Microscopic Examination Of Urine Sediment Research Articles

Urolithiasis Problems in Finishing Pigs.

This paper describes cases of urolithiasis in fattening pigs on two farms (A and B). Bladder rupture due to urethral obstruction with calculi was the principal finding during the necropsy of the pigs. An in-depth diagnostic examination was performed to elucidate possible pathophysiological mechanisms, namely Fourier-transform infrared spectrophotometry (FT-IR) analysis of the uroliths, blood analysis (farm A: 5 samples, farm B: 10 samples) for assessing concentrations of minerals, the bone resorption marker cross-linked C-telopeptide of type 1 collagen (CTX), parathyroid hormone (PTH), and vitamin D components, biochemical urinalysis (farm A: 5 samples, farm B: 7 samples), microscopic examination of urinary sediment (Farms A and B: 7 samples each), mineral composition of the feed, and analysis of the drinking water. Calcium carbonate was the main component found in stones from both farms, and calcium carbonate and struvite were the main components found in crystals from farms A and B, respectively. On farm A, urinary calcium excretion and urinary pH were high; on farm B, urinary phosphorus was high and urinary calcium was low with a normal urinary pH. The mineral compositions of the feed and drinking water were similar on both farms and could therefore not explain the difference between the two farms. Disturbances in calcium and phosphorus absorption and homeostasis might have been involved in these problems. Further research should focus on the calcium, phosphorus, and vitamin D levels in the feed and take into account other factors, such as the absorption and excretion of minerals due to gut and urinary microbiota.

Comparison of the clinical performance of the Atyp.C parameter of the UF-5000 fully automated urine particle analyzer with that of microscopic urine sediment analysis

a) ObjectivesUrinalysis is one of the most common laboratory screening tests to detect problems in the renal and urinary system; however, they cannot detect atypical cells (Atyp.Cs). The Sysmex UF-5000, a fully automated urine particle analyzer, can detect Atyp.Cs via its Atyp.C parameter. This study aimed to compare the clinical value of the Atyp.C parameter with that of urine sediment microscopy. b) MethodA total of 471 leftover urine samples were submitted to the Department of Clinical Laboratory at the University of Tokyo Hospital for urinalysis by manual sediment microscopy examination and UF-5000 Atyp.C analysis. c) ResultOf 471 submitted samples, 117 were positive for Atyp.Cs by urine sediment and 354 samples were negative. The histological subtypes of the Atyp.Cs included 105 cases of suspected urothelial carcinoma cells, 10 suspected squamous carcinoma cells, and 2 of suspected adenocarcinoma cells. The Atyp.C values for the Atyp.C-positive and -negative groups were 2.64 ± 0.69 and 0.38 ± 0.16, respectively. The optimal Atyp.C cutoff value determined by the receiver operating characteristic curve analysis was 0.4/μL. The area under the curve was 0.856, with a sensitivity of 79.5% and specificity of 85.1%. Atyp.C values of the UF-5000 showed high predictive performance for Atyp.C-positive specimens identified by urine sediment microscopy. d) ConclusionsThis study shows that a combination of UF-5000 analysis and microscopic examination of urine sediment improves Atyp.C detection in urine sediment analysis. These results suggest that Atyp.C measured by UF-5000 could be a useful screening parameter in routine testing of urine samples.

Profil mikroskopis sedimen urin pada kondisi glukosuria di Laboratorium Klinik Prodia, Banda Aceh

