Dysmorphic RBC of the UriSed 3 Pro Comparison with Manual Microscopy
Keywords:
Dysmorphic red blood cells, Automated urine sediment analysis, Microscopic examinationAbstract
This study was experiment research aimed to compare the performance of DRBC detection between the UriSed 3 Pro automated analyzer and conventional manual microscopy. A comparative study was conducted using 143 urine samples collected from patients who underwent urinalysis at the Clinical Microscopy Laboratory, Somdej Phra Yupparat Sa Kaeo Hospital, between February and July 2025. All samples were analyzed using the UriSed 3 Pro and subsequently confirmed by manual microscopic examination. Data were analyzed using descriptive statistics, agreement analysis with the Kappa coefficient, paired sample t-test for comparison, and receiver operating characteristic (ROC) curve analysis to evaluate diagnostic performance.
The results showed that the UriSed 3 Pro detected DRBC in 70.63% of samples, while manual microscopy yielded positive results in 69.23% of samples. The Kappa coefficient was 0.63, indicating good agreement between the two methods. No statistically significant difference was observed between the methods (p > 0.05). The UriSed 3 Pro demonstrated a sensitivity greater than 80%, with moderate specificity.
References
Preechaborisutkul B, Supokawej A.(2025). Urine. 1st ed. Bangkok: Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University. In Thai.
Clinical and Laboratory Standards Institute (CLSI).(2009). Urinalysis; approved guideline. 3rd ed. CLSI document GP16-A3. Wayne (PA): CLSI.
Fairley KF, Birch DF.(1982). Hematuria: a simple method for identifying glomerular bleeding. Kidney Int. 1982;21:105–108.
Becker GJ, Garigali G, Fogazzi GB.(2016). Advances in urine microscopy. Am J Kidney Dis. 2016;68(6):954–64.
Ito CA, Pecoits-Filho R, Bail L, Wosiack MA, Afinovicz D, Hauser AB.(2011). Comparative analysis of two methodologies for the identification of urinary red blood cell casts. J Bras Nefrol. 2011;33(4):402–7.
Smerville JA, Maxted WC, Pahira JJ.(2005). Urinalysis: a comprehensive review. Am Fam Physician. 2005;71(6):1153–1162.
Fogazzi GB.(2010). The urinary sediment: an integrated view. Kidney Int. 2010;78:1223–1231.
Tomita M, Kitamoto Y, Nakayama M, Sato T.(1992). A new morphological classification of urinary erythrocytes for differential diagnosis of glomerular hematuria. Clin Nephrol. 1992 Feb;37(2):84-9.
Köhler H, Wandel E, Brunck B.(1991). Acanthocyturia — a characteristic marker for glomerular bleeding. Kidney Int. 1991 Jul;40(1):115–20. doi:10.1038/ki.1991.188.
Jintasuthanon P, Khejnont V, Opasikattikul N, Chinswangwatanakul W, Gongteyai V.(2017). Evaluation of the performance of the automated urine sediment analyzer “UriSed” compared with the manual method. Clin Lab. 2017;63(2):213–20.
Elektronika Kft.(2020). LabUMat 2 and UriSed 3 Pro: integrated urinalysis system. Budapest: 77 Elektronika Kft; 2020. Available from: https://www.e77.hu
Landis JR, Koch GG.(1977). The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174.
Hrubi M.(2011). Urised 3 fully automated urine sediment analyzer: user manual. Budapest: 77 Elektronika Kft; 2011.
International Organization for Standardization.(2022). ISO 15189:2022: medical laboratories—requirements for quality and competence. Geneva: ISO; 2022.
Ouima B, Kunakorn M, Khositnitthikul R, Kongasa S, Phundhusuwannakul S, Songngam S. (2022). A comparative study of automated urine sediment analyzers using flow cytometry and digital image-based systems with manual microscopic examination. J Med Tech Assoc Thailand. 2022;50(3):1–12.
Sae-Ung N, Srisukkho P, Archwichaiudom S, Sairos K, Jungtrakuld Y, Anutrakulchai S; CKDNET Group.(2019). Advantage of acanthocyte flag message of UriSed 3 Pro automated microscopy urine analyzer. Clin Chim Acta. 2019;493(Suppl 1):S476. doi:10.1016/j.cca.2019.03.1005.
Fungpia N, Kunakorn M, Uamkhyan A, Khositnitthikul R, Songngam S, Ouima B, et al.(2022). Comparison of red blood cell examination methodologies. Journal of Medical Technology Association of Thailand. 2022;50(3):1–15.
Enko D, Stelzer I, Böckl M, Derler B, Schnedl WJ, Anderssohn P, et al.(2019). Comparison of the diagnostic performance of two automated urine sediment analyzers with manual phase-contrast microscopy. Clin Chem Lab Med. 2020;58(3):417–24. doi:10.1515/cclm-2019-0919.
De Santo NG, Nuzzi F, Capodicasa G, Lama G, Caputo G, Rosati P, Giordano C.(1987). Phase contrast microscopy of the urine sediment for the diagnosis of glomerular and nonglomerular bleeding: data in children and adults with normal creatinine clearance. Nephron. 1987;45(1):35–39. doi:10.1159/000184068.
