Urinary sediment analysis

Baños-Laredo, Martha E.; Núñez-Álvarez, Carlos A.; Cabiedes, Javier

doi:10.1016/S2173-5743(10)70062-9

Información del artículo

Abstract

Urinary analysis is one of the most requested tests in the clinical laboratory. This test includes the physical, chemical and microscopic analysis of urine. This last one allows for the observation of urinary sediment (US) in search of formed elements (cellular cast, leukocytes, etc.), with different diagnostic uses. Urinary analysis can be assessed by manual or automated methods. In the laboratory diagnosis of autoimmune diseases, US analysis is mainly oriented towards the assessment of renal function in patients with lupus nephritis (LN) as this is a common clinical manifestation associated to systemic lupus erythematosus (SLE). Additionally, its value lies mainly for diagnostic criteria and evaluation of kidney injury, as well as for several damage indexes directed to patients with SLE. In the last years, several groups have sought to establish new urinary biomarkers of kidney damage in patients with SLE; however, this requires a greater number of studies to determine their true diagnostic value in this patients group.

Keywords:

Urinary sediment (US)

Systemic lupus erythematosus (SLE)

Lupus nephritis (LN)

Resumen

El examen general de orina es una de las pruebas más solicitadas dentro del laboratorio de análisis clínicos e incluye el análisis físico, químico y análisis microscópico. En este último, se analiza el sedimento urinario en búsqueda de distintos elementos formes (leucocitos, cilindros, etc.) con diferente utilidad diagnóstica. El análisis de sedimento urinario se puede valorar mediante métodos manuales y automatizados. En el diagnóstico por el laboratorio de las enfermedades autoinmunes el análisis de sedimento urinario está principalmente orientado hacia el apoyo y valoración renal en pacientes con nefritis lúpica, una de las manifestaciones clínicas más frecuentes en pacientes con lupus eritematoso generalizado. Adicionalmente, su utilidad radica fundamentalmente en su valoración en la mayoría de los criterios diagnósticos y de afección renal, así como en los diferentes índices de daño en pacientes con lupus eritematoso generalizado. En los últimos años, diversos grupos de investigación han buscado nuevos biomarcadores urinarios de afección renal en pacientes con lupus eritematoso generalizado, sin embargo se requiere un mayor número de estudios para determinar su verdadero valor diagnóstico en este grupo de pacientes.

Palabras clave:

Sedimento urinario (SU)

Lupus eritematoso generalizado (LEG)

Nefritis lúpica (NL)

El Texto completo está disponible en PDF

References

[1.]

L. Graff.

A handbook of routine urinanalysis.

Lippincott, (1983),

[2.]

I. Davidsohn, J. Bernard.

Todd-Sanford clinical diagnosis by laboratory methods.

14 Ed, WB Saunders Co., (1969),

[3.]

E.M. Tan, A.S. Cohen, J.F. Fries, A.T. Masi, D.J. McShane, N.F. Rothfield, et al.

The 1982 revised criteria for the classification of systemic lupus erythematosus.

Arthritis Rheum, 25 (1982), pp. 1271-1277

Medline

[4.]

M.H. Liang, P.R. Fortin, D.A. Isenberg, L. Snaith.

Quantitative clinical assessment of disease activity in systemic lupus erythematosus: progress report and research agenda.

Rheumatol Int, 11 (1991), pp. 133-136

Medline

[5.]

S. Althof, J. Kindler.

El sedimento urinario. Atlas, técnicas de estudio y valoración.

Ed. Médica Panamericana, (2003),

[6.]

J. Ben-Ezra, L. Bork, R.A. McPherson.

Evaluation of the Sysmex UF-100 automated urinalysis analyzer.

Clin Chem, 44 (1998), pp. 92-95

Medline

[7.]

C. Ottiger, A.R. Huber.

Quantitative urine particle analysis: integrative approach for the optimal combination of automation with UF-100 and microscopic review with KOVA cell chamber.

Clin Chem, 49 (2003), pp. 617-623

Medline

[8.]

M.R. Langlois, J.R. Delangue, S.R. Steyaert, K.C. Everaert, M.L. De Buyzere.