Background: Laboratory examination of urine (urinalysis) is crucial in establishing various diagnoses. Urine examination can be done through macroscopic examination, including color, clarity, and microscopic examination of urine sediment (U-sed) and urine chemical examination such as glucose. Urine sediment is insoluble elements such as erythrocytes, leukocytes, epithelial cells, thorax, bacteria, crystals, fungi, and parasites originating from the blood, kidneys, and urinary tract. Glucosuria is a condition where glucose is found in the urine, and when excessive >180 mg/dL can experience hyperglycemia, the impact is to damage the capillary blood vessels in the kidneys. U-sed is used to identify sediment elements that can be used to detect kidney and urinary tract abnormalities.Objectives: This study aims to determine the U-sed profile in glucosuria at Prodia Clinical Laboratory, Banda Aceh.Methods: Descriptive research using an experimental design and analyzing secondary data from patients with glucosuria and referred for U-sed examination at Prodia Clinical Laboratory, Banda Aceh Branch. The study was conducted in Mai 2022, with a total sample size of 24 respondents. Microscopic examination U-sed data was processed in stages starting from editing, coding, entry, and cleaning data. Data were only analyzed descriptively using frequency distribution.Results: The results of the study of the U-sed profile in patients with glucosuria conditions were abnormal flat epithelial cells (50,0%), the occurrence of leukocyturia (67,7%), the occurrence of hematuria (70,8%), and other sediments that were above normal only 25,0% of patients. Thus, the U-sed profile in patients with glucosuria conditions may be pathological such as infection, inflammation, and stones in the urinary tract.Conclusion: Some of the MSU profile data in patients who performed laboratory examinations at Prodia Banda Aceh showed above-normal threshold values, such as the data of flat epithelial cells, leukocytes, erythrocytes, and some other sentiments that were above normal had a low frequency. Patients who perform urine tests are at risk of infection and inflammation of the urinary tract and even the risk of kidney stones.

Concomitant Identification of Muddy Brown Granular Casts and Low Fractional Excretion of Urinary Sodium in AKI.

Fractional excretion of urinary sodium (FENa) is a widely utilized clinical test to evaluate acute kidney injury (AKI). A low FENa (<1%) is deemed consistent with prerenal azotemia and inconsistent with acute tubular injury (ATI). Muddy brown granular casts (MBGC) on microscopic examination of urinary sediment (MicrExUrSed) are highly suggestive of ATI. We hypothesized that there is poor concordance between the presence of MBGC and FENa in ATI. We conducted a prospective observational study in patients with AKI seen during inpatient consultation. We extracted patients who underwent assessment of percentage of low power fields (LPFs) with MBGC by MicrExUrSed and concomitant measurement of FENa. Diagnostic concordance between MBGC and FENa and their individual prognostic value were examined. Our cohort included 270 patients, 111 (41%) of whom were women. Median age was 61 years (range 27-92 years), and median serum creatinine was 3.7 mg/dl ( range1.2-22.0 mg/dl). MBGC were found in 49% (133/270). FENa <1% (inconsistent with ATI) was found in 50/133 (38%), 38/115 (33%), and 16/45 (36%) of those with >0%, ≥10%, and ≥50% LPFs with MBGC, respectively. Concordance between FENa and MBGC for ATI diagnosis was deemed fair (estimated κ-coefficient=0.2), and poor (κ=-0.11) within a subgroup of patients with preexisting chronic kidney disease (n=139). In patients with biopsy-proven ATI (n=49), MBGC had 100% specificity and 100% positive predictive value for ATI. MBGC were associated with greater risk for ≥50% increase in creatinine from baseline at discharge (acute kidney disease [AKD]). About two of five patients with MBGC identified by MicrExUrSed presented with FENa <1%. Presence of MBGC was consistent with ATI, as verified by biopsy, and were predictive of AKD. These data suggest that the sole reliance in low FENa to exclude ATI should be abandoned, and MicrExUrSed should be pursued for AKI diagnosis.

Uji Kesesuaian Hasil Pemeriksaan Sedimen Urine Metode Shih-Yung pada Volume Urine 10 mL dan 5 mL

