title: Enhancing the Detection of Dysmorphic Red Blood Cells and Renal Tubular Epithelial Cells with a Modified Urinalysis Protocol.
abstract: Urinary sediment is used to evaluate patients with possible urinary tract diseases. Currently, numerous protocols are applied to detect dysmorphic red blood cells (RBCs) and renal tubular epithelial cells (RTECs) in urinary sediment. However, distinct protocols are used by nephrologists and medical technologists for specimen concentration and observation, which leads to major discrepancies in the differential counts of formed elements such as dysmorphic RBCs and RTECs and might interfere with an accurate clinical diagnosis. To resolve these problems, we first tested a modified urinalysis protocol with an increased relative centrifuge force and concentration factor in 20 biopsy-confirmed glomerulonephritis patients with haematuria. We successfully improved the recovery ratio of dysmorphic RBCs in clinical specimens from 34.7% to 42.0% (P < 0.001). Furthermore, we confirmed the correlation between counts by the modified urinary protocol and Sysmex UF-1000i urinary flow cytometer (r ≥ 0.898, P < 0.001). A total of 28 types of isomorphic and dysmorphic RBCs were detected using a bright field microscope, with results comparable to those using a standard phase contrast microscope. Finally, we applied Sternheimer stain to enhance the contrast of RTECs in the urinary sediments. We concluded that this modified urinalysis protocol significantly enhanced the quality of urinalysis.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei City 10617, Taiwan.|Department of Laboratory Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Taipei City 10002, Taiwan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chu-Su
authors.affiliation: Department of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Shukuya
authors.affiliation: Department of Central Clinical Laboratory, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjyuku-ku, Tokyo 162-8666, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Pathology and Graduate Institute of Pathology, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd., Taipei City 10002, Taiwan.
authors.forename: Wei-Chou
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Graduate Institute of Toxicology, College of Medicine, No. 1, Jen-Ai Rd., Taipei City 10002, Taiwan.|Department of Integrated Diagnostics &Therapeutics, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Taipei City 10002, Taiwan.
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei City 10617, Taiwan.
authors.forename: Chii-Wann
authors.initials: CW
authors.lastname: Lin
mesh_terms: D002498:Centrifugation; D004847:Epithelial Cells / Q000473:pathology*; D004912:Erythrocytes / Q000473:pathology*; D005434:Flow Cytometry; D006801:Humans; D007684:Kidney Tubules / Q000473:pathology*; D016482:Urinalysis / Q000379:methods*