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      Differential Diagnosis between Glomerular and Nonglomerular Hematuria by Automated Urinary Flow Cytometer

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          Abstract

          Objective, fast and easy methods have not been established in the examination of urine sediment to differentiate between glomerular and nonglomerular hematuria. In this study, we used a newly developed automated urinary flow cytometer that can clearly recognize red blood cells (RBC), white blood cells, epithelial cells, bacteria and crystals by their size and fluorescence intensity without sedimentation. 98 urine samples from 31 glomerular and 67 nonglomerular lesions were analyzed by the device, and the criteria to determine the origin of hematuria were established based on the results. Additional 108 cases were tested to evaluate the validity of these criteria. According to the analysis of histograms of urinary RBC size distribution, cases in whom ≥80% of all RBC have forward scatter (FSC) intensities ≦126 and <80% of all RBC have FSC intensities ≥84 were regarded as representing the glomerular type. Cases in whom ≥80% of all RBC have intensities FCS ≥84 and <80% all RBC have FSC intensities ≦126 were regarded as representing the nonglomerular type. Cases in whom <80% of all RBC have FSC intensities ≦126 and <80% of all RBC have FCS intensities ≥84 were regarded as the mixed type. Cases in whom ≥80% of all RBC have FSC intensities ≦126 and ≥80% of all RBC have FSC intensities ≥84 were regarded as the nonglomerular type. The sensitivity for glomerular RBC in the first 98 cases was 90.3% and the specificity 92.5%, and in the second 108 cases the values were 100 and 86.6%, respectively. The automated urinary flow cytometer is useful as a means for routine differential diagnosis of hematuria, and at least it is promising as the screening test for differentiation between glomerular and nonglomerular hematuria, because it can examine numerous samples within a short time and does not necessitate any special skill or knowledge.

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          Most cited references 2

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          Red cell morphology as a diagnostic aid in hematuria

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            'Idiopathic' hematuria. A prospective evaluation

             J. V. COPLEY (1987)
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              Author and article information

              Journal
              NEF
              Nephron
              10.1159/issn.1660-8151
              Nephron
              S. Karger AG
              1660-8151
              2235-3186
              1999
              August 1999
              04 August 1999
              : 82
              : 4
              : 312-323
              Affiliations
              Kidney Center, Kitasato University Hospital, Sagamihara City, Japan
              Article
              45446 Nephron 1999;82:312–323
              10.1159/000045446
              10450033
              © 1999 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Figures: 8, Tables: 7, References: 32, Pages: 12
              Product
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/45446
              Categories
              Original Paper

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