Microscopic examination of urine sediment using shih-yung system requires 10ml urine volume. Pediatric patients and kidney disease patients with oliguria difficult to get 10mL urine samples, so it needs to be studied to determine the accuracy of results with smaller sample volumes. Objectives: To analyze agreement of urine sediment examination using Shih-yung system in 10 mL and 5 mL urine volume. Methods: This study was a cross-sectional analysis of 37 urine specimens that met inclusion and exclusion criteria at the central laboratory of Dr. M. Djamil Hospital from July to September 2020. Examination of erythrocyte sediment, leukocyte sediment, and non-hyaline cast using Shih-yung system was done in 10 mL and 5 mL urine volume. Data were analyzed using kappa reliability/agreement test and significant if p&lt;0.05. Results: Agreement test of erythrocyte sediment examination using Shih-yung system in 10ml and 5mL urine volume were moderate significantly (κ=0.600; p&lt;0.05), agreement of leukocyte sediment examination were moderate significantly (κ=0.571; p&lt;0.05), and agreement of nonhialin cast examination were substantial significantly (κ=0.767; p&lt;0.05). Conclusion: Agreement test of erythrocyte and leukocyte sediment examination in 10ml and 5mL urine volume is moderate, so 5ml urine volume was not recommended. Manual examination with microscope and difference in urine sample volume causing difference sediment concentration and amount of sediment per microscope field of view.Keywords: Shih-yung, urine sediment, urine volume

Discrepancy in results between dipstick urinalysis and urine sediment microscopy.

With the advancement of urine test automation and the large-scale application of quality management policies, the source of the most crucial errors has become the pre-analytical phase. This study is an attempt to compare the results obtained from the examination of urine strips with those obtained by microscopic examination of urinary sediment, highlighting discordant results. This observational study was conducted between February and August 2019 in a private medical laboratory in Mureş County, and 2,600 urine samples were analyzed. We calculated the sensitivity, specificity, positive predictive value, negative predictive value for leukocytes, nitrites and red blood cells, taking as reference the microscopic examination of urine summary screening. Urine samples were collected from patients who presented to the laboratory. The 2,600 urine samples were analyzed using strips with 10 parameters: glucose, protein, bilirubin, urobilinogen, pH, specific density, red blood cells, nitrite, and leukocytes, and then using the microscope to examine the urinary sediment. We identified a small percentage (1.92%) of inconsistencies from the 2,600 samples of urine, between urinalysis and the microscopic examination and we identified the causes. The most common discordant results were: false-negatives for nitrite (72%), followed by false-positives results for red blood cells (22%), false-negative results for leukocytes (16%), false-negative results for red blood cells (4%) and false-positives for leukocytes (4%). The study confirmed that discrepancies appear despite the proper instruction of patients.

Imported schistosomiasis haematobia in Suzhou City: a case report

To report the diagnosis and treatment of an imported case of schistosomiasis haematobia. The patient's medical records were collected, and the clinical features, laboratory diagnosis, epidemiological survey, diagnosis and treatment were analyzed. The patient had arrived to Sudan and Egypt for many times and had a history of contact with the infested water. After returning to China, the patient reported a gross hematuria with unknown causes. Cystoscopy showed neoplasms in the bladder, and pathologic examinations showed chronic granulomatous inflammation with infiltration of plenty of plasma cells, and parasite eggs. Serological test showed positive for the dipstick dye immunoassay, and the microscopic examination of urine sediment revealed Schistosoma haematobium eggs. Following praziquantel treatment for a month, S. haematobium eggs were still detected in the urine. The case was treated with praziquantel again and cured without adverse reactions. Health education should be strengthened among China-aid-African workers to improve the awareness of self-protection. In addition, the diagnosis and treatment should be improved in medical professionals to achieve a timely definitive diagnosis.

Comparative Performance Analysis of Urised 3 and DIRUI FUS-200 Automated Urine Sediment Analyzers and Manual Microscopic Method.

Objective:Microscopic examination of urine sediment is necessary for evaluation of renal and urinary tract diseases. In this study, we evaluated and compared analytic and diagnostic performances of DIRUI FUS-200 and a new image-based automated urine sediment analyzer Urised 3.Method:A total of 440 urine samples, submitted to our laboratory, were evaluated by two automated urine sediment analyzers and a standardized manual microscopy. Precision, linearity and method comparison studies were performed according to CLSI guidelines.Results:Considering the red blood cell (RBC) and white blood cell (WBC) counts, strong correlations existed between FUS-200 and manual microscopy (r=0.993 vs 0.861), Urised 3 and manual microscopy (r=0.962 vs 0.818), FUS200 and Urised 3 (r=0.961 vs 0.961). Clinical non-concordance ranged from 7% to 14.16% among all methods.Conclusions:The concordance between the analyzers and manual microscopy for WBC was better than that of RBC. The concordance between the two analyzers was better for WBC and RBC, with respect to the manual microscopy. Although the Urised 3, FUS-200 and manual microscopy counts were in agreement; confirmation of the results of automated analyzers with manual microscopy is particularly helpful, for pathological samples with near cut-off values.

