Ito Carmen Antonia Sanches, Pecoits-Filho Roberto, Bail Larissa, Wosiack Mônica Arcoverde, Afinovicz Danieli, Hauser Aline Borsato
Universidade Estadual de Ponta Grossa, Brazil.
J Bras Nefrol. 2011 Dec;33(4):402-7.
Dysmorphic red blood cells (RBCs) in the urine are a strong indicator of a glomerular bleeding source. RBC casts, which while generally following RBC dysmorphism are not frequently seen on routine urinalysis, are also important indicators of glomerular hematuria.
This study tested the superiority of a urine concentration technique (CT) over the standard method (SM) for RBC cast identification in a group of patients suspected of glomerular hematuria.
Of a total of 4,227 routine urinary samples, 249 with dysmorphic hematuria were selected. The samples were processed according to two techniques: standard method (SM) and concentration technique (CT). The percentages of RBC cast identification according to each method were compared.
The CT showed a higher rate of RBC casts (52.6%) compared to the SM (8.4%) (p < 0.001).
We suggest that the SM did not sufficiently concentrate the urine sample, the RBC casts remaining in the supernatant and being discarded. The CT increased the sensitivity of the RBC cast yield. The CT, associated with the presence of RBC dysmorphism, was useful to increase the agreement of the two parameters used for identification of glomerular-based bleeding and the diagnosis of glomerular diseases, important causes of chronic kidney disease.
尿中异形红细胞是肾小球出血来源的有力指标。红细胞管型虽然通常伴随红细胞异形，但在常规尿液分析中并不常见，也是肾小球性血尿的重要指标。
本研究在一组疑似肾小球性血尿患者中，测试了尿液浓缩技术（CT）相较于标准方法（SM）在识别红细胞管型方面的优越性。
在总共4227份常规尿液样本中，选取了249份异形血尿样本。这些样本按照两种技术进行处理：标准方法（SM）和浓缩技术（CT）。比较了每种方法识别红细胞管型的百分比。
与标准方法（8.4%）相比，浓缩技术显示出更高的红细胞管型检出率（52.6%）（p < 0.001）。
我们认为标准方法没有充分浓缩尿液样本，红细胞管型残留在上清液中并被丢弃。浓缩技术提高了红细胞管型的检出敏感性。浓缩技术与红细胞异形的存在相结合，有助于提高用于识别基于肾小球的出血和诊断肾小球疾病（慢性肾脏病的重要病因）的两个参数的一致性。
