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El sedimento urinario es una herramienta utilizada hace tantos años para caracterizar manifestaciones renales de enfermedades primarias y secundarias, que es necesario realizar una estandarización y aprender a interpretar el mismo. En los pacientes ingresados a la unidad de cuidados intensivos, muchas veces no se realiza, o hay que tener en cuenta varios factores para su interpretación debido al estado hemodinámico del paciente a la filtración glomerular, la excreción tubular, la reabsorción de agua y los solutos además del equilibrio acido-base, los cuales pueden variar significativamente en pacientes en estado crítico con diferentes condiciones fisiopatológicas. Se presenta una revisión de las condiciones para la interpretación del urianálisis.
A urinary sediment is a tool used for years to characterize renal manifestations of primary and secondary diseases, which requires standardization and learning to interpret it. In patients admitted to the intensive care unit, it is often not performed, or several factors must be taken into account for its interpretation due to the patient's hemodynamic status, glomerular filtration, tubular excretion, water reabsorption, and solutes. In addition to the acid-base balance, which can vary significantly in critically ill patients with different pathophysiological conditions? A review of the conditions for the interpretation of urinalysis is presented.
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El sedimento urinario es una herramienta utilizada hace tantos años para caracterizar manifestaciones renales de enfermedades primarias y secundarias, que es necesario realizar una estandarización y aprender a interpretar el mismo. En los pacientes ingresados a la unidad de cuidados intensivos, muchas veces no se realiza, o hay que tener en cuenta varios factores para su interpretación debido al estado hemodinámico del paciente a la filtración glomerular, la excreción tubular, la reabsorción de agua y los solutos además del equilibrio acido-base, los cuales pueden variar significativamente en pacientes en estado crítico con diferentes condiciones fisiopatológicas. Se presenta una revisión de las condiciones para la interpretación del urianálisis.
A urinary sediment is a tool used for years to characterize renal manifestations of primary and secondary diseases, which requires standardization and learning to interpret it. In patients admitted to the intensive care unit, it is often not performed, or several factors must be taken into account for its interpretation due to the patient's hemodynamic status, glomerular filtration, tubular excretion, water reabsorption, and solutes. In addition to the acid-base balance, which can vary significantly in critically ill patients with different pathophysiological conditions? A review of the conditions for the interpretation of urinalysis is presented.
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BACKGROUND: Urinalysis is one of the most commonly performed tests in clinical laboratories. In this study, we compared YD URiSCAN PluScope (PluScope; YD Diagnostics Corp., Korea) and Sysmex UF-1000i (UF-1000i; Sysmex Corp., Japan) for urine microscopic sediment analysis. METHODS: A total of 404 fresh urine samples were collected and analyzed using PluScope, UF-1000i, and manual microscopy. Quantitative correlation analyses for red blood cells (RBCs), white blood cells (WBCs), epithelial cells (EC), and casts were performed using Spearman's correlation. We evaluated agreement among the three systems by using weighted Cohen's κ and calculating concordance rates within one grade of difference for semiquantitative and qualitative parameters. RESULTS: There were moderate-high correlations between PluScope and UF-1000i for RBCs, WBCs, and ECs (r=0.542, 0.714, and 0.571, respectively) but negligible correlation for casts (r=0.186). There were moderate-high correlations between manual microscopy and automated devices for RBCs, WBCs, and ECs (r=0.550–0.745) but negligible correlations for casts (PluScope: r=0.247; UF-1000i: r=0.223). The pairwise concordance rates within one grade difference among the three methods were good for RBCs, WBCs, and ECs (95.0%–99.0%, κ=0.41–0.74). For casts, the concordance rate between PluScope and manual microscopy was fair (96.8%, κ=0.25), but concordance rates between UF-1000i and manual microscopy and between the two automated devices were poor (81.2% and 81.7%; κ=0.04 and 0.06, respectively). CONCLUSIONS: The two automated urine sediment analyzers showed a moderate-high correlation and concordance rate. They showed good correlations and concordance rates for RBCs, WBCs, and ECs. However, manual microscopic examinations are still needed for reviewing and confirming the presence of pathologic particles in urine, such as casts and crystals.
