• Phase contrast microscopy
• Polarized light microscopy
• Renal disease diagnosis
• Standardized approach
• Urinalysis
• Urinary sediment
• Urine microscopy

• Humans
• Urinalysis/methods
• Kidney Diseases/urine
• Kidney Diseases/diagnosis
• Hematuria/urine
• Hematuria/diagnosis

• EFLM guideline
• Urinalysis
• urine biochemistry screening
• urine particle analysis
• visual microscopy

• AKI
• kidney diseases
• microscopy
• urine sediment

• Humans
• Male
• Cats
• Dogs
• Animals
• Cat Diseases/diagnosis
• Cat Diseases/microbiology
• Dog Diseases/diagnosis
• Dog Diseases/microbiology
• Urinalysis/veterinary
• Urinalysis/methods
• Urinary Sediment Analysis/veterinary
• Urine/chemistry

• bladder cancer
• expert systems
• hematuria
• peroxidase
• pigmenturia

• Humans
• Hematuria/etiology
• Peroxidase
• Hemoglobins
• Erythrocytes
• Osmolar Concentration

• ANCA-associated vasculitis (AAV)
• Acanthocytes
• IgA nephropathy (IgAN)
• RBC casts
• anti-neutrophil cytoplasmic antibody (ANCA)
• dysmorphic RBC
• glomerular disease
• hematuria
• liquid biopsy
• lupus nephritis (LN)
• nephritic syndrome
• red blood cell (RBC)
• review
• sensitivity and specificity
• urine microscopy

Automated urine sediment analysis has been developed to address the limitations of microscopic examination of dysmorphic red blood cells (RBCs). We evaluated the urinary RBC distribution (URD) parameter of a recently launched automated urinary flow cytometry analyzer, UF-5000 (Sysmex, Kobe, Japan), to differentiate glomerular hematuria (GH) from non-GH (NGH).

Samples submitted for urine sediment analysis from patients with hematuria (>20 RBCs/μL) were divided into derivation (N=156; 101 GH, 55 NGH) and validation cohorts (N=107; 60 GH, 47 NGH). The clinical diagnosis of GH or NGH was established based on clinical data review. Differences in UF-5000 parameters (URD, small RBC, lysed RBC, RBC-P70FSC, RBC-SF-FSC-W, mean forward-scattered light, and mean side-scattered light) between GH and NGH, and areas under the ROC curves (AUC) were analyzed in the derivation cohort. The derived ideal cut-off value was evaluated in the validation cohort. We applied the Kitasato criteria to compare the diagnostic performance.

URD (%), differed significantly between GH and NGH (P<0.001) in the two cohorts. The AUC of URD was 0.814 and 0.806 in the derivation and validation cohorts, respectively. Using a cut-off of >20.1%, the sensitivity was 99.0%/89.4% and the specificity was 50.9%/63.3% in the derivation/validation cohort. When the Kitasato criteria were applied, the sensitivity and specificity were 80.2% and 52.7%, respectively.

URD is a rapid, objective, and quantitative measure that can be used to differentiate GH and NGH.

• Automated urinary flow cytometry analyzer
• Glomerular hematuria
• UF-5000
• Urinary RBC distribution

• Adult
• Hematuria/etiology
• Humans

The determination of hemoglobin (Hb) level is indispensable in the pathological study of many blood diseases. Graphene oxide (GO), with its excellent optical properties and great biocompatibility, has attracted significant attention and been widely utilized in biochemical detection. Here, we report an ultrasensitive Hb sensor based on a graphene oxide (GO)-coated microfiber. The GO was utilized as a linking layer deposited on the microfiber surface, which can provide an enhanced local evanescent light field and abundant bonding sites for Hb molecules. The optical microfiber with a compact structure and a strong evanescent light field served as the platform for biosensing. The surface morphology characterized by optical microscope, scanning electron microscope, and Raman spectroscopy offers detailed evidence for the success of GO deposition. The dynamic bonding between GO and target Hb molecules was monitored in real-time through an optical spectrum analyzer. An ultrahigh sensitivity of 6.02 nm/(mg/mL) with a detection limit of 0.17 μg/mL was achieved by tracking the resonant wavelength shift of spectra. It is important to highlight that the detection limit of GO-coated microfiber is 1–2 orders of magnitude lower than other reported fiber optic Hb sensors. Benefiting from high sensitivity, low cost, small size, and fast response, the proposed sensing microfiber coated with GO could be a competitive alternative in the diagnosis of blood diseases and a subject of further research in the medical field.

