The role of organic urine sediment analysis in the monitoring of renal diseases

The role of organic urine sediment analysis in the monitoring of renal diseases

Cytological analysis of urine sediment is an integral part of urine analysis and a useful, cost-effective diagnostic tool for all routine clinical examinations, which can sometimes be overlooked in veterinary practice. Proper handling and timely urine sample analysis are essential for valid microscopic analysis. Microscopic urinary sediment testing is usually carried out with stained or unstained specimen. A common urine may contain a small number of cells (erythrocytes and leukocytes, epithelial cells) of several crystals, spermatozoids (male animals). In contrast, a large number of cells or casts, the presence of unusual types of crystals, neoplastic cells, parasites, and microorganisms include abnormal findings, requiring a specialized diagnostic approach. Correct identification of organic components of the urinary sediment are crucial for accurate and timely diagnosis of kidney disorders. Laboratory experts should be trained to properly identify and classify organic components of the urinary tract.

___

  • Adamama-Moraitou, K.K., Pardali, D., Prassinos. N.N., Menexes, G., Patsikas, M.N., Rallis, T.S. (2017). Evaluation of dogs with macroscopic haematuria: a retrospective study of 162 cases (2003–2010) New Zealand Veterinary Journal, 65(4), 204–208.
  • Alatzas, D.G., Mylonakis, M.E., Polyzopoulou, Z.S., Koutinas, A.F. (2012). Urine sediment evaluation in the dog and cat. Journal of the Hellenic Veterinary Medical Society, 63(2),135-146.
  • Anderlini, R., Manieri, G., Lucchi, G., Raisi, O., Soliera, A.R., Torricelli, F., Varani, M., Trenti, T. (2015).Automated urinalysis with expert review for incidental identification of atypical urothelial cells: An anticipated bladder carcinoma diagnosis, Clinica Chimica Acta; International Journal of Clinical Chemistry, 451(Pt B), 252-256.
  • Bakan, E., Ozturk, N., Kilic Baygutalp, N., Polat, E., Akpinar, K., Dorman, E., Polat, H., Bakan, N. (2016). Comparison of Cobas 6500 and Iris IQ200 fully-automated urine analyzers to manual urine microscopy Biochemia Medica, 26(3), 635–75.
  • Bogaert, L., Peeters, B., Billen, J. (2016). Evaluation of a new automated microscopy urinesediment analyser – sediMAX conTRUST®, Acta Clinica Belgica, 72(2),91-94. Doi: 10.1080/17843286.2016.1249999
  • Bottini, P.V., Garlipp, C.R., Lauand, J.R., Cioffi, S.G.L., Afaz, S.H., Prates, R.L. (2005). Glomerular and Non-Glomerular Haematuria: Preservation of Urine Sediment. Lab Medicine , 36 (10), 647-649.
  • Caleffi, A., Lippi, G. (2015). Cylindruria. Clin Chem Lab Med, aop. 1-7. Doi: 10.1515/cclm-2015-0480
  • Caleffi, A., Manoni, F., Alessio, M.G., Ottomano, C., Lippi, G. (2010). Quality in the extra analytical phases of urinalysis. Biochem Med, 20, 179–183.
  • Chew, D.J., Di Bartola, S.P. (2004). Interpretation of Canine and Feline Urinalysis. Clinical Handbook Series. USA: The Gloyd Group, Inc.Wilmington, Delaware.
  • Chew, D.J., Di Bartola, S.P., Schenck, P.A. (2011). Canine and Feline Nephrology and Urology. 2nd ed. USA: Elsevier Saunders, St. Louis.
  • Clinical and Laboratory Standard Institute (ex NCCLS) (2009). GP16- A3-Urinalysis; approved guideline, 3rd ed. Wayne, PA: CLSI, Comparison of Cobas 6500 and Iris IQ200 fully-automated urine analyzers to manual urine microscopy Biochemia Medica, 26(3),635–75.
  • Cook, A.K., Cowgill, L.D. (1996). Clinical and pathological features of protein-losing glomerular disease in the dog: A review of 137 cases (1985-1992). Journal of the American Animal Hospital Association, 32(4), 313-322.
  • Eggensperger, D., Schweitzer, S., Ferriol, E., O' Dowd, G., Light, J.A. (1988). The utility of cytodiagnostic urinalysis for mo- nitoring renal allograft injury. A clinicopatho- logical analysis of 87 patients and over 1000 urine specimens. Am J Nephrol, 8 (1), 27-34.
  • European Confederation of Laboratory Medicine. (2000). European urinalysis guidelines. Scand J Clin Lab Invest Suppl, 231, 1–86.
  • Falk, R., Jennette, J.C., Nachman, P. (2004). Primary glomerular disease. In: Brenner B (ed), Brenner & Rector’s the Kidney. Saunders, Philadelphia, USA, 1293-1356.
  • Fogazzi, G,B. (2010). The urinary sediment. An integrated view, 3rd ed. Milan: Masson Elsevier.
  • Forrester, S. (2004). Diagnostic approach to hematuria in dogs and cats. Veterinary Clinics of North America, Small Animal Practice, 34, 849e867.
