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When it comes to patients with kidney and urinary tract illnesses, urine analysis is a valuable diagnostic and monitoring tool. The sample volume in a general chemistry lab can range from a moderate to a large amount, with up to 30% of all samples received being subjected to this procedure in some instances. Regular urinalysis consists of three components: macroscopic examination, chemical analysis, and microscopic examination of urine sediment. Macroscopic examination is the most common type of microscopic urine analysis. Every component, as well as their potential clinical significance (if applicable), is summarized in Table 1. Go to mlo-online. com and look at the current month's test by selecting the CE menu item from the drop-down menu. This will earn you CEUs.
OBJECTIVES FOR LEARNING INSTRUCTIONSFollowing the completion of this article, the reader will be able to do the following things:Review the findings of the microscopic urine analysis and how they should be interpreted.
Read on to find out more about the automated methods for urine sediment identification that have been developed in this article!
It is necessary to describe in detail the methodology that was used for the automated urinalysis sediment exam.
In this comparison, we will look at the advantages and disadvantages of manual microscopy versus automated microscopy systems.
Chemical analyses of urine samples are frequently carried out using reagent strips that have been introduced into the sample prior to analysis. Color changes can be detected manually or by strip readers that use reflectance photometry to detect the changes in the color of the strip. If you prefer a higher level of precision in measuring the concentration of most elements, chemical autoanalyzers, pH probes, and osmometers can be used.1, 2, 3, 4, 5, 6, 7, and 8 are the numbers of the alphabet. Tradition has it that the examiner performs the microscopic examination of sediment from a centrifuged urine sample by hand, rather than using a microscope. This process will not be completed successfully unless both time and labor are invested. On top of all that, accurate interpretation requires advanced technologist training and can be prone to errors as a result of insufficient pelleting or degradation of formed elements during centrifugation or sample storage, among other factors.
Following the guidelines for urine analyzer published by the Clinical and Laboratory Standards Institute3 (CLSI3), each laboratory should determine when it is appropriate to perform microscopic examination of urine sediment based on the patient population that it serves. Doctors' preferences, as well as laboratory protocols for specific patient populations, are among the factors to consider when developing a treatment plan. Manual microscopic screening on all routine urinalysis samples is not feasible for most labs due to the significant amount of work involved and the large volume of samples. There has been some success with a two-step procedure in which dipstick tests are used as a screen to exclude urine samples from further manual microscopic analysis in some laboratories. Researchers found that the complete automated approach outperformed the two-step approach in terms of sensitivity (98% vs. 91%) as well as negative predictive value (96.5% vs. 66.5%) when it came to the detection of pathologic urine sediments.4 A trend toward automating routine urine analysis has emerged, affecting not only large reference laboratories but also smaller diagnostic laboratories, as the benefits of improved patient care and even cost savings can more than offset the initial investment.
In some instances, is performed using automated equipment.
The result of a traditional is a negative result after 12 mL of urine is centrifuged at 1400 rpm for 5 minutes, indicating that there is no infection. The resulting pellet is resuspended in 250 mL of urine in order to create a suspension of the drug. Under high magnification, an approximately one-drop sample is examined on a microscope slide, and the elements observed are counted as the number of elements per field of view under high magnification. Using a hemocytometer has been described as a more precise method of quantification5, but this is a technique that is rarely employed today.
In contrast to manual microscopy, automated systems can complete the same task in less than one minute per sample. Because of this, labor costs are reduced, and turnaround times are frequently reduced by a significant amount. Each instrument, when used in conjunction with automated test strip analyzers, can completely automate the process of routine urinalysis testing, saving time and money. It has come to the authors' attention that three automated urine sediment analysis systems have been evaluated in the literature, and they would like to share this information with the audience. Tables 2 and 3 contain a list of the analytical and technical specifications, which are described in more detail below.
Each system, which employs a different technology to classify and quantify urine sediment particles, provides a higher level of standardization than manual microscopy by eliminating the possibility of inter-technician variability during slide interpretation, which can occur during slide interpretation, which can occur during slide interpretation. Additionally, because samples can be processed more efficiently and therefore closer to the time of collection, the quality of the results may be improved, as the likelihood of cell lysis, microbial contamination, or precipitation from prolonged storage, all of which can have a negative impact on the outcome, is reduced. Each method is described in greater detail further down on this page. The advantages and disadvantages of each of the options are summarized in Table 4 below.
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