Urinary Decoy Cell Grading and Its Clinical Implications

Koh, Myoung Ju; Lim, Beom Jin; Noh, Songmi; Kim, Yon Hee; Jeong, Hyeon Joo

doi:10.4132/koreanjpathol.2012.46.3.233

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…The correlation between decoy cell number and the severity of renal injury remains controversial. Koh et al reported that urinary decoy cell number is associated with sustained cell shedding, positive urinary PCR results, and the development of BKVAN [ 66 ]. On the other hand, Singh et al found no correlation between the severity of BKVAN and either decoy cell counts or BKV DNA levels in plasma or urine [ 67 ].…”

Section: Screeningmentioning

confidence: 99%

BK Virus-Associated Nephropathy after Renal Transplantation

Funahashi

2021

Pathogens

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Recent advances in immunosuppressive therapy have reduced the incidence of acute rejection and improved renal transplantation outcomes. Meanwhile, nephropathy caused by BK virus has become an important cause of acute or chronic graft dysfunction. The usual progression of infection begins with BK viruria and progresses to BK viremia, leading to BK virus associated nephropathy. To detect early signs of BK virus proliferation before the development of nephropathy, several screening tests are used including urinary cytology and urinary and plasma PCR. A definitive diagnosis of BK virus associated nephropathy can be achieved only histologically, typically by detecting tubulointerstitial inflammation associated with basophilic intranuclear inclusions in tubular and/or Bowman’s epithelial cells, in addition to immunostaining with anti-Simian virus 40 large T-antigen. Several pathological classifications have been proposed to categorize the severity of the disease to allow treatment strategies to be determined and treatment success to be predicted. Since no specific drugs that directly suppress the proliferation of BKV are available, the main therapeutic approach is the reduction of immunosuppressive drugs. The diagnosis of subsequent acute rejection, the definition of remission, the protocol of resuming immunosuppression, and long-term follow-up remain controversial.

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Section: Screeningmentioning

confidence: 99%

BK Virus-Associated Nephropathy after Renal Transplantation

Funahashi

2021

Pathogens

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“…Figure 2C (g-i) show the underlying urothelium, and the appearance of different parts of the epithelium indicates lesions in the corresponding parts. Figure 2C (j-l) show a decoy cell, which is a shed renal tubular epithelial cell containing polyoma viral inclusion bodies, which are related to BKV (BK virus) infection and renal insufficiency after renal transplantation ( 24 - 26 ).…”

Section: Discussionmentioning

confidence: 99%

Performance analysis of urine formed element analyzer EH-2090 was found to have good accuracy in detecting RBCs and WBCs when compared to manual microscopic

Bai,

Xu,

2024

Transl Androl Urol

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Background EH-2090 is Mindray’s new-generation fully automatic urine formed element analyzer (hereinafter referred to as EH-2090). Currently, there are no studies on EH-2090, so we evaluated the analytical and clinical performance of this instrument to verify that it can meet daily clinical needs, and used manual microscopy as a reference method. Methods The analytical performance of the EH-2090 was first evaluated for repeatability, linearity, reproducibility, and carryover. We collected urine samples from outpatient and inpatient departments of Peking University Shenzhen Hospital. Uncentrifuged urine was compared with the EH-2090 using the Fuchs–Rosenthal counting method—a quantitative reference method for microscopy—for comparative studies in terms of red blood cell (RBC) and white blood cell (WBC) counting accuracy. Passing-Bablok regression analysis was performed for RBC and WBC counts. Two laboratory technicians performed centrifugation and manual analysis (microscopy) to evaluate its performance at detecting RBCs, WBCs, and casts, sensitivities and specificities were calculated. Results The EH-2090’s between-run reproducibility, within-day reproducibility, between-day reproducibility, and within-laboratory reproducibility for formed components of urine all met the laboratory requirements. There was a good correlation between the counting accuracy of RBCs (r=0.965, P<0.0001) and WBCs (r=0.894, P<0.0001) by the EH-2090 and the Fuchs-Rosenthal method. The positive coincidence rates of RBC and manual microscopy were 86.08% and 92.41%, respectively, and the negative coincidence rates were 88.39% and 85.81%, respectively. The positive coincidence rates before and after the WBC review were 89.33% and 92.00%, respectively, whereas the negative ones were 77.64% and 83.23%, respectively. The positive coincidence rates before and after cast review were 77.78% and 82.05%, respectively, and the negative ones were 97.09% and 93.60%, respectively. Conclusions The EH-2090 has good analytical and clinical performance. Its RBC and WBC counting accuracy correlates well with the quantitative reference method of microscopy.

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“…Routine screening for BK has been shown to be effective in preventing allograft loss in patients with BK viruria or viremia. Reduction of immunosuppression remains the mainstay of BK nephropathy treatment and is the best studied intervention (7). The present study was conducted on thirty-three patients (22 males and 11 females) who received kidney transplantation from living donors.…”

Section: Discussionmentioning

confidence: 99%

Decoy Cell Viruria in Kidney Transplant Patients : Does It Correlate with Renal Function ?

Abedi¹,

Mortazavi²,

Mirmosayyeb³

2017

ME-JFM

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Objective: BK virus (BKV) infection after kidney transplantation has been a topic of great interest in the recent decade. Prospective screening studies have revealed that BKVN is principally an early complication of renal transplantation occurring within the first post-transplant year in most cases. The aim of the present study was to observe the incidence of decoy cell viruria in renal transplant recipients. Furthermore, correlation of decoy cell viruria with graft function was assessed. Methods: This analytic cross-sectional study was conducted in the Transplant Center of Alzahra Hospital, Isfahan, Iran between Jun 2014 and June 2015. Clinical screening for polyomavirus infection was done by means of urine cytological evaluation for decoy cells. Urine samples were analyzed in three steps including 2-4 months after transplantation, three and six months later. Results: Thirty-three patients (22 male and 11 female) received kidney transplant from living donors. The average of patients' age was 41.9±12.83 (range: 20-63 years). Peritoneal and hemodialysis were used for 15.6% and 84.4% of recipients. The occurrence of decoy cell viruria at the time of enrollment, 3 and 6 months later was found in 18.2%, 10.7% and zero, respectively. Conclusion: As urine cytology is easy to perform and of low cost, it is a useful tool for the investigation of active polyoma virus infection. Moreover, the findings advocate that the presence of decoy cells along with high creatinine is a better indicator of the virus presence.

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Urinary Decoy Cell Grading and Its Clinical Implications

Cited by 8 publications

References 11 publications

BK Virus-Associated Nephropathy after Renal Transplantation

BK Virus-Associated Nephropathy after Renal Transplantation

Performance analysis of urine formed element analyzer EH-2090 was found to have good accuracy in detecting RBCs and WBCs when compared to manual microscopic

Decoy Cell Viruria in Kidney Transplant Patients : Does It Correlate with Renal Function ?

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