Comparison of urine analysis using manual and sedimentation methods / Comparación del análisis de orina usando el método manual y el método de sedimentación

OBJECTIVE: Microscopic examination of urine sediment is an essential part in the evaluation of renal and urinary tract diseases. Traditionally, urine sediments are assessed by microscopic examination of centrifuged urine. However, the current method used by the Georgetown Public Hospital Corporation Medical Laboratory involves uncentrifuged urine. To encourage high level of care, the results provided to the physician must be accurate and reliable for proper diagnosis. The aim of this study is to determine whether the centrifuge method is more clinically significant than the uncentrifuged method. METHODS: In this study, a comparison between the results obtained from centrifuged and uncentrifuged methods were performed. A total of 167 urine samples were randomly collected and analysed during the period April-May 2010 at the Medical Laboratory, Georgetown Public Hospital Corporation. The urine samples were first analysed microscopically by the uncentrifuged, and then by the centrifuged method. The results obtained from both methods were recorded in a log book. These results were then entered into a database created in Microsoft Excel, and analysed for differences and similarities using this application. Analysis was further done in SPSS software to compare the results using Pearson's correlation. RESULTS: When compared using Pearson's correlation coefficient analysis, both methods showed a good correlation between urinary sediments with the exception ofwhite bloods cells. The centrifuged method had a slightly higher identification rate for all of the parameters. CONCLUSIONS: There is substantial agreement between the centrifuged and uncentrifuged methods. However, the uncentrifuged method provides for a rapid turnaround time.

OBJETIVO: El examen microscópico del sedimento de orina es una parte esencial en la evaluación de enfermedades renales y del tracto urinario. Tradicionalmente, los sedimentos de orina son evaluados mediante examen microscópico de orina centrifugada. Sin embargo, el método actual usado por el Laboratorio Médico de la Corporación del Hospital Público de Georgetown recurre a la orina no centrifugada. Con el propósito de estimular un alto nivel de cuidado, los resultados proporcionados al médico tienen que ser exactos y fiables para un diagnóstico apropiado. El objetivo de este estudio es determinar si el método de la centrifugación es clinicamente más significativo que el método sin centrifugación. MÉTODOS: En este estudio, se hace una comparación entre los resultados obtenidos a partir del método con centrifugado y sin centrifugado. Un total de 167 muestras de orina fueron recogidas aleatoriamente y analizadas durante el periodo de abril a mayo de 2010 en el Laboratorio Médico de la Corporación del Hospital Público de Georgetown. Las muestras de orina se analizaron primero microscópicamente por el método sin centrifugado, y entonces por el método con centrifugación. Los resultados obtenidos mediante ambos métodos fueron registrados en un en un diario de documentación. Estos resultados fueron entonces introducidos en un banco de datos creado en Microsoft Excel, y analizados en cuanto a sus diferencias y similitudes usando esta aplicación. El análisis se realizó también más tarde mediante el software de SPSS para comparar los resultados usando la correlación de Pearson. RESULTADOS: Al ser comparados mediante análisis basado en el coeficiente de correlación de Pearson, ambos métodos mostraron una buena correlación de los sedimentos urinarios, con excepción de los leucocitos. El método de la centrifugación tuvo una tasa de identificación ligeramente más alta para todos los parámetros. CONCLUSIONES: Existe una correspondencia sustancial entre los métodos con centrifugado y sin centrifugado. Sin embargo, el método que no emplea la centrifugación ofrece un tiempo de respuesta más rápido.

Field’s staining technique for identification of urinary casts.

Dried smears of urinary sediment stained with simple, rapid dip quick Field’s stain were studied in 173 selected patients with urinary casts. This permanent staining technique facilitated studying of casts formation, structure and composition. It permitted more accurate identification of mixed cellular cast, bacterial and renal epithelial cells cast. The advantages over bright field microscopy (wet preparation) are that it is more generally available and provides a permanent record. Slide can be used for re-evaluation, teaching and consultation purposes.

CLINICAL SIGNIFICANCE OF ANALYSIS OF URINE TRACE PROTEINS AND PROTEIN CONSTITUENTS OF CASTS IN ESSENTIAL HYPERTENSION PATIENTS / 解放军医学杂志

The trace Alb, IgG, and IgM in urine were determined with ELISA, and urinary casts protein romposition was analysed by means of immunoenzyme stain methods, in 123 cases of primary hypertension patients. A significant high level of urine Alb and Ig were found in these patients, and a positive correlation existed between urinary trace proteins and disease severity, blood pressure and disease course. These increased proteins fell to normal level after giving treatment. Besides TH (Tamm-horsfall glycoprotein), no IgG, IgA, IgM and Alb were detected in urinary casts. These results suggested that the conbined use of both methods would be benefirial to distinguish primary hypertension from renal hypertension as well as to make early prognosis and monitor of renal function.