EVALUATION OF UF5000 AUTOMATED ANALYZER FOR DETECTION OF GLOMERULAR HEMATURIA: A COMPARATIVE STUDY WITH DIRECT MICROSCOPIC EXAMINATION

Introduction:

Distinguishing between glomerular hematuria and urinary tract disease relies heavily on the detection of dysmorphic red blood cells (RBCs) in urine. An automated analyzer with a discrimination program presents a promising alternative to manual urine examination due to its improved reproducibility. This study aimed to evaluate the performance of the UF5000 automated analyzer in detecting urine RBC features compared to conventional methods.

Methods:

A cross-sectional diagnostic study was conducted, involving the collection of urine samples with hematuria (RBC ≥ 5 cells/HPF) from patients with biopsy-proven glomerular diseases (GN group) and non-glomerular hematuria. Urine specimens were analyzed by an experienced technician, a nephrology fellow, and the UF-5000 automated analyzer. Differences in UF-5000 parameters between both groups were assessed using ROC curve analysis and multiple logistic regression analysis.

Results:

A total of 201 patients were enrolled, with 101 in the GN group and 100 in the non-GN group. The urinary RBC distribution (%URD) from the UF-5000 machine in the GN group was significantly higher than in the non-GN group (66.3 ± 23.6 vs. 12.6 ± 19.8%; P < 0.0001), with an AUC of 0.950 (95% CI 0.919–0.982). Using a %URD cutoff > 25.0%, the sensitivity for detecting glomerular RBCs was 91.1%, with a specificity of 89.0%. Comparison with manual assays assessed by the technician and nephrology fellow showed higher sensitivity of %URD compared to both methods (91.1 vs. 60.4 vs. 83.2%, respectively), while specificity was comparable (90.0 vs. 81.0 vs. 89.0%, respectively). The %URD demonstrated comparable discriminative power for each disease in the GN group.

Conclusions:

The %URD parameter from the UF-5000 automated analyzer serves as an accurate diagnostic tool for detecting glomerular hematuria, surpassing manual urine examination in reliability.

I have potential conflict of interest to disclose.
Grant from Sysmex Asia Company Limited.

I did not use generative AI and AI-assisted technologies in the writing process.