• graphene oxide
• hemoglobin
• microfiber

• external quality assessment programs
• urinalysis
• urinary sediment

• dysmorphic
• erythrocyte
• external quality assessment program
• hematuria
• morphology
• red blood cell
• urine

Retinoids are one of the most effective drugs in inducing complete or prolonged remission of severe acne vulgaris, but the adverse reactions associated with the use of them are raising a concern about the potential effect of these drugs on internal organs function such as the kidney. The aim of this review is to comprehensively gather data about isotretinoin, both potential adverse and beneficial effects on the kidney based on the current experimental and clinical findings. Very few studies, including five case reports, described that systemic oral isotretinoin within usual doses (40 mg/day or 0.5 mg/kg⁄day) within 1 to 4 months of treatment might be associated with different types of renal dysfunctions. These include acute interstitial nephritis, nephrotic syndrome, and hematuria with dysuria. The adverse reactions of systemic isotretinoin on the kidney and urinary system are unlikely and rare. In contrast, six experimental studies demonstrated the beneficial effects of either oral or parenteral low- (2 or 5 mg/kg/day) or high- (10, 20, 25, 40 mg/kg/day) dose isotretinoin on the kidney in the rat models of glomerulonephritis, obstructive nephropathy or allograft nephropathy. The nephroprotective functions of isotretinoin in these studies were attributed to its anti-proliferative, anti-fibrotic, and anti-inflammatory actions. However, clinical studies are warranted to elucidate the possible beneficial effects of isotretinoin in preventing or attenuating kidney injury in different settings.

• adverse effects
• beneficial effects
• isotretinoin
• kidney

• complement
• focal segmental glomerulosclerosis
• glomerulonephritis
• hemolytic uremic syndrome
• podocyte

The objective of this study was to identify the prevalence and risk factors of renal complications of spondyloarthritis (SpA) patients, and to assess increased risks compared to general people. We conducted a retrospective study enrolled with consecutive SpA patients from an inpatient department and age, sex-matched general population (GP). The renal disorders investigated in this study contained decreased estimated glomerular filtration rate (eGFR), hematuria, proteinuria and nephrolithiasis. A total of 350 admitted SpA patients with complete medical records and 323 age and sex-matched GP were enrolled. Most SpA patients were male (n = 283, 80.9%) and the mean age was 31.61 ± 10.73 years old. Among 350 SpA patients, 29 (8.8%) suffered from hematuria, six (1.8%) suffered from proteinuria, one (0.3%) had decreased eGFR, and 27 (13.0%) presented with nephrolithiasis. The relative risk (RR) of nephrolithiasis in SpA compared to the GP was 2.24 (95% CI, 1.00-4.98), and the RR of renal insufficiency was 2.04 (95% CI, 1.11-3.77). In a univariate analysis, nephrolithiasis was significantly associated with age, age of onset, smoking, extra-articular manifestation and a bamboo spine. Renal insufficiency was significantly associated with age, peripheral manifestation, serum albumin, C-reactive protein and erythrocyte sedimentation rate. In a multivariable analysis, only extra-articular manifestation (OR = 8.43, 95% CI, 1.65-43.06, p = 0.010) and bamboo spine (OR = 3.47, 95% CI, 1.01-12.06, p = 0.049) remained significantly associated with nephrolithiasis. However, no variable was recognized as an independent risk factor for renal insufficiency. Renal complications are more common in SpA patients, with more than two-fold increased risk compared with GP. Extra-articular manifestation and bamboo spine are independent risk factors of renal disease in SpA patients.

