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A useful new classification of dysmorphic urinary erythrocytes

Daisuke Nagahama1,2, Kenichi Yoshiko3, Mikio Watanabe4

  • 1Department of Clinical Laboratory, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan. nagahama@med.nagoya-u.ac.jp.

Clinical and Experimental Nephrology
|December 20, 2005
PubMed

Insights

Dysmorphic urinary erythrocytes (D cells) classification reveals D3 cells as sensitive markers for glomerular diseases, while D1/D2 cells indicate severe conditions, aiding in urinalysis interpretation.

Area of Science:

  • Nephrology
  • Urology
  • Pathology

Background:

  • Dysmorphic urinary erythrocytes (D cells), particularly G1 cells (doughnut-shaped with blebs), are established markers for glomerular diseases.
  • The clinical significance of D cells with cytoplasmic color loss and without blebs remains unclear.
  • A novel classification system for D cells was developed to investigate their relationship with urinalysis findings.

Purpose of the Study:

  • To classify dysmorphic urinary erythrocytes (D cells) into distinct types.
  • To examine the correlation between these D cell types and urinalysis data.
  • To determine the diagnostic value of different D cell types for glomerular diseases.

Main Methods:

  • D cells were classified into three types: D1 (severe color loss, blebs), D2 (moderate color loss, blebs), and D3 (mild color loss, no blebs).
  • Bright-field microscopy was used to count D cell types in 45 patients with glomerular diseases and 303 general outpatients.
  • Statistical analysis correlated D cell counts with urinalysis parameters like proteinuria, hematuria, and cast excretion.

Main Results:

  • D1, D2, and D3 cell counts correlated with proteinuria, hematuria, and urinary casts in glomerular disease patients.
  • D1 and D2 cell proportions increased with glomerular disease activity, correlating with albumin and N-acetyl-beta-D-glucosaminidase levels.
  • D3 cells showed 73% sensitivity and 93% specificity for detecting glomerular diseases, while D1/D2 cells had 46% sensitivity and 99% specificity.

Conclusions:

  • The D3 cell type serves as a sensitive indicator for the presence of glomerular diseases.
  • D1 and/or D2 cells are indicative of severe glomerular disease activity.
  • This classification system enhances the diagnostic utility of dysmorphic urinary erythrocytes in nephrology.
Abstract

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