Comparison of Urinary Red Blood Cell Distribution (URD) and Dysmorphic Red Blood Cells for Detecting Glomerular Hematuria: A Multicenter Study

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2025-02-03 DOI:10.1002/jcla.25159

A-Jin Lee, Hae In Bang, Sun Min Lee, Dongil Won, Myung Seo Kang, Hyun-ji Choi, In Hee Lee, Chang-Ho Jeon

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Abstract

Background

The clinical utility of urinary red blood cell (RBC) distribution (URD) remains limited. This study aimed to compare the diagnostic performance of URD and dysmorphic RBC (dRBC) in a multicenter study.

Methods

This study enrolled 703 patients who visited four tertiary medical centers in Korea. Patients were classified into glomerular diseases with biopsy (N = 169), renal diseases including chronic kidney disease (N = 194), nephrotic syndrome (NS; N = 88), tubulointerstitial diseases (N = 36), acute kidney injury (N = 32), others (N = 10), and extrarenal diseases (N = 174). Renal parameters, urine microscopic examination, urinalysis, and URD assessments were conducted. The diagnostic performances of dRBC and URD were evaluated.

Results

Median values of both dRBC and URD were significantly elevated in patients with glomerular diseases. URD exhibited a significant correlation with dRBC (r = 0.536) and albumin creatinine ratio (r = 0.186), while no significant correlation was observed with specific gravity (r = −0.03). Among renal diseases, dRBC and URD values were notably higher in patients with NS. The agreement rate between dRBC and URD results was 78.3% (112/143), with 31 instances showing discrepancies. ROC curve analysis comparing glomerular and extrarenal diseases yielded cutoff values of 18% for dRBC and 31.9% for URD, resulting in corresponding areas under the curve (AUC) of 0.79 and 0.83, respectively.

Conclusions

URD exhibited a comparable diagnostic performance, as indicated by a similar AUC value to that of dRBC, while offering the added advantage of providing objective and standardizable results. This attribute enhances its utility as a parameter for distinguishing between patients with glomerular hematuria (GH) and those with non-GH.

Abstract Image

查看原文本刊更多论文

尿红细胞分布（URD）和畸形红细胞检测肾小球血尿的比较：一项多中心研究。

背景：尿红细胞（RBC）分布（URD）的临床应用仍然有限。本研究旨在在一项多中心研究中比较URD和畸形红细胞（dRBC）的诊断性能。方法：本研究纳入了703名患者，他们在韩国的4个三级医疗中心就诊。通过活检将患者分为肾小球疾病（N = 169）、肾脏疾病包括慢性肾病（N = 194）、肾病综合征(NS；88例)、小管间质性疾病（36例）、急性肾损伤（32例）、其他（10例）、肾外疾病（174例）。进行肾脏参数、尿镜检查、尿液分析和URD评估。评价dRBC和URD的诊断性能。结果：肾小球疾病患者dRBC和URD的中位值均显著升高。URD与dRBC （r = 0.536）、白蛋白肌酐比值（r = 0.186）有显著相关性，与比重无显著相关性（r = -0.03）。在肾脏疾病中，NS患者的dRBC和URD值明显较高。dRBC和URD结果的符合率为78.3%(112/143)，有31例出现差异。比较肾小球和肾外疾病的ROC曲线分析显示，dRBC和URD的截断值分别为18%和31.9%，相应的曲线下面积（AUC）分别为0.79和0.83。结论：URD表现出与dRBC相似的AUC值，具有相当的诊断性能，同时具有提供客观和标准化结果的额外优势。这一属性增强了其作为区分肾小球性血尿（GH）和非GH患者的参数的效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.