Characteristics of urinary tract infections in children up to 7 years of age

&amp;lt;p&amp;gt;Urinary tract infection (UTI) is defined as a presence of significant bacteriuria in a properly collected urine sample, followed by various clinical manifestations - from asymptomatic bacteriuria to acute pyelonephritis. It is most common in infancy and particularly in females. There is a higher risk of UTI in children with underlying urological anomalies, voiding dysfunction and constipation. The subsequent long-term complications such as hypertension and chronic renal insufficiency might arise in children with recurrent pyelonephritis due to renal scarring. The early and proper diagnosis of UTI needs to be based on the recognition of clinical signs and symptoms of UTI, microscopic examination of urine sediment, urine culture and radiological findings. The objective of various medical imaging studies, including kidney and bladder ultrasound, voiding cystourethrography and technetium-99m-dimercaptosuccinic acid renal scintigraphy, is to identify urinary tract abnormalities, as well as risk factors for recurrent infections. The UTI that has been diagnosed requires a 7-14-day course of antimicrobial therapy in symptomatic and especially febrile children. In most children, the early diagnosis and treatment of recurrent UTI is of utmost importance. In this way the development of permanent kidney damage, as well as permanent consequences will be prevented.&amp;lt;/p&amp;gt;

The efficient workflow to decrease the manual microscopic examination of urine sediment using on-screen review of images

BackgroundThe manual microscopic examination (MME) of urine sediment is labor-intensive, time-consuming, and imprecise. Therefore, automated urinalysis systems based on flow cytometry or digital imaging techniques could replace MME. The purpose of this study was to evaluate the rate of MME using two automated urine sediment analyzers, alone and in combination. MethodsThis study was conducted using the freshly collected urine specimens of 1055 in-patients and 1119 out-patients. All samples were analyzed using UF-1000i (Sysmex Corporation) and Cobas 6500 instrument (Roche Diagnostics International). The rate of MME was evaluated using two analyzers, both individually and in combination. ResultsUsing the UF-1000i alone, 34.2% and 16.8%, respectively, of in- and out-patient samples were analyzed by MME, compared to 15.6% and 3.7%, respectively, using the Cobas 6500. In combined assay using the UF-1000i followed by the Cobas 6500, 27.9% and 11.3% in-patient samples required on-screen review and MME, respectively. And the respective rates were 10.3% and 2.7% of out-patient. Samples using the Cobas 6500 followed by the UF-1000i, 42.3% and 11.3% in-patient needed on-screen review and MME, respectively. And the respective rates were 18.9% and 2.7% of out-patient samples. ConclusionsUse of the Cobas 6500 compared to the UF-1000i resulted in decreases in the rate of MME from 34.2% to 15.6% for in-patient samples, and from 16.8% to 3.7% for out-patient samples. Use of the Cobas 6500 reduced the rate of MME, and compared to use of only the Cobas 6500, the combined use resulted in a reduction in the rate of on-screen review.

Urine sediment evaluation in the dog and cat

Microscopic examination of the urine sediment is an integral part of urinalysis and a useful, cost-effective diagnostic tool in the everyday practice. Diagnostic investigation of urinary diseases and several systemic metabolic diseases make the microscopic evaluation of urine sediment a priority along with the physical and biochemical examination of urine. The different methods of urine collection (midstream voiding, catheterization or percutaneous cystocentesis) have advantages and disadvantages and the clinician has to decide on the best fitted method of urine collection, according to the medical background of the animal and the case-specific objectives of urinalysis. Proper handling and timely analysis of urine sample are essential for a valid microscopic evaluation. The microscopic examination of urinary sediment is usually conducted in stained or unstained “wet-mounted” preparations; occasionally, air-dried Giemsa-stained sediment smears are examined.Normal urine is sterile and may contain small numbers of cells (white and red blood cells, epithelial cells), few crystals, occasional casts, fat droplets and spermatozoa (male animals). In contrast, large numbers of cells or casts, presence of unusual types of crystals, neoplastic cells, parasites and microorganisms comprise abnormal findings, necessitating a more specialized diagnostic approach. This review focuses on the technical aspects pertaining to the proper sediment microscopic examination, the normally expected elements of sediment and the clinically relevant interpretation of abnormal findings.

