Untersuchung mittels Flow-Zytometrie [27] und die Proteinuriedifferenzierung [28] können wertvolle Hinweise auf die Hämaturiequelle geben, sind jedoch vergleichsweise aufwendig und der konventionellen Mikroskopie des Geübten hinsichtlich Sensitivität und Spezifität nicht überlegen.…”

Section: Bladder Neoplasm · Hematuria · Diagnosticsunclassified

H�maturie beim Harnblasenkarzinom

Wawroschek¹,

Roth

2003

Der Urologe A

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In the majority of cases, painless macroscopic hematuria is a typical initial symptom of bladder carcinoma. The time of occurrence (early and late symptom) neither correlates with tumor size and degree nor with infiltration depth. The respective testing method and threshold value exert a significant influence on frequency and constancy of a potential microscopic hematuria. Without sufficient standardization, however, it is understandable that even the existing guidelines for diagnosis of hematuria recommend different methods and threshold values. This paper provides an overview of the various testing methods and threshold values in microscopic hematuria, their influence on the diagnosis of bladder carcinoma as well as the possibility of differentiating the source of hematuria morphologically.

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“…However, it is time-consuming, labor-intensive, and associated with wide inter-observer variation, hampering standardization. Automated analyzers for urine sediment analysis have been evaluated as an alternative for differentiating GH from NGH [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Characteristics of Urinary Red Blood Cell Distribution Incorporated in UF-5000 for Differentiation of Glomerular and Non-Glomerular Hematuria

et al. 2022

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Background: Automated urine sediment analysis has been developed to address the limitations of microscopic examination of dysmorphic red blood cells (RBCs). We evaluated the urinary RBC distribution (URD) parameter of a recently launched automated urinary flow cytometry analyzer, UF-5000 (Sysmex, Kobe, Japan), to differentiate glomerular hematuria (GH) from non-GH (NGH).Methods: Samples submitted for urine sediment analysis from patients with hematuria ( > 20 RBCs/μL) were divided into derivation (N = 156; 101 GH, 55 NGH) and validation cohorts (N = 107; 60 GH, 47 NGH). The clinical diagnosis of GH or NGH was established based on clinical data review. Differences in UF-5000 parameters (URD, small RBC, lysed RBC, RBC-P70FSC, RBC-SF-FSC-W, mean forward-scattered light, and mean side-scattered light) between GH and NGH, and areas under the ROC curves (AUC) were analyzed in the derivation cohort. The derived ideal cut-off value was evaluated in the validation cohort. We applied the Kitasato criteria to compare the diagnostic performance.Results: URD (%), differed significantly between GH and NGH (P < 0.001) in the two cohorts. The AUC of URD was 0.814 and 0.806 in the derivation and validation cohorts, respectively. Using a cut-off of > 20.1%, the sensitivity was 99.0%/89.4% and the specificity was 50.9%/63.3% in the derivation/validation cohort. When the Kitasato criteria were applied, the sensitivity and specificity were 80.2% and 52.7%, respectively.Conclusions: URD is a rapid, objective, and quantitative measure that can be used to differentiate GH and NGH.

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The Value of Comparative Volumetric Analysis of Urinary and Blood Erythrocytes to Localize the Source of Hematuria

Cited by 12 publications

References 35 publications

Diagnostic Value of Urinary Dysmorphic Erythrocytes in Clinical Practice

Diagnostic Value of Urinary Dysmorphic Erythrocytes in Clinical Practice

H�maturie beim Harnblasenkarzinom

Diagnostic Characteristics of Urinary Red Blood Cell Distribution Incorporated in UF-5000 for Differentiation of Glomerular and Non-Glomerular Hematuria

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