• nephrolithiasis
• renal insufficiency
• retrospective study
• risk factors
• spondyloarthritis

Dysmorphic red blood cells (dRBCs) are first-line biomarkers for detecting glomerulonephritis (GN) in patients with hematuria. The UF-1000i system (Sysmex, Kobe, Japan), based on flow cytometry, provides small red blood cell (RBC) values (UF-1000i [UF]-%sRBCs). We evaluated the clinical application of UF-%sRBCs for detecting %dRBCs and GN.

Urine samples of 103 patients (47 with GN; 56 without GN [NGN]) were analyzed using UF-1000i urinalysis, phase-contrast microscopy (PCM), and urine chemistry. Serum creatinine (mg/dL), serum albumin (g/dL), serum protein (mg/dL), urine protein (mg/dL), and urea nitrogen (mg/dL) levels were measured using an automated chemical analyzer. To determine the cut-off level of predicting GN, ROC curve was analyzed.

UF-%sRBCs, %dRBCs, urine protein, serum creatinine, and estimated-glomerular filtration rate differed between the GN and NGN groups, with the greatest differences detected for UF-%sRBCs and %dRBCs (P<0.0001). In ROC curve analysis, urine protein had the highest area under the curve (0.828), followed by %dRBCs (0.771) and UF-%sRBCs (0.745). To screen for GN, the best cut-off values of UF-%sRBCs and %dRBCs were >40.5% and >6.7%, respectively. %dRBCs (P=0.0001) and UF-%sRBCs (P=0.0006) differed between the GN and NGN groups in patients with isolated hematuria but without proteinuria.

UF-%sRBCs had similar diagnostic power to %dRBCs determined by PCM for identifying patients with GN. UF-%sRBCs may be more useful for diagnosing GN in patients with isolated hematuria. Predicting %dRBCs using UF-1000i will provide information on possible GN in patients presenting with asymptomatic hematuria.

• Dysmorphic red blood cell
• Glomerulonephritis
• Hematuria
• Screening
• Small red blood cell
• UF-1000i

• Glomerular isolated hematuria
• Isolated microscopic hematuria
• Urinalysis
• Urinary sediment

• Diabetic nephropathy
• Dysmorphic erythrocytes
• Hematuria
• Meta-analysis
• Non-diabetic renal disease
• Renal biopsy

• Diabetes Mellitus, Type 2/urine
• Diabetic Nephropathies/urine
• Hematuria/etiology
• Hematuria/pathology
• Humans

• Early detection of cancer
• Hematuria, glomerular
• Neoplasms, urologic
• Urinary bladder neoplasms
• Urine analysis

• Diagnosis, Differential
• Early Diagnosis
• Early Medical Intervention
• Glomerulonephritis/diagnosis
• Glomerulonephritis/therapy
• Hematuria/diagnosis
• Hematuria/etiology
• Hematuria/therapy
• Humans
• Incidental Findings
• Risk Adjustment
• Urologic Neoplasms/diagnosis
• Vasculitis/diagnosis
• Vasculitis/therapy

Urinary sediment is used to evaluate patients with possible urinary tract diseases. Currently, numerous protocols are applied to detect dysmorphic red blood cells (RBCs) and renal tubular epithelial cells (RTECs) in urinary sediment. However, distinct protocols are used by nephrologists and medical technologists for specimen concentration and observation, which leads to major discrepancies in the differential counts of formed elements such as dysmorphic RBCs and RTECs and might interfere with an accurate clinical diagnosis. To resolve these problems, we first tested a modified urinalysis protocol with an increased relative centrifuge force and concentration factor in 20 biopsy-confirmed glomerulonephritis patients with haematuria. We successfully improved the recovery ratio of dysmorphic RBCs in clinical specimens from 34.7% to 42.0% (P < 0.001). Furthermore, we confirmed the correlation between counts by the modified urinary protocol and Sysmex UF-1000i urinary flow cytometer (r ≥ 0.898, P < 0.001). A total of 28 types of isomorphic and dysmorphic RBCs were detected using a bright field microscope, with results comparable to those using a standard phase contrast microscope. Finally, we applied Sternheimer stain to enhance the contrast of RTECs in the urinary sediments. We concluded that this modified urinalysis protocol significantly enhanced the quality of urinalysis.