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Células Epiteliais , Eritrócitos , Citometria de Fluxo , Leucócitos , Microscopia , UrináliseRESUMO
Objective To evaluate the clinical application of COBIO XS automated urine sediment analyzer for screening urinary tract infection(UTI) .Methods Midstream urine samples were collected from 182 patients with suspected UTI .White blood cell counts(WBC) and bacteria counts(BACT) were determined by COBIO XS automated urine sediment analyzer .By comparing with quantitative urine culture as the golden standard of UTI .The area under the ROC curve(AUC) was constructed to evaluate the dis‐criminative power of variables to predict UTI .Results The positive rate of urine culture was 30 .8% .The isolated rate of Esche‐richia coli ,Enterococcus species and proteus species were 53 .6% ,16 .1% ,10 .7% ,respectively .ROC curve analysis showed that AUC was 0 .808(95% CI 0 .710-0 .867) for WBC and 0 .899(95% CI 0 .797 -0 .923) for BACT .The best cutoff value for WBC was 50/μL ,sensitivity was 89 .0% ,specificity was 83 .8% ,positive predictive value was 86 .3% and negative predictive value was 93 .7% .The best cutoff value for BACT was 110/μL ,sensitivity was 82 .5% ,specificity was 85 .6% ,positive predictive value was 78 .5% and negative predictive value was 88 .0% .Conclusion COBIO XS analyzer is adopted to conduct rapid and reliable a screen‐ing tool for UTI .
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Objective To evaluate the efficacy of IQ200 urine sediment quantitative analyzer(IQ200) and Mejer700 urine dry chemistry analyzer(Mejer700) in detecting urine erythrocyte(RBC)and leukocyte(WBC) .Methods The WBC and RBC in 1 000 u‐rine specimens were detected by using IQ200 ,Mejer700 and sediment microscopy respectively .Taking sediment microscopy as the golden standard ,the sensitivity ,specificity and accuracy of IQ200 and Mejer700 in detecting urine RBC and WBC were analysed .Re‐sults No statistically significant differences of positive rates of RBC and WBC detected by using the three methods were found (P>0 .05) .When IQ200 and Mejer700 were combined ,the sensitivities of detection of RBC and WBC test were improved .Conclu‐sion The sensitivities of RBC and WBC detection by using IQ200 and Mejer700 are high .Combing the two methods the sensitivity and accuracy is higher ,which could improve work efficiency .Combination of the three methods should be recommended ,in order to improve the quality of urine analysis .
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Objective To evaluate performance of the AVE‐766 automated urine sediment analyzer(AVE‐766) based on the ma‐chine vision for detecting erythrocytes(RBCs) ,leukocytes(WBCs) ,epithelial cells(ECs)and CASTs in urine specimen .Methods The within‐run variable coefficients(CVs) ,linearities and carryover rates for RBC ,WBC ,EC ,and CAST in urine specimens detected by using the AVE‐766 were analyzed ,the results of RBC ,WBC ,EC ,and CAST count in urine specimens detected by using AVE‐766 and Fast‐Read102 counting plate(Fast‐Read102) were compared .Results The within‐run CVs for RBC ,WBC ,EC ,and CAST detected by using AVE‐766 and Fast‐Read102 were increased by decreases of concentration of urine sediment .Good linearities (R2 >0 .97 ,P<0 .05) were observed for RBC(in the range of 60 -1 255/μL) ,WBC(in the range of 68 -2 718/μL) ,EC(in the range of 28-296/μL) and CAST(in the range of 5-86/μL) detected by using the AVE‐766 .The carryover rates for RBC ,WBC , EC ,and CAST detected by using AVE‐766 was 0 .9% or less .The values detected by using AVE‐766 were correlated well with those detected by using Fast‐Read102 for RBC ,WBC ,and EC in urine specimens(0 .67< r<0 .75) .However ,for CAST ,the values detected by using AVE‐766 were poorly correlated with those detected by using Fast‐Read102(r=0 .183) .There were statistically significant differences between manual and automated urinalysis for RBC ,WBC ,EC ,and CAST in urine specimens(P<0 .05) .Con‐clusion The AVE‐766 could not take over microscopic examination ,only is suitable for the first screening to detect RBC ,WBC , EC ,and CAST in urine specimen .
