Marcussen N, Schumann J, Campbell P, Kjellstrand C
Department of Pathology, University of Alberta Hospital Edmonton, Canada.
Ren Fail. 1995 Nov;17(6):721-9. doi: 10.3109/08860229509037640.
Cytodiagnostic urinalysis was tested to determine its utility in the differential diagnosis of acute renal failure (ARF). Fifty-one patients with acute renal failure were included and evaluated clinically with regard to the etiology of the renal failure, whether underlying chronic renal failure was present, and if dialysis was required. Urine specimens were macroscopically examined and subjected to a multiparameter reagent-strip analysis. Papanicolaou stain was done on cytocentrifuge preparations and the number of blood cells, renal cells, and casts examined in a standardized fashion. The results showed that the 34 patients with acute tubular necrosis (ATN) of either ischemic or toxic origin had a higher number of collecting duct cells, and a higher total number of casts than the 17 non-ATN patients. Twelve patients requiring dialysis had a higher number of different types of casts (granular, waxy, leukocytic, broad casts) as well as more renal cells (mainly necrotic) than the 39 patients who did not require dialysis. A significant positive correlation was found between the magnitude of rise of serum creatinine and a number of cytodiagnostic parameters. We conclude that cytodiagnostic urinalysis may be valuable in addition to other tests in the evaluation of patients with acute renal failure.
进行了细胞诊断尿分析，以确定其在急性肾衰竭（ARF）鉴别诊断中的效用。纳入了51例急性肾衰竭患者，并就肾衰竭的病因、是否存在潜在慢性肾衰竭以及是否需要透析进行了临床评估。对尿液标本进行了肉眼检查，并进行了多参数试带分析。对细胞离心涂片进行巴氏染色，并以标准化方式检查血细胞、肾细胞和管型的数量。结果显示，34例缺血性或中毒性急性肾小管坏死（ATN）患者的集合管细胞数量以及管型总数高于17例非ATN患者。12例需要透析的患者比39例不需要透析的患者有更多不同类型的管型（颗粒管型、蜡样管型、白细胞管型、宽大管型）以及更多的肾细胞（主要是坏死细胞）。血清肌酐升高幅度与一些细胞诊断参数之间存在显著正相关。我们得出结论，在评估急性肾衰竭患者时，除其他检查外，细胞诊断尿分析可能有价值。