Uric acid, an important screening tool to detect inborn errors of metabolism: a case series

BackgroundUric acid is the metabolic end product of purine metabolism in humans. Altered serum and urine uric acid level (both above and below the reference ranges) is an indispensable marker in detecting rare inborn errors of metabolism. We describe different case scenarios of 4 Sri Lankan patients related to abnormal uric acid levels in blood and urine.Case 1A one-and-half-year-old boy was investigated for haematuria and a calculus in the bladder. Xanthine crystals were seen in microscopic examination of urine sediment. Low uric acid concentrations in serum and low urinary fractional excretion of uric acid associated with high urinary excretion of xanthine and hypoxanthine were compatible with xanthine oxidase deficiency.Case 2An 8-month-old boy presented with intractable seizures, feeding difficulties, screaming episodes, microcephaly, facial dysmorphism and severe neuro developmental delay. Low uric acid level in serum, low fractional excretion of uric acid and radiological findings were consistent with possible molybdenum cofactor deficiency. Diagnosis was confirmed by elevated levels of xanthine, hypoxanthine and sulfocysteine levels in urine.Case 3A 3-year-10-month-old boy presented with global developmental delay, failure to thrive, dystonia and self-destructive behaviour. High uric acid levels in serum, increased fractional excretion of uric acid and absent hypoxanthine–guanine phosphoribosyltransferase enzyme level confirmed the diagnosis of Lesch–Nyhan syndrome.Case 4A 9-year-old boy was investigated for lower abdominal pain, gross haematuria and right renal calculus. Low uric acid level in serum and increased fractional excretion of uric acid pointed towards hereditary renal hypouricaemia which was confirmed by genetic studies.ConclusionAbnormal uric acid level in blood and urine is a valuable tool in screening for clinical conditions related to derangement of the nucleic acid metabolic pathway.

Survey of ferns and clinico-pathological studies on the field cases of Enzootic bovine haematuria in Himachal Pradesh, a north-western Himalayan state of India

Enzootic bovine haematuria (EBH) in cattle occurs in upland areas of the world. In India, the disease is present in isolated pockets in the Himalayas and in the Nilgiri Hills. The variation in the disease incidence has been attributed to different environmental conditions and animal rearing practices followed in the different regions. The aim of the study was to conduct field surveys in parts of EBH endemic regions of Himachal Pradesh, a north-western Himalayan state of India. Out of the total 103 plant samples collected, a total of 95 samples were identified as ferns. The major ferns identified included, Onychium japonicum (Thunb.) Kunze, Polystichum piceopaleaceum Tagawa, Dryopteris juxtaposita Christ, Pseudocyclosorus canus (Baker) Holttum and J.W. Grimes, Onychium contiguum C. Hope, Dryopteris nigropaleacea (Fraser-Jenk.), Pteridium aquilinum (L.) Kuhn, Diplazium esculentum (Retz.) Sw., Allantodia maxima (D. Don) Ching, Woodwardia unigemmata (Makino) Nakai, Pteris cretica L., Pteris vittata L., Asplenium trichomanes L., Thelypteris phegopteris (L.) Sloss. ex Rydb, Adiantum venustum D. Don and Paraceterach vestita (Hook.) R.M. Tryon. The concentration of ptaquiloside (PTA) and pterosin B (PtB) in some of the ferns collected from Kullu and Chamba regions ranged from 0 to 358.6 ± 70.5 μg/g and 0 to 652.4 ± 50.0 μg/g, respectively. In addition, field cases of the disease in cattle were also studied in the EBH endemic districts. A total of sixteen cattle urine samples and one urinary bladder of EBH affected cattle were collected. On physical, chemical (benzidine test) and microscopic examination of urine sediment, all the sixteen field samples were found to be positive for erythrocytes and the cases were diagnosed as macrohaematuria. The clinico-pathological studies on the field cases and the presence of PTA and PtB in the ferns indicated that EBH is a prevalent disease and there is an association between chronic fern ingestion and EBH in cattle. On the basis of gross pathology, histopathology and immunohistochemistry (p53 and H-ras nuclear expression in the urothelial cells) of the urinary bladder tissue, the field case was diagnosed as transitional cell adenocarcinoma with chronic lymphocytic cystitis.