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Objective To compare the differences and comparability of the results of the Changsha AVE-764B urine sediment analyzer and the traditional artificial microscopy for detecting the urine sediment visible components .Methods The visible compo-nents in the same fresh urine were detected by the AVE-764B urine sediment analyzer and the artificial microscopy method .The negative and positive coincidence rate ,sensitivity ,specificity and Chi square test were adopted to conduct the statistical analysis on the test data .Results The Chi square value of WBC ,RBC ,Cast and crystal were 2 .274 7 ,1 .554 1 ,3 .817 5 and 0 .258 1 respective-ly(P>0 .05);the negative and positive coincidence rates of WBC ,RBC ,cast and crystal were 84% ,86% ,84% and 78 .5% respec-tively ;the specificities of WBC ,RBC ,cast and crystal were 80 .2% ,85 .9% ,85 .9% and 77 .2% respectively ;the sensitivities of WBC ,RBC ,Cast and crystal were 90 .9% ,86 .3 % ,70 .8% and 80 .2% respectively .Conclusion The Chi square test results showed no statistically significant differences in the detection results between the two kinds of detection method (P> 0 .05) .The recognition and classification of the visible components detected by the AVE-764B automatic urine visible component analyzer have the higher coincidence rate with those detected by the standard artificial microscopy ,this analyzer has high automation degree ,is easy and simple to operate ,standardizes the urine routine test and meets the clinical demand .
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Se realizó un estudio descriptivo y observacional de 56 pacientes con infecciones urinarias a repetición que acudieron al Laboratorio Clínico del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, procedentes de las salas y consultas externas del Policlínico de Especialidades de dicha institución, de junio del 2010 a mayo del 2011, para determinar las características del sedimento de la orina previo al diagnóstico y posterior al tratamiento mediante 2 técnicas: cituria y conteo de Addis. En la serie preponderaron el sexo femenino y las edades de 20 a 51 años, y coincidieron en ambas pruebas las variaciones patológicas del sedimento urinario de la mayoría de los afectados. Después de la terapéutica, no obstante, persistió la positividad en la sedimentación en 100 % de las muestras analizadas por el conteo de Addis, aunque con una mejoría ostensible de esta.
A descriptive and observational study of 56 patients with repeated urine infections who were attended at the Clinical Laboratory from "Saturnino Lora Torres" Clinical Surgical Teaching Provincial Hospital in Santiago de Cuba, coming from the rooms and outpatients department from the Specialties Polyclinic in this institution was carried out from June, 2010 to May, 2011, to determine the characteristics of urine sediment previous to the diagnosis and after treatment by means of 2 techniques: cyturia and Addis count. Female sex and ages from 20 to 51 years prevailed in the series, and in both tests the pathological variations of the urinary sediment of most affected patients coincided. However, after therapy, the positive result in sedimentation persisted in 100% of the samples analyzed through Addis count, although with an ostensible improvement of it.
