Is the red cell morphology really useful to detect the source of hematuria?

Favaro, S; Bonfante, Luciana; D'Angelo, Angela; Giacomini, A; Normanno, M; Caló, L; Bordin, V; Vianello, Daniela; Meani, A; Antonello, A; Borsatti, A.

Morphological analysis of urinary red blood cells by phase-contrast microscopy to identify the source of bleeding was, and still is, widely used also as a starting point for workup. To evaluate the reliability of this approach, we studied 129 outpatients presenting with persistent isolated microhematuria; 31 subjects also had mild proteinuria (1 g/day), while 21 had pathological albumin levels. All patients were followed for a period of 6 years. During this time, 6 patients underwent renal biopsy for the onset of macrohematuria episodes and proteinuria of 2-3 g/day. Glomerular bleeding was identified in only 14.7% of the patients, despite the persistent microhematuria and the presence of proteinuria or microalbuminuria. The renal origin of the urinary erythrocytes correlated with histological findings in only 2 of 6 patients with dysmorphic erythrocytes who developed proteinuria (exceeding 1 g/day), and none with isomorphic erythrocytes showed urological abnormalities. These results challenge the validity and reliability of morphological analysis to identify the source of bleeding along the urinary tract.

Titolo:	Is the red cell morphology really useful to detect the source of hematuria?
Autori:	Favaro S BONFANTE, LUCIANA D'ANGELO, ANGELA Giacomini A Normanno M CALO', LORENZO Bordin V VIANELLO, DANIELA Meani A Antonello A Borsatti A. mostra contributor esterni nascondi contributor esterni
Data di pubblicazione:	1997
Rivista:	AMERICAN JOURNAL OF NEPHROLOGY
Abstract:	Morphological analysis of urinary red blood cells by phase-contrast microscopy to identify the source of bleeding was, and still is, widely used also as a starting point for workup. To evaluate the reliability of this approach, we studied 129 outpatients presenting with persistent isolated microhematuria; 31 subjects also had mild proteinuria (1 g/day), while 21 had pathological albumin levels. All patients were followed for a period of 6 years. During this time, 6 patients underwent renal biopsy for the onset of macrohematuria episodes and proteinuria of 2-3 g/day. Glomerular bleeding was identified in only 14.7% of the patients, despite the persistent microhematuria and the presence of proteinuria or microalbuminuria. The renal origin of the urinary erythrocytes correlated with histological findings in only 2 of 6 patients with dysmorphic erythrocytes who developed proteinuria (exceeding 1 g/day), and none with isomorphic erythrocytes showed urological abnormalities. These results challenge the validity and reliability of morphological analysis to identify the source of bleeding along the urinary tract.
Handle:	http://hdl.handle.net/11577/2516388
Appare nelle tipologie:	01.01 - Articolo in rivista

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