Schistosomiasis haematobium prevalence among haematuric patients: Parasitological and immuno-assay

Schistosoma haematobium infection is a clinically important water born parasitic disease. This study was conducted to detect the prevalence of schistosomiasis haematobium among haematuric patients by microscopy and immunoassay. About 474 symptomized patients with urological manifestations and attending Beni-Suef University Hospital, Egypt were subjected to microhaematuria detection using dipstick reagent strip. Positive patients for microhaematuria were subjected to parasitological and immunological assay to detect S. haematobium eggs and antibodies. Haematuria prevalence was 17.7% (n=84). Egg of S. haematobium wasn’t detected by microscopic examination of urine sediment of all haematuric patients, immunological prevalence of Schistosoma antibodies was 46.4% (n=39). On comparing seropositive and seronegative patients for schistosomiasis antibodies none of the sociodemographic or clinical data were statistically significant. It was concluded that, negative microscopy for schistosomiasis doesn’t exclude infection. Combination of both clinical and epidemiological data in addition to sensitive diagnostic tools is essential for schistosomiasis. There is a critical need to develop more sensitive method to detect true prevalence of schistosomiasis.

Urinary tract bacterial infection of local Iraqi buffaloes (Bubalus Bubalis) in Mosul city

This study is conducted on the samples of urine obtained from buffaloes. Eighty six urine samples were obtained from local buffaloes of different ages, of both sex in Mosul abattoir. The results showed that urine of infected animals was cloudy, dark yellow to reddish color with putrid odor of low specific gravity. Microscopic examination of urine sediment demonstrated increased number of pus cell, erythrocytes, epithelial cell, presence of casts and crystals/ high power filed. Chemical examination revealed elevated urine pH and protein content. Serum examination displayed increase levels of urea and creatinine compered to normal urine samples. Culture of urine samples confirmed 24 positive samples (27.90%). Corynebacterium renale being the most isolated organisms 12(50%), Trueperella pyogens 5(20.83%), Staphylococcus aureus 4(16.66%) and 1(4.16%) for each of Acinetobacter lwoffii, Corynebacterium pilosum and Corynebacterium cystitidis. Male buffalo calves at age 1-3 years revealed high percentage (18.60%) of urinary tract infection, while low percentage of urinary tract infection existed by female buffaloes age more than 3 years (6.98%).

Comparative analysis of commercially available methods for proteinuria assessment from the medical decision point of view – what do we keep forgetting about

Introduction: In assessing the kidney function Proteinuria still appears to be the most common screening test. Although recommendations focus on albuminuria, also in association with urine creatinine level, tradition, habits and economical reasons determine wide use of dipstick tests the tool for determining urine protein during routine urinalysis. Aim: The aim of this study was to compare 3 methodologically different tests used for assessing proteinuria, from medical point of view: the qualitative Sorenson method and 2 quantitative methods: the traditional Exton method and the method with pyrogallol red. Material and Methods: In this study we analyzed 395 urine samples from patients aged 3-101 years old, 45% (n=182) men, ordered from 18 entities. In all the samples we determined protein concentration with use of: Combur Test M dipstic tests, cobas u411, Roche; The Exton Reagent, Specol 11, Aqua-Med; Urinary/CSF protein, AU640, Beckman Coulter. Additionally we performed microscopic examination of urinary sediment and assessed if any physical or morphological parameters or the patients’ condition influence differences in obtained protein levels. Results: Analyzing the results we noticed the Sorenson method had tendency to generate ambiguous and inflated results in comparison to quantitative methods. The automatic method with pyrogallol red was characterized with the smallest imprecision across all its analytical linearity. Both quantitative methods was characterized with very good correlation coefficient (R=0.97) of results. The color of the urine, presence of bacteria and casts as well as serum C-reactive protein and creatinine level, and GFR were associated with statistically relevant differences in protein levels obtained with use of analytical methods in question. Conclusions: Only quantitative methods appear to ensure obtaining reliable proteinuria assessment. Laboratories should consider providing automatic quantitative methods for determining the concentration of the urine protein in routine urinalysis.