Automated flow cytometry compared with automated dipstick reader for urinalysis.

Clin Chem, 45 (1999), pp. 118-122

Medline

[9.]

Instrucción operativa (IO-INM-63 V:0; Análisis de Sedimento Urinario). Laboratorio de Inmunología y Reumatología. Laboratorio Certificado ISO9001:2000 No. Cert: US04/3688.

[10.]

National Committee for Clinical Laboratory Standards. Urinalysis and collection, transportation and preservation of urine specimens; urinalysis approved guideline. Clinical and Laboratory Standards Institute. 2009. Third Ed. Vol. 29 Number 4.

[11.]

S. Fukuoka, K. Kobayashi.

Analysis of the C-terminal structure of urinary Tamm-Horsfall protein reveals that the release of the glycosyl phosphatidylinositol-anchored counterpart from the kidney occurs by phenylalanine-specific proteolysis.

Biochem Biophys Res Commun, 289 (2001), pp. 1044-1048

http://dx.doi.org/10.1006/bbrc.2001.6112 | Medline

[12.]

D. Cavallone, N. Malagoni, F. Serafini-Cessi.

Mechanism of release of urinary Tamm-Horsfall glycoprotein from the kidney GPI-anchored counterpart.

Biochem Biophys Res Commun, 280 (2001), pp. 110-114

http://dx.doi.org/10.1006/bbrc.2000.4090 | Medline

[13.]

F. Serafini-Cessi, N. Malagolini, D. Cavallone.

Tamm-Horsfall glycoprotein: biology and clinical relevance.

Am J Kidney Dis, 42 (2003), pp. 658-676

Medline

[14.]

M.C. Hochberg.

Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

Arthritis Rheum, 40 (1997), pp. 1725

http://dx.doi.org/10.1002/1529-0131(199709)40:9<1725::AID-ART29>3.0.CO;2-Y | Medline

[15.]

C. Bombardier, D. Gladman, M.B. Urowitz, D. Caron, C.H.L. Chang.

Derivation of the SLEDAI. A disease activity index for lupus patients.

Arthritis Rheum, 35 (1992), pp. 630-640

Medline

[16.]

J. Guzmán, M.H. Cardiel, A. Arce-Salinas, J. Sánchez-Guerrero, D. Alarcón-Segovia.

Measurement of disease activity in systemic lupus erythematosus. Prospective validation of 3 clinical indices.

J Rheumatol, 19 (1992), pp. 1551-1558

Medline

[17.]

E.M. Hay, P.A. Bacon, C. Gordo, D.A. Isenberg, P. Maddison, M.L. Snaith, et al.

The BILAG index: a reliable and valid instrument for measuring clinical disease activity in systemic lupus erythematosus.

Q J Med, 86 (1993), pp. 447-458

Medline

[18.]

P.H. Schur, J. Sandson.

Immunological factors and clinical activity in lupus erythematosus.

N Engl J Med, 278 (1968), pp. 533-538

http://dx.doi.org/10.1056/NEJM196803072781004 | Medline

[19.]

N.F. Rothfield, B.D. Stollar.

The relation of immunoglobulin class, pattern of antinuclear antibody an complement fixing antibodies to DNA in sera from patients with systemic lupus erythematosus.

J Clin Invest, 46 (1967), pp. 1785-1795

http://dx.doi.org/10.1172/JCI105669 | Medline

[20.]

G.B. Appel, F.G. Silva, C.L. Pirani, J.I. Meltzer, D. Estes.

Renal involvement in systemic lupus erythematosus (SLE): a study of 56 patients emphasizing histologic classification.

Medicine, 57 (1978), pp. 371-410

Medline

[21.]

T. Wu, C. Xie, H.W. Wang, X.J. Zhou, N. Schwartz, S. Calixto, et al.

Elevated urinary VCAM-1, P-Selectin, soluble TNF receptor-1, and CXC chemokine ligand 16 in multiple murine lupus strains and human lupus nephritis.

J Immunol, 179 (2007), pp. 7166-7175

Medline