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Automated urine analysis poses the advantage of rapid turn around time and is suitable for initial screening of large number of samples.However,standardized manual microscopic examination of urine sediment remains valuable for a variety of differential diagnosis,such as screening the potential causes of hematuria,to predict proliferative and non-proliferative renal pathological injury. Urinary sediment scoring system is often used to differentiate acute tubular necrosis (ATN) from pre-renal acute kidney injury (AKI).The urinary podocytes serves as a marker of glomerular injury to determine the location of and to monitor activity of glomerular lesions,as well as to differentiate focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).These useful analyses shows the importance of urine microscopy in the clinical practice of nephrology.( Chin J Lab Med,2012,35:780-783)
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Objective: To compare the performance of the Urised, an image-based automated urine sediment analyzer, against the manual method in urine sediment analysis. Methods: The study was carried out in the Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University in November 2008. One hundred and one urine samples were measured by both automated urine sediment analyzer “Urised” and manual method routinely done in the laboratory. Results from the both methods were compared for their correlation or agreement. Precision, linearity, and carry over of the Urised were also determined. Results: Urised and the conventional manual examination were in good correlations for the following parameters: red blood cell (RBC), white blood cell (WBC), crystals, bacteria, and mucus. Although the squamous epithelial cell (SQE) analysed from both methods showed excellent correlation, they were not statistically significant. For pathologic casts, the statistics showed good agreement between the two methods, but the ability to detect pathologic casts of the Urised was less than the manual method. No yeast was found in any specimen included in this study, therefore this parameter could not be evaluated. Poor agreement between both methods for evaluation of small round cell (SRC) and hyaline casts was noted. Conclusion: Urised was reliable in measurement of some certain urinary parameters such as RBC, WBC, crystals, bacteria, and mucus. However, the examination by experienced technicians was suggested for SRC, hyaline casts, and pathologic casts.
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BACKGROUND: The UF-100 flow cytometer (Sysmex Co., Japan) and the Iris iQ200 (Iris Diagnostics, USA) are widely used for routine urinalysis in Korea. We compared the diagnostic accuracy of these two automated systems based on the microscopic finding, and evaluated the clinical performance of the automated systems. METHODS: A total of 323 fresh urine samples were selected and analyzed by conventional microscopy and the automation systems, the UF-100 and the iQ200. Quantification for RBCs, WBCs, and bacteria were also evaluated using both automated systems. RESULTS: For 158 of urine sample classified as normal urines, the agreement rate for the UF-100 and the iQ200 was 84.8% (N=134) and 89.9% (N=142), respectively. For 165 of urine samples classified as abnormal urines, the agreement rate for the UF-100 and the iQ200 was 90.9% (N=150) and 81.8% (N=135), respectively. The UF-100 showed a good linearity in the quantitative measurements of RBCs and WBCs. For both systems, false-negative value for WBCs and bacteria were about 30% in abnormal urines. Both systems showed inaccurate results for pathologic casts and bacteria. CONCLUSIONS: We compared the microscopic finding and the primary results of automated systems without user reclassification, and the agreement rate was about 85%. The agreement rate will be improved by deliberating "Review" comments of the instruments.
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Automação , Bactérias , Iris , Coreia (Geográfico) , Microscopia , UrináliseRESUMO
BACKGROUND: Microscopic examination of urine sediment is one of the most commonly performed tests in the clinical laboratory. However, manual microscopic sediment examination is labor-intensive, time-consuming and imprecise. In this study, we evaluated the analytical performance and clinical usefulness of a recently introduced image-based automated urinalysis system, Iris iQ200 (Iris Diagnostics, USA). METHODS: We assessed the iQ200 for linearity, precision and carryover rate using patient's samples and quality control materials. On 337 urine samples, urine sediment analyses performed by the iQ200 were compared with manual microscopy results. RESULTS: The iQ200 showed a good linearity (r2>0.99) for all cellular components analyzed. Within-run and total CVs on urine specimens and quality control samples were less than 10% except for within-run CV for the samples with low concentration of the squamous epithelial cells. The carryover rates were 0.21% for RBCs and 1.92% for WBCs. The agreement rates within one grade between the iQ200 and manual microscopy for RBCs, WBCs, and squamous epithelial cells were 93.8%, 94.2% and 96.9%, respectively. CONCLUSIONS: Since the iQ200 showed a reliable analytical performance and good concordance with manual microscopy, it could be useful in the clinical practice as a screening procedure.
