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[Acanthocyturia is more efficient in to differentiate glomerular from non-glomerular hematuria then dysmorphic
José Luis Catalá López1, Marian Fábregas Brouard
1Servicio de Bioquímica Clínica, Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, España. beljos@teleline.es
Objective:
Our purpose was to determine which was the most reliable method for differentiating glomerular from non-glomerular (lower urinary tract) hematuria by microscopic examination of urinary red blood cells: dysmorphic red cell count or acanthocyte count. The latter is a special type of dysmorphic red cell specific to glomerular hematuria.
Methods:
Urine samples of 170 patients with hematuria [73 had renal and 97 non-renal (urological) pathology] were analyzed. Urinary sediment phase-contrast microscopy was performed to determine the percentage of dysmorphic red cells and acanthocytes in each patient. Data were correlated with the diagnosis.
Results:
Glomerular hematuria defined as dysmorphic red cell count > 35% showed a sensitivity and specificity of 69% and 100%, respectively. Glomerular hematuria defined as acanthocytes > 5% showed a sensitivity and specificity of 88% and 100%, respectively.
Conclusions:
Phase-contrast microscopy urinary sediment acanthocyte count is more effective than dysmorphic red cell count in the diagnosis of glomerular hematuria.