Flow-cytometric measurement of cellular changes in urine: a simple and rapid method for perioperatively monitoring patients after kidney transplantation.
OBJECTIVE
In renal transplant patients having graft dysfunction, it is usually difficult to obtain the accurate diagnosis, such as acute rejection, acute tubular necrosis, infection, or cyclosporin nephrotoxicity. An accurate diagnosis can provide the proper treatment of these patients, thereby lessening the chance of kidney loss.


METHODS
A total of 42 patients were enrolled. By using the flow-cytometric technique, the white cell populations of urine in these patients were analyzed and linked to their clinical course. All patients underwent sonography-guided biopsy of the transplanted kidney with a definitive diagnosis.


RESULTS
When 10% lymphocytes and 15% granulocytes in urine were set as the cutoff point of a normal ratio threshold, the flow-cytometric analysis presented the highest sensitivity and the highest negative predictive rate for acute tubular necrosis. However, a lower sensitivity and positive predictive rate was found in acute rejection cases.


CONCLUSIONS
Our results suggest that flow-cytometric analysis of the urinary cell population can be used as an adjunct in patient follow-up after kidney transplantation.
Yu
D S
DS
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan/ROC. yuds@ms21.hinet.net
Sun
G H
GH
Lee
S S
SS
Wu
C J
CJ
Ma
C P
CP
Chang
S Y
SY
D000208:Acute Disease; D016572:Cyclosporine / Q000009:adverse effects; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000652:urine*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000473:pathology*; D007683:Kidney Tubular Necrosis, Acute / Q000652:urine*; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014556:Urine / Q000166:cytology
D007166:Immunosuppressive Agents; D016572:Cyclosporine