Department of Clinical Laboratory, Fujita Health University Hospital, Kutsukakecho, Toyoake, Aichi, Japan.
Department of Biochemical and Analytical Science, Fujita Health University, Kutsukakecho, Toyoake, Aichi, Japan.
Clin Chem Lab Med. 2021 Apr 28;59(9):1547-1553. doi: 10.1515/cclm-2021-0287. Print 2021 Aug 26.
The microscopic examination of hematuria, a cardinal symptom of glomerulonephritis (GN), is time-consuming and labor-intensive. As an alternative, the fully automated urine particle analyzer UF-5000 can interpret the morphological information of the glomerular red blood cells (RBCs) using parameters such as UF-5000 small RBCs (UF-%sRBCs) and Lysed-RBCs.
Hematuria samples from 203 patients were analyzed using the UF-5000 and blood and urine chemistries to determine the cut-off values of RBC parameters for GN and non-glomerulonephritis (NGN) classification and confirm their sensitivity to the IgA nephropathy and non-IgA nephropathy groups.
The UF-%sRBCs and Lysed-RBCs values differed significantly between the GN and NGN groups. The cut-off value of UF-%sRBCs was >56.8% (area under the curve, 0.649; sensitivity, 94.1%; specificity, 38.1%; positive predictive value, 68.3%; and negative predictive value, 82.1%), while that for Lysed-RBC was >4.6/μL (area under the curve, 0.708; sensitivity, 82.4%; specificity, 56.0%; positive predictive value, 72.6%; and negative predictive value, 69.1%). Moreover, there was no significant difference in the sensitivity between the IgA nephropathy and non-IgA nephropathy groups (87.1 and 89.8% for UF-%sRBCs and 83.9 and 78.4% for Lysed-RBCs, respectively). In the NGN group, the cut-off values showed low sensitivity (56.0% for UF-%sRBCs and 44.0% for Lysed-RBCs).
The RBC parameters of the UF-5000, specifically UF-%sRBCs and Lysed-RBCs, showed good cut-off values for the diagnosis of GN.
血尿是肾小球肾炎（GN）的主要症状，显微镜检查血尿既耗时又费力。作为替代方法，全自动尿粒子分析仪 UF-5000 可以使用 UF-5000 小红细胞（UF-%sRBC）和溶血性 RBC 等参数来解释肾小球 RBC 的形态信息。
对 203 例血尿样本进行 UF-5000 分析和血液及尿液化学分析，以确定 RBC 参数的截断值，用于 GN 和非肾小球肾炎（NGN）分类，并确认它们对 IgA 肾病和非 IgA 肾病组的敏感性。
GN 和 NGN 组的 UF-%sRBC 和 Lysed-RBC 值有显著差异。UF-%sRBC 的截断值为＞56.8%（曲线下面积，0.649；敏感性，94.1%；特异性，38.1%；阳性预测值，68.3%；阴性预测值，82.1%），而 Lysed-RBC 的截断值为＞4.6/μL（曲线下面积，0.708；敏感性，82.4%；特异性，56.0%；阳性预测值，72.6%；阴性预测值，69.1%）。此外，IgA 肾病和非 IgA 肾病组之间的敏感性无显著差异（UF-%sRBC 为 87.1%和 89.8%，Lysed-RBC 为 83.9%和 78.4%）。在 NGN 组中，截断值的敏感性较低（UF-%sRBC 为 56.0%，Lysed-RBC 为 44.0%）。
UF-5000 的 RBC 参数，特别是 UF-%sRBC 和 Lysed-RBC，对 GN 的诊断具有良好的截断值。