Development and implementation of a novel method for quality control of microscopic examination of urine sediment by urine occult blood analysis

Development and implementation of a novel method for quality control of microscopic examination of urine sediment by urine occult blood analysis

Manual urine microscopy versus automated urine analyzer microscopy in patients with acute kidney injury.

To examine whether a significant difference exists between the reported ranges of granular and muddy brown casts in urine specimens using manual microscopy compared with an automated urine analyzer in a cohort of patients with acute kidney injury (AKI). Freshly voided urine specimens from 25 consecutive patients who were under evaluation by the Department of Nephrology for AKI were simultaneously examined using the iQ200 automated microscopy system and manual microscopy performed by a trained observer. We coded the results according to the number of pathological casts identified and performed a 3 × 2 Freeman-Halton extension of the Fisher exact probability test. Overall, the number of casts identified via manual microscopy differed significantly (P <.001) from the number identified via the automated microscopy system. This study provides evidence of the importance of performing a manual microscopic examination of urine sediment in patients with AKI. Further studies are needed to assess whether manual microscopy provides prognostic implications regarding renal recovery, hemodialysis dependency, and mortality.

Evaluation of a Catalase‐Based Urine Test for the Detection of Urinary Tract Infection in Dogs and Cats

Bacterial infection of the urinary tract is a common disorder in dogs and cats. Although microscopic examination of urine sediment is routinely used to screen for infection, this test can lack sensitivity or require expertise. A reliable in-clinic screening test would be a useful adjunct for the identification of dogs and cats with bacterial urinary tract infection (UTI). That a catalase-based urine test (Accutest Uriscreen™) is a more sensitive screening test for UTI in dogs and cats than urine microscopic sediment examination. One hundred and sixty client-owned dogs and cats. Surplus urine from animals presented to a veterinary teaching hospital was used in this prospective observational study. A routine urinalysis, aerobic bacterial culture, and the Uriscreen test were performed on cystocentesis samples. Sensitivity and specificity with 95% confidence intervals and positive and negative likelihood ratios were calculated for Uriscreen and microscopic sediment examination using culture results as the gold standard. Bacterial culture was positive in 27/165 (16.4%) samples. The sensitivity, specificity, and positive and negative likelihood ratios for the Uriscreen were 89%, 71%, 3.0, and 0.15, respectively. Sensitivity, specificity, and positive and negative likelihood ratios for urine sediment microscopic examination were 78%, 90%, 7.8, and 0.24, respectively. The Uriscreen is a more sensitive screening test for UTI in dogs and cats than sediment examination; however, the urine sediment examination was more specific. A negative Uriscreen result helps exclude UTI; however, urine bacterial culture is still necessary to exclude or confirm UTI in all cases.

Diagnostic value of microscopic examination of urine sediment

Automated urine analysis poses the advantage of rapid turn around time and is suitable for initial screening of large number of samples.However, standardized manual microscopic examination of urine sediment remains valuable for a variety of differential diagnosis，such as screening the potential causes of hematuria, to predict proliferative and non-proliferative renal pathological injury. Urinary sediment scoring system is often used to differentiate acute tubular necrosis (ATN) from pre-renal acute kidney injury (AKI).The urinary podocytes serves as a marker of glomerular injury to determine the location of and to monitor activity of glomerular lesions, as well as to differentiate focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).These useful analyses shows the importance of urine microscopy in the clinical practice of nephrology.(Chin J Lab Med, 2012，35：780-783) Key words: Kidney diseases; Kidney failure; acute; Podocytes; Urinalysis; Urine sediment; Microscopy