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Related Experiment Videos

Urinary red cell size: diagnostic value and determinants.

P Goldwasser1, A Antignani, N Mittman

  • 1Division of Nephrology, Long Island College Hospital, Brooklyn, N.Y.

American Journal of Nephrology
|January 1, 1990
PubMed
Summary
This summary is machine-generated.

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Urinary red blood cell (RBC) size and morphology effectively differentiate glomerular (GN) from nonglomerular (NG) hematuria. A mean corpuscular volume (MCV) cutoff of 72 fl and RBC dysmorphia are key diagnostic indicators.

Area of Science:

  • Nephrology
  • Urology
  • Hematology

Background:

  • Urinary red blood cells (RBCs) exhibit distinct size and morphological characteristics based on their origin.
  • Glomerular (GN) hematuria typically presents with small, abnormal RBCs, while nonglomerular (NG) hematuria shows larger, normal RBCs.
  • Understanding these differences is crucial for diagnosing the source of hematuria.

Purpose of the Study:

  • To assess the diagnostic value of urinary RBC size and morphology in differentiating GN from NG hematuria.
  • To investigate the underlying mechanisms responsible for alterations in urinary RBC size.

Main Methods:

  • Electronic sizing (mean corpuscular volume - MCV) of urinary RBCs in 34 patients with hematuria.
  • Correlation of MCV with RBC dysmorphia (abnormal morphology) in 28 cases.

Related Experiment Videos

  • Analysis of MCV in relation to urine chemistries in 15 cases, and serial monitoring during furosemide diuresis in two GN cases.

    • Main Results:

    • Significantly lower MCV values were observed in GN and probable GN hematuria compared to NG hematuria (p < 10^-6).
    • An MCV cutoff of 72 fl accurately distinguished GN/probable GN from NG cases.
    • Dysmorphic RBCs (≥50%) were prevalent in GN (12/13) and probable GN (3/4) but absent in NG hematuria.

    Conclusions:

    • Urinary RBC MCV and morphology are valuable diagnostic tools for differentiating glomerular from nonglomerular hematuria.
    • Urinary RBC size in NG hematuria is influenced by urine pH, with higher pH leading to larger cell volumes.
    • Furosemide-induced diuresis partially corrected microcytosis in GN RBCs, suggesting urine composition plays a role.