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Licensed Unlicensed Requires Authentication Published by De Gruyter December 20, 2019

Renal tubular epithelial cells add value in the diagnosis of upper urinary tract pathology

Matthijs Oyaert, Marijn Speeckaert, Jerina Boelens and Joris R. Delanghe

Abstract

Background

Diagnosis of upper urinary tract infections (UTI) is challenging. We evaluated the analytical and diagnostic performance characteristics of renal tubular epithelial cells (RTECs) and transitional epithelial cells (TECs) on the Sysmex UF-5000 urine sediment analyzer.

Methods

Urinary samples from 506 patients presenting with symptoms of a UTI were collected. Only samples for which a urinary culture was available were included. Analytical (imprecision, accuracy, stability and correlation with manual microscopy) and diagnostic performance (sensitivity and specificity) were evaluated.

Results

The Sysmex UF-5000 demonstrated a good analytical performance. Depending on the storage time, storage conditions (2–8 °C or 20–25 °C) and urinary pH, RTECs and TECs were stable in urine for at least 4 h. Using Passing-Bablok and Bland-Altman analysis, an acceptable agreement was observed between the manual and automated methods. Compared to TECs, RTECs demonstrated an acceptable diagnostic performance for the diagnosis of upper UTI.

Conclusions

While TECs do not seem to serve as a helpful marker, increased urinary levels of RTECs add value in the diagnosis of upper UTI and may be helpful in the discrimination between upper and lower UTIs.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2019-10-15
Accepted: 2019-11-23
Published Online: 2019-12-20
Published in Print: 2020-03-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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