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The EFLM European Urinalysis Guideline 2023.

Timo T Kouri1,2, Walter Hofmann3, Rosanna Falbo4

  • 1Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland.

Clinical Chemistry and Laboratory Medicine
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PubMed
Summary

Updated European urinalysis guidelines enhance accuracy in clinical labs. Recommendations cover urine testing strategies, patient preparation, and advanced diagnostics for kidney disease and urinary tract infections.

Keywords:
bacteriological techniqueskidney diseasespractice guidelinereference measurement proceduresurinalysisurinary tract infections

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Area of Science:

  • Clinical Laboratory Science
  • Urology
  • Microbiology

Background:

  • The European Urinalysis Guidelines (2000) have been updated by the EFLM Task and Finish Group Urinalysis.
  • The update aims to improve the accuracy of urinalysis and urine bacterial culture examinations in European clinical laboratories.
  • It also supports the development of new diagnostic technologies.

Purpose of the Study:

  • To provide updated, evidence-based recommendations for urinalysis and urine bacterial culture.
  • To enhance diagnostic accuracy for urinary tract infections (UTIs) and kidney disease.
  • To guide the development and implementation of new diagnostic technologies in clinical laboratories.

Main Methods:

  • Review and synthesis of current practices and emerging technologies in urinalysis and urine culture.
  • Development of graded recommendations across various aspects of urine testing.
  • Establishment of quality indicators for specimen collection and testing.

Main Results:

  • Specific strategies for urine testing in patients with varying UTI complexity and kidney disease risk.
  • Recommendations for sensitive kidney disease detection using urine albumin and α1-microglobulin.
  • Updated procedures for microscopy, including automated particle counting and verification of new instruments.
  • Primary use of chromogenic agar for urine cultures, with optimized workflows and reduced antimicrobial susceptibility testing.
  • Incorporation of MALDI-TOF mass spectrometry for rapid uropathogen identification and inclusion of new uropathogens.

Conclusions:

  • The updated guidelines provide a comprehensive framework for improving urinalysis and urine culture diagnostics.
  • Emphasis is placed on quality indicators, sensitive kidney disease markers, and advanced bacteriology techniques.
  • The recommendations aim to standardize practices, enhance accuracy, and support technological innovation in European clinical laboratories.