title: [Distinction between renal and nonrenal hematuria using immunoperoxidase staining of erythrocytes in urine for Tamm-Horsfall protein].
abstract: A recently described immunocytochemical staining method to distinguish renal from non-renal haematuria was adapted for use in the standard clinical chemical laboratory. The method is based on the observation that only in case of renal haematuria are erythrocytes in urine coated with so-called Tamm-Horsfall protein, originating from the renal tubuli. Erythrocytes in urine were stained using an indirect immunoperoxidase method, resulting in cells with dark-brown stained surfaces. The staining methods were validated with material from clinically diagnosed cases of haematuria of renal or non-renal origin and compared with scores of the number of dysmorphic erythrocytes, another method to distinguish renal from non-renal haematuria. In specimens of presumed strictly renal haematuria 86% (SD 8.7; n = 26) of the erythrocytes stained immunocytochemically. However, in specimens of haematuria originating from bleeding in the renal pelvis few cells stained (6%; SD 5.8; n = 4). In specimens of purely non-renal haematuria only 13% (SD 13.5; n = 21) stained. Immunocytochemical staining of erythrocytes permitted a much better distinction between renal and non-renal haematuria, with better sensitivity and specificity, than the inspection of erythrocyte morphology. We conclude that immunochemical staining of erythrocytes in urine is a valuable method for distinguishing renal and non-renal haematuria.
authors.affiliation: Centraal Klinisch Chemisch Laboratorium, Academisch Ziekenhuis St. Radbound, Nijmegen.
authors.forename: P M
authors.initials: PM
authors.lastname: Janssens
authors.forename: L A
authors.initials: LA
authors.lastname: Monnens
authors.forename: J L
authors.initials: JL
authors.lastname: Willems
mesh_terms: D003937:Diagnosis, Differential; D004912:Erythrocytes / Q000737:chemistry*; D006417:Hematuria / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007124:Immunoenzyme Techniques; D007674:Kidney Diseases / Q000150:complications; D008138:Loop of Henle / Q000378:metabolism; D009088:Mucoproteins / Q000096:biosynthesis / Q000302:isolation & purification*; D058949:Uromodulin
chemical_list: D009088:Mucoproteins; C548612:UMOD protein, human; D058949:Uromodulin
vernacular_title: Onderscheid tussen renale en niet-renale hematurie met immunoperoxydasekleuring van erytrocyten in urine op Tamm-Horsfall-eiwit.