  • Grossfeld, G.D., Litwin, M.S., Wolf, J.S., Hricak, H., Schuler, C.L., Agerter, D.C., Carroll, P.R. (2001). Evaluation of asymptomatic microscopic hematuria in adults: The American Urological Association best practice policy – part I: definition, detection, prevalence, and etiology. Urology, 57, 599–603.
  • Jerkić, M., Božić, T. (2012). Poremećaj funkcije bubrega. U: Božić T (ur.), Patološka fiziologija domaćih životinja. Univerzitetski udžbenik, 2. izdanje. Naučna KMD, Beograd, Srbija, 463-490.
  • Kardum-Skelin, I. (2004). Citologija mokraće. U: Flegar- Meštrić Z (ur.), Kliničko-biokemijska korelacija rezultata kvalitativne analize mokraće. Medicinska naklada, Zagreb, Hrvatska, 81-106.
  • Knežević, G., Parigros, K., Križaj, B., Anić, V., Pažur, M., Jelić-Puškarić, B., Šušterčić, D., Kardum-Skelin, I. (2011). Erythrocyte morphology in urine determined by light microscopy in patients with bladder cancer. Acta med Croatica, 65 (Supl. 1), 121-125.
  • Kouri, T., Fogazzi, G., Gant, V., Hallander, H., Hofmann, W., Guder, W.G. (2000). European urinalysis guidelines. ECLM - European Urinalysis Group. Scand J Clin Lab Invest 60, Suppl 23, 11-96.
  • Manoni, F., Gessoni, G., Alessio, M.G., Caleffi, A., Saccani, G., Epifani, M.G., et al. (2014). Gender’s equality in evaluation of urine particles: results of a multicenter study of the Italian Urinalysis Group. Clin Chim Acta, 427, 1–5.
  • Manoni, F., Gessoni, G., Alessio, M.G., Caleffi, A., Saccani, G., Silvestri, M.G., et al. (2011). Mid-stream vs. first-voided urine collection by using automated analyzers for particle examination in healthy subjects: an Italian multicenter study. Clin Chem Lab Med, 50, 679–84.
  • Manoni, F., Valverde, S., Caleffi, A., Alessio, M.G., Silvestri, M.G., De Rosa, R., et al. (2008). Stability of common analytes and urine particles stored at room temperature before automated analysis. RIMeL – IJLaM 4, 192–8.
  • Nakamura, K., Kasraeian, A., Iczkowski, K.A., Chang, M., Pendleton, J., Anai, S., Rosser, C.J. (2009). Utility of serial urinary cytology in the initia evaluation of the patient with microscopic hematuria. BMC Urol, 9, 12. doi: 10.1186/1471-2490-9-12.
  • Nash, A., Wright, N., Spencer, A., Thompson, H., Fisher, E. (1979). Membranous nephropathy in the cat: a clinical and pathological study. Veterinary Record 105, 71-77.
  • Orita. Y., Imai, N., Ueda, N., Aoki, K., Sugimoto, K., Ando, A., et al. (1977). Immunofluorescent studies of urinary casts. Nephron, 19, 19–25.
  • Ostović, K.T. (2015). Cytologic urinalysis with hematuria and glomerulonephritis. Paediatr Croat, 59 (Supl 1), 66-71.
  • Oyaert, M., Delanghe, J. (2018). Progress in Automated Urinalysis, Ann Lab Med, 39,15-22.
  • Reine, N.J., Langston, C.E. (2005). Urinalysis Interpretation: How to squeeze out the maximum information from a small sample. Clin Tech Small Anim Pract, 20, 2-10.
  • Ringsrud, K.M. (2001). Casts in the urine sediment. Lab Med, 32(4), 191-3.a
  • Ringsrud, K.M. (2001). Cells in the urine sediment. Lab Med, 32(3), 153-5.
  • Rizzi, T.E., Valenciano, A., Bowles, M., Cowell, R., Tyler, R., De Nicola, D.B. (2017). Atlas of Canine and Feline Urinalysis. 1st ed. USA: John Wiley & Sons, Inc. Published. doi:10.1002/9781119365693.ch4
  • Roth, S. Urinary Erthrocyte Morphology and Diagnosis of Hematuria. (1991). In: Rather P, Roth S, Soloway MS (ed’s), Urinary Cytology, Manual and Atlas. 2nd ed. Berlin Heidelberg, Germany, 187-204.
  • Rutecky, G.J., Goldsmith, C., Schreiner, G.E. (1971). Characterization of proteins in urinary casts. N Engl J Med, 284, 1049–52.
  • Sharma, S., Ksheersagar, P., Sharma, P. ( 2009). Diagnosis and treatment of bladder cancer. Am Fam Physician, 80(Suppl. 7), 717-2.
  • Sikirica, M., Bobetić-Vranić, T., Flegar-Meštrić, Z., Kardum-Skelin, I., Juretić, D. (2002). Standardized analysis of supravitally stained urine sediment. Biochemia Medica, 12(3-4,:57-72.
  • Spinelli, D., Consonni, D., Garigali, G., Fogazzi, G.B. (2013). Waxy casts in the urinary sediment of patients with different types of glomerular diseases: results of a prospective study. Clin Chim Acta, 424, 47–52.
  • Swenson, C.L., Boisvert, A.M., Kruger, J.M., Gibbons-Burgener, S.N. (2004). Evaluation of modified Wright-staining of urine sediment as a method for accurate detection of bacteriuria in dogs. J Am Vet Med Assoc, 224, 1282-9.
  • White, J.D., Norris, J.M., Bosward, K.L., Fleay, R., Malik, R. (2008). Persistent haematuria and proteinuria due to glomerular disease in related Abyssinian cats. Journal of Feline Medicine and Surgery, 10, 219e229. doi:10.1016/j.jfms.2007.11.007