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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 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
ISSN
1437-4331
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Volume 57, Issue 11

Issues

Comparison of five automated urine sediment analyzers with manual microscopy for accurate identification of urine sediment

Jooyoung ChoORCID iD: https://orcid.org/0000-0002-9628-2334 / Kyeong Jin Oh / Beom Chan Jeon / Sang-Guk Lee / Jeong-Ho Kim
Published Online: 2019-07-08 | DOI: https://doi.org/10.1515/cclm-2019-0211

Abstract

Background

While the introduction of automated urine analyzers is expected to reduce the labor involved, turnaround time and potential assay variations, microscopic examination remains the “gold standard” for the analysis of urine sediments. In this study, we evaluated the analytical and diagnostic performance of five recently introduced automated urine sediment analyzers.

Methods

A total of 1016 samples were examined using five automated urine sediment analyzers and manual microscopy. Concordance of results from each automated analyzer and manual microscopy were evaluated. In addition, image and microscopic review rates of each system were investigated.

Results

The proportional bias for red blood cells (RBCs), white blood cells (WBCs) and squamous epithelial cells in the automated urine sediment analyzers were within ±20% of values obtained using the manual microscope, except in the cases of RBCs and WBCs analyzed using URiSCAN PlusScope and Iris iQ200SPRINT, respectively. The sensitivities of Roche Cobas® u 701 and Siemens UAS800 for pathologic casts (73.6% and 81.1%, respectively) and crystals (62.2% and 49.5%, respectively) were high, along with high image review rates (24.6% and 25.2%, respectively). The detection rates for crystals, casts and review rates can be changed for the Sysmex UF-5000 platform according to cut-off thresholds.

Conclusions

Each automated urine sediment analyzer has certain distinct features, in addition to the common advantages of reducing the burden of manual processing. Therefore, laboratory physicians are encouraged to understand these features, and to utilize each system in appropriate ways, considering clinical algorithms and laboratory workflow.

This article offers supplementary material which is provided at the end of the article.

Keywords: automated urine sediment analyzer; Cobas® u 701; Iris iQ200SPRINT; UAS800; UF-5000; URiSCAN PlusScope

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About the article

Corresponding author: Sang-Guk Lee, MD, PhD, Department of Laboratory Medicine, Yonsei University College of Medicine, Severance Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea, Phone: +82-2228-2455, Fax: +82-2-364-1583


Received: 2019-02-22

Accepted: 2019-06-01

Published Online: 2019-07-08

Published in Print: 2019-10-25


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

Research funding: This work was supported by five companies – Sysmex Corporation (Kobe, Japan), Roche Diagnostics International (Rotkreuz, Switzerland), Siemens Healthineers (Erlangen, Germany), Beckman Coulter (Brea, CA, USA), and YD diagnostics (Yongin, Korea).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organizations played no role in designing the study, collection, analysis and interpretation of data, writing of the report, or in the decision to submit the findings for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 11, Pages 1744–1753, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2019-0211.

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