Pre-hepatic jaundice associated with babesiosis in a malabari goat and its successful management is described. The animal was presented with muco-purulent nasal discharge, dyspnoea, coughing, icteric sclera and oral mucosa, bloated abdomen, diarrhoea, hematochezia and coffee coloured urine. History of tick infestation was reported by the owner. Clinical examination revealed pyrexia, tachycardia, tachypnea, pre-scapular and pre-femoral lymphadenopathy and respiratory wheezes. Laboratory investigations revealed anaemia, neutrophilia, thrombocytopaenia, hypoproteinemia, hyperbilirubinemia and haemoglobinuria. On microscopic examination, small pyriform Babesia sp. (probably B. ovis) could be detected in Giemsa stained peripheral blood smear. The animal had undergone babesicidal therapy using diminazene aceturate (3.5 mg/kg bodyweight deep IM, two doses at 48hr interval) and oxytetracycline (10 mg/kg body weight once daily for 5 days), and supportive therapy using NSAIDs, polyionic isotonic fluids, antihistamines, B complex vitamins, stomachic and iron supplements. The animal made an uneventful clinical recovery after two weeks.

•

Rare acute febrile form of small Babesia sp. infection in a goat.

• Babesiosis
• Goat
• India
• Jaundice
• Kerala
• Therapeutics
• Tick borne disease

• Acute kidney injury
• Chronic kidney disease
• Glomerulonephritis
• Haematuria
• Red blood cells

• Acute Kidney Injury/complications
• Acute Kidney Injury/epidemiology
• Acute Kidney Injury/physiopathology
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Female
• Follow-Up Studies
• Glomerulonephritis/complications
• Glomerulonephritis/epidemiology
• Glomerulonephritis/physiopathology
• Hematuria/complications
• Hematuria/epidemiology
• Hematuria/physiopathology
• Humans
• Male
• Middle Aged
• Registries
• Sex Factors
• Spain/epidemiology

• Chronic kidney disease
• Dysmorphic red blood cells
• Glomerular filtration barrier
• Haematuria
• Microscopic haematuria
• Pathogenesis

• Atypical/malignant urothelial cells
• Bladder carcinoma
• Phase contrast microscopy
• Urinary sediment

• biofluids
• rare cell analysis
• cytology

• Amniotic Fluid/cytology
• Blood Cells/cytology
• Body Fluids/cytology
• Bone Marrow Cells/cytology
• Bronchoalveolar Lavage Fluid/cytology
• Humans
• Microfluidic Analytical Techniques
• Point-of-Care Systems
• Specimen Handling
• Synovial Fluid/cytology
• Urine/cytology

• T32 AI089398 NIAID NIH HHS

• C1q nephropathy
• persistent macroscopic hematuria
• urethritis

• Animals
• Biomarkers
• Diagnostic Tests, Routine
• Homocysteine/blood
• Humans
• Hypertension/blood
• Hypertension/diagnosis
• Hypertension/genetics
• Hypertension/physiopathology
• Kidney/physiology
• Risk Factors

• Humans
• Italy
• Laboratories/standards
• Medical Laboratory Personnel/education
• Microscopy, Phase-Contrast/methods
• Reproducibility of Results
• Surveys and Questionnaires
• Teaching/methods
• Urine/cytology

• Child
• Collagen Type IV/genetics
• Female
• Genetic Variation
• Glomerular Basement Membrane/pathology
• Hematuria/genetics
• Humans
• Male
• Mutation
• Nephritis, Hereditary/pathology
• Pedigree

• Adolescent
• Autoantigens/genetics
• Child
• Child, Preschool
• Collagen Type IV/genetics
• Exons
• Female
• Glomerular Basement Membrane/pathology
• Hematuria/genetics
• Humans
• Introns
• Kidney Glomerulus/pathology
• Male
• Mutation
• Nephritis, Hereditary/genetics
• Polymorphism, Genetic
• Proteinuria/genetics