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Licensed Unlicensed Requires Authentication Published by De Gruyter June 22, 2023

Urine transfer devices may impact urinary particle results: a pre-analytical study

  • Nathan Debunne , Joris Delanghe ORCID logo , Leen Raman and Matthijs Oyaert EMAIL logo

Abstract

Objectives

Well-standardized procedures in the pre-analytical phase of urine diagnostics is of utmost importance to obtain reliable results. We investigated the effect of different urine collection methods and the associated urine transfer tubes on urine test strip and particle results.

Methods

In total, 146 selected urine samples were subdivided into three different collection containers and subsequently transferred into its accompanying transfer tube (BD, Greiner, Sarstedt vacuum and Sarstedt aspiration). As reference, the original urine sample was directly measured on the analyser. Both chemical test strip analysis (Sysmex UC-3500) and fluorescence flow cytometry particle analysis (Sysmex UF-5000) were performed on all samples.

Results

No statistically significant differences in test strip results were found between the studied transfer methods. On the contrary, transfer of urine samples to the secondary tubes affected their particle counts. Clinically significant reductions in counts of renal tubular epithelial cells and hyaline casts were observed using the BD and Greiner transfer tubes and in counts of pathological casts using the BD, Greiner and Sarstedt vacuum tubes.

Conclusions

The results of this study indicate that the use of urine transfer tubes may impact counts of fragile urine particles. Clinical laboratories need to be aware about the variation that urine collection methods can induce on urine particle counts.


Corresponding author: Matthijs Oyaert, Pharm, PhD, Department of Laboratory Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium, Phone: +09/332 63 10, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

References

1. Delanghe, J, Speeckaert, M. Preanalytics in urinalysis. Clin Biochem 2016;49:1346–50. https://doi.org/10.1016/j.clinbiochem.2016.10.016.Search in Google Scholar PubMed

2. Oyaert, M, Delanghe, J. Progress in automated urinalysis. Ann Lab Med 2019;39:15–22. https://doi.org/10.3343/alm.2019.39.1.15.Search in Google Scholar PubMed PubMed Central

3. Coppens, A, Speeckaert, M, Delanghe, J. The pre-analytical challenges of routine urinalysis. Acta Clin Belg 2010;65:182–9. https://doi.org/10.1179/acb.2010.038.Search in Google Scholar PubMed

4. Kouri, T, Fogazzi, G, Gant, V, Hallander, H, Hofmann, W, Guder, WG. European urinalysis guidelines. Scand J Clin Lab Invest 2000;60:1–96. https://doi.org/10.1080/00365513.2000.12056993.Search in Google Scholar

5. Guder, W, Delanghe, J. Spot or timed urine – the pre-analytics of urinalysis. In: Guder, W, Narayanan, S, editors. Pre examination procedures in laboratory diagnostics. Preanalytical aspects and their impact on the quality of medical laboratory results. Boston: Walter De Gruyter GmbH Berlin; 2015:69–80 pp.10.1515/9783110334043-013Search in Google Scholar

6. Andersen, E, Brandslund, I. Pneumatic tube transportation of urine samples. Clin Chem Lab Med 2020;59:905–11. https://doi.org/10.1515/cclm-2020-1198.Search in Google Scholar PubMed

7. Kosem, A, Topcuaglu, C, Sezer, S, Demir, E, Turhan, T. The effects of transport by pneumatic tube system on urine analysis. Scan J Clin lab Invest 2021;81:361–4. https://doi.org/10.1080/00365513.2021.1923058.Search in Google Scholar PubMed

8. Topcuoglu, C, Sezer, S, Kosem, A, Ercan, M, Turhan, T. Comparison of vacuum and non-vacuum urine tubes for urinary sediment analysis. Scand J Clin Lab Invest 2017;77:592–4. https://doi.org/10.1080/00365513.2017.1371324.Search in Google Scholar PubMed

9. Langlois, MR, Delanghe, JR, Steyaert, SR, Everaert, KC, De Buyzere, ML. Automated flow cytometry compared with an automated dipstick reader for urinalysis. Clin Chem 1999;45:118–22. https://doi.org/10.1093/clinchem/45.1.118.Search in Google Scholar

10. Delanghe, J, Langlois, M. Pre-analytical effect of vacuum aspiration on urinalysis. In: Preanalytical phase in patient care and hospital management, fifth symposium. Pratolino, Florence, Italy; 1999.Search in Google Scholar

11. Meijer, D, Gijzen, K, Vogt, L, Sturk, G, Haagen, I, Fischer, J. Het effect van vacuümbuisbemonstering op urinesedimentanalyse. Laboratoriumgeneeskunde 2018;4:68–74.Search in Google Scholar

12. Oyaert, M, Delanghe, JR. Semiquantitative, fully automated urine test strip analysis. J Clin Lab Anal 2019;33:e22870. https://doi.org/10.1002/jcla.22870.Search in Google Scholar PubMed PubMed Central

13. Previtali, G, Ravasio, R, Seghezzi, M, Buoro, S, Alessio, MG. Performance evaluation of the new fully automated urine particle analyser UF-5000 compared to the reference method of the Fuchs-Rosenthal chamber. Clin Chim Acta 2017;472:123–30. https://doi.org/10.1016/j.cca.2017.07.028.Search in Google Scholar PubMed

14. Oyaert, M, Maghari, S, Speeckaert, M, Delanghe, J. Improving clinical performance of urine sediment analysis by implementation of intelligent verification criteria. Clin Chem Lab Med 2022;60:1772–9. https://doi.org/10.1515/cclm-2022-0617.Search in Google Scholar PubMed

15. Oyaert, M, Speeckaert, MM, Delanghe, JR. Estimated urinary osmolality based on combined urinalysis parameters: a critical evaluation. Clin Chem Lab Med 2019;57:1169–76. https://doi.org/10.1515/cclm-2018-1307.Search in Google Scholar PubMed

16. Rotgers, E, Linko, S, Theodorsson, E, Kouri, T. Clinical decision limits as criteria for setting analytical performance specifications for laboratory tests. Clin Chim Acta 2023;540:117233. https://doi.org/10.1016/j.cca.2023.117233.Search in Google Scholar PubMed

17. Kouri, T