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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2017: 3.556

CiteScore 2017: 2.34

SCImago Journal Rank (SJR) 2017: 1.114
Source Normalized Impact per Paper (SNIP) 2017: 1.188

Online
ISSN
1437-4331
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Volume 56, Issue 7

Issues

Quantitative urine test strip reading for leukocyte esterase and hemoglobin peroxidase

Matthijs N. Oyaert / Jonas Himpe / Marijn M. Speeckaert / Veronique V. Stove / Joris R. Delanghe
Published Online: 2018-02-10 | DOI: https://doi.org/10.1515/cclm-2017-1159

Abstract

Background:

Recently, urine test strip readers have become available for automated test strip analysis. We explored the possibilities of the Sysmex UC-3500 automated urine chemistry analyzer based on complementary metal oxide semiconductor (CMOS) sensor technology with regard to accuracy of leukocyte esterase and hemoglobin peroxidase results. We studied the influence of possible confounders on these measurements.

Methods:

Reflectance data of leukocyte esterase and hemoglobin peroxidase were measured using CMOS technology on the Sysmex UC-3500 automated urine chemistry analyzer. Analytical performance (imprecision, LOQ) as well as the correlation with white blood cell (WBC) and red blood cell (RBC) counts (Sysmex UF-5000) were studied. Furthermore, the influence of urinary dilution, haptoglobin, pH and ascorbic acid as confounders was determined.

Results:

Within- and between-run imprecision (reflectance signal) ranged from 1.1% to 3.6% and 0.9% to 4.2% for peroxidase and 0.4% to 2.5% and 0.4% to 3.3% for leukocyte esterase. Good agreement was obtained between the UF-5000 for RBCs and peroxidase reflectance (r=0.843) and for WBCs and leukocyte esterase (r=0.821). Specific esterase activity decreased for WBC counts exceeding 100 cells/μL. Haptoglobin influenced the peroxidase activity, whereas leukocyte esterase and peroxidase activities showed a pH optimum between 5.0 and 6.5. A sigmoidal correlation was observed between urinary osmolality and peroxidase activity.

Conclusions:

CMOS technology allows to obtain high quality test strip results for assessing WBC and RBC in urine. Quantitative peroxidase and leukocyte esterase are complementary with flow cytometry and have an added value in urinalysis, which may form a basis for expert system development.

Keywords: hemoglobin peroxidase; leukocyte esterase; urine sediment analysis; urine test strip analysis

References

  • 1.

    Bonnardeaux A, Somerville P, Kaye M. A study on the reliability of dipstick urinalysis. Clin Nephrol 1994;41:167–72.PubMedGoogle Scholar

  • 2.

    Penders J, Fiers T, Delanghe J. Quantitative evaluation of urinalysis tests strips. Clin Chem 2002;48:2236–41.Google Scholar

  • 3.

    Decavele AS, Fiers T, Penders J, Delanghe J. A sensitive quantitative test strip based point-of care albuminuria screening assay. Clin Chem Lab Med 2012;50:673–578.PubMedWeb of ScienceGoogle Scholar

  • 4.

    Delanghe J, Himpe J, De Cock N, Delanghe S, De Herde K, Stove V, et al. Sensitive albuminuria analysis using dye-binding based test strips. Clin Chim Acta 2017;471:107–12.Web of SciencePubMedCrossrefGoogle Scholar

  • 5.

    Delanghe JR, Kouri TT, Huber AR, Hannemann-Pohl K, Guder WG, Lun A, et al. The role of automated urine particle flow cytometry in clinical practice. Clin Chim Acta 2000;301:1–18.PubMedCrossrefGoogle Scholar

  • 6.

    Ben-Ezra J, Bork L, McPherson A. Evaluation of the Sysmex UF-100 automated urinalysis analyzer. Clin Chem 1998;44:92–5.PubMedGoogle Scholar

  • 7.

    Hannemann-Pohl K, Kampf SC. Automation of urine sediment examination: a comparison of the Sysmex UF-100 automated flow cytometer with routine manual diagnosis (microscopy, Test strips, and bacterial culture). Clin Chem Lab Med 1999;37:753–64.PubMedGoogle Scholar

  • 8.

    Jiménez-Guerra G, Heras-Cañas V, Valera-Arcas MD, Rodríguez-Grangér J, Navarro JM, Gutiérrez Fernández J. Comparison between urine culture profile and morphology classification using fluorescence parameters of the Sysmex UF-1000i urine flow cytometer. J Appl Microbiol 2017;122:473–80.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 9.

    Previtali G, Ravasio R, Seghezzit M, Buoro S, Alessio MG. Performance evaluation of the new fully automated urine particle analyser UF-50000 compared to the reference method of the Fuchs-Rosenthal chamber. Clin Chim Acta 2017;472:123–30.PubMedCrossrefGoogle Scholar

  • 10.

    Langlois MR. Delanghe JR, Steyaert SR, Everaert KC, De Buyzere ML. Automated flow cytometry compared with an automated dipstick reader for urinalysis. Clin Chem 1999;45:118–22.PubMedGoogle Scholar

  • 11.

    Dumoulin EN, Van Biervliet S, De Vos M, Himpe J, Speeckaert MM, Delanghe JR. Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease. Clin Chem Lab Med 2015;53:2003–8.Web of SciencePubMedGoogle Scholar

  • 12.

    Kass L. Cytochemistry of esterases. CRC Crit Rev Clin Lab Sci 1979;10:205–23.PubMedCrossrefGoogle Scholar

  • 13.

    Skjold AC, Stover LR, Pendergrass JH, Corey PF, Cattell JA, Burkhardt AE, et al. New dip-and-read test for determining leukocytes in urine. Clin Chem 1987;33:1242–5.PubMedGoogle Scholar

  • 14.

    Fink PC, Römer M, Haeckel R, Fateh-Moghadam A, Delanghe J, Gressner AM, et al. Measurement of proteins with the Behring Nephelometer. A multicentre evaluation. J Clin Chem Clin Biochem 1989;27:261–76.PubMedGoogle Scholar

  • 15.

    Langlois M, Delanghe J. Biological and clinical significance of haptoglobin polymorphism in humans. Clin Chem 1996;42:1589–600.PubMedGoogle Scholar

  • 16.

    Delanghe J, Allcock K, Langlois M, Claeys L, De Buyzere M. Fast determination of haptoglobin phenotype and calculation of hemoglobin binding capacity using high pressure gel permeation chromatography. Clin Chim Acta 2000;291:43–51.CrossrefPubMedGoogle Scholar

  • 17.

    Mambatta AK, Jayarajan J, Rashme VL, Harini S, Menon S, Kuppusamy J. Reliability of dipstick assay in predicting urinary tract infection. J Fam Med Primary Care 2015;4:265–8.CrossrefGoogle Scholar

  • 18.

    Regeniter A, Haenni V, Risch L, Köchli HP, Colombo JP, Frei R, et al. Urine analysis performed by flow cytometry: reference range determination and comparison to morphological findings, dipstick chemistry and bacterial culture results: a multicenter study. Clin Nephrol 2001;55:384–92.PubMedGoogle Scholar

  • 19.

    Ottomano C. Tecnologia ed automazione dell’ esame urine quantitative. Riv Med Lab 2002;3:60–70.Google Scholar

  • 20.

    Mattenheimer H, Adams EC. The peroxidase-like activity of the hemoglobin-haptoglobin complex. Z Klin Chem Klin Biochem 1968;6:69–78.PubMedGoogle Scholar

  • 21.

    Bhensdadia NM, Hunt KJ, Lopes-Virella MF, Tucker JM, Mataria MR, Alge JL, et al. Urine haptoglobin levels predict early renal functional decline in patients with type 2 diabetes. Kidney Int 2013;83:1136–43.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 22.

    Palek J, Jarolin P. Hereditary spherocytosis. In: Williams WJ, Beutler E, Erslev AJ, Lichtman MA, editors. Hematology, 4th ed. New York: McGraw-Hill Book Company, 1990:558–69.Google Scholar

  • 23.

    Marigo S, Bersezio A. Osmotic resistance of leukocytes in patients with onset of diabetes before twenty-five years. Acta Diabetol Lat 1975;12:289–95.PubMedCrossrefGoogle Scholar

About the article

Corresponding author: Joris R. Delanghe, MD, PhD, Department of Laboratory Medicine, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium, Phone: 09/332 29 56, Fax: 09/332 49 85


Received: 2017-12-12

Accepted: 2018-01-11

Published Online: 2018-02-10

Published in Print: 2018-06-27


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

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

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.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 56, Issue 7, Pages 1126–1132, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2017-1159.

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