de Melo Caroline Vilas Boas, Tavares Maria Brandão, Fernandes Paula Neves, Dos Santos Silva Carlos Alberto, Couto Ricardo David, Oliveira Marília Bahiense, Dos-Santos Washington L C
Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Rua Waldemar Falcão 121, Candeal, Salvador, BA, CEP 40296-710, Brazil.
Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
BMC Res Notes. 2020 Aug 27;13(1):401. doi: 10.1186/s13104-020-05244-6.
Acute tubular necrosis (ATN) is a frequent cause of acute kidney injury (AKI). In patients with nephrotic syndrome (NS), AKI demands the differential diagnosis between ATN and rapidly progressive glomerulonephritis. In some cases, conclusive diagnosis is possible only by kidney biopsy. We aimed to study the potential use of urine cytology in the differential diagnosis between ATN and proliferative glomerular lesion in patients with NS.
Cell size analysis showed a higher proportion of small cells and a lower proportion of large cells in the urine of patients with AKI. Cells phenotypes were easily defined using cytological preparations. Leukocytes were found to be a primary classifier of NS groups, with higher number in patients with AKI and patients with proliferative glomerular lesions. Although renal biopsy is still required for confirmative diagnosis, our data suggests that urinary cytology can be readily performed and support the differential diagnosis between proliferative glomerular lesion and ATN in patients with NS and AKI.
急性肾小管坏死（ATN）是急性肾损伤（AKI）的常见原因。在肾病综合征（NS）患者中，AKI需要鉴别诊断ATN和快速进展性肾小球肾炎。在某些情况下，只有通过肾活检才能做出明确诊断。我们旨在研究尿细胞学在NS患者ATN与增殖性肾小球病变鉴别诊断中的潜在应用。
细胞大小分析显示，AKI患者尿液中小细胞比例较高，大细胞比例较低。使用细胞学制剂可轻松定义细胞表型。白细胞被发现是NS组的主要分类指标，在AKI患者和增殖性肾小球病变患者中数量较多。虽然确诊仍需肾活检，但我们的数据表明，尿细胞学检查操作简便，可辅助NS合并AKI患者增殖性肾小球病变与ATN的鉴别诊断。