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Humanos , Autoanálise/métodos , Controle de Qualidade , Sensibilidade e Especificidade , Urinálise/instrumentação , Urina/citologiaRESUMO
1.8?104 s)while the Mumford-Shah model based Level Set algorithm was much faster(5.42 s).Conclusion The Mumford-Shah model based Level Set algorithm can achieve urine sediment examinations accurately with both fast speed and strong robustness to the noise.
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Objective;To discuss if automatic detecting instrument could be applied on cell count in hydrothorax or ascites instead of traditional method. Methods; 121 cases of hydrothorax or ascites specimens were collected. SysmexUF - 100 automatic urine sediment appearance, SysmexKX -21 blood cell analysis instrument and traditional manual method were used to count white blood cell and totoal cell in all samples. The data were treat with student-T test and relativity analysis. Results;There was significant difference between data collected by SysmexUF - 100 aytinatuc urine sediment appearance and traditional manual method after T test ( P
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Objective To establish a quality control process for Sysmex UF 100 Urine analyzer. Methods L J control process of UF 100 Urine analyzer; x m Q C methods; Chemistry and UF 100 methods comparison; Microscope examination Results L J control process can reflect and monitor the instrument status and the reagent quality; The x m Q C method can indicate the influence factor which come from the samples; Chemistry and UF 100′s comparison can find their contradiction and the error causes;Microscopy can make up UF 100′s test blind spots Conclusions These methods can monitor the result′s quality practically and effectively It is benefit to improve the test quality of UF 100 analyzer
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BACKGROUND: Although the culture of urethral discharge using a cutton swab is regarded as one of the most sensitive and reliable diagnostic methods of gonorrhea, it may give pain or diagnostic methods of gonorrhea, it may give pain or discomfort to patients, and its detection rate may be influenced by the examiner's technical ability. OBJECTIVE: The purpose of this study was to compare the positive culture rates between ure4thral discharge and urinary sediment for the diagnosing of Neisseria gonorrheae. METHODS: We compared this technique with the culture of urethral discharge using the specimens from 357 male patients with gonococcal infection at VD clinic of Jungku Pvblic Health center in Seoul from Jan 1991 to Jun 1993. RESULTS: The culture of urinary sediment was positive in 339 of 357(94.95), whereas the culture of urethral discharge was positive in 346 of 357(96.95). However, these data have no statistical significance(P<0.05). The obe observed sensitivity and specificity of culture of urinary sediment comjpared to culture of urethral discharge were 97.75 and 90.9%, respectively. The predictive value of positive and negative test compared to the culture of urethral discharge were 99.7% and 55.65, respectively. As our data showed low negative predictive value, a negative culture result of urinary sediment does not always imply a negative culture result of urethral discharge. CONCLUSION: Therefore, at present, the previous method of the culture of urethral discharge is more highly recommended and further studies for this diagnostic and/or new method of gonorrhea based on larger group of patients is encouraged.
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Humanos , Masculino , Gonorreia , Neisseria gonorrhoeae , Neisseria , Sensibilidade e Especificidade , SeulRESUMO
Two types of urine dipstick assays, Multistix-SG and Comber-9-Test RL, were compared for compatibility, accuracy, specificity and predictive values of a positive and negative test in 501 patients' urine and artificially prepared specimen. We found that the results of semiquantitative tests of Multistix-SG and Comber-9-Test RL performed were statistically similar in patients' specimen. The urinary leukocyte esterase tests of Comber-9-Test RL assays compared with urine sediment microscopy in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test 83.7%, 48.1%, 90.3%, 47.4% and 90.1%, respectively. The urinary nitrite tests of Comber-9-Test RL assays compared with urine culture tests, in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test were 90.3%, 19.4%, 84.7%, 53.8% and 94.1, respectively. For the urinary protein, the sulfosalicylic acid method was the most sensitive test for any kinds of protein, and Multistix-SG appeared more sensitive than Comber-9-Test RL for the albuminuria. For the urinary bilirubin and glucose, two dipstick assays were similar in their diagnostic efficiency. Finally in the urinary occult blood tests, Comber-9-Test RL assays was more sensitive than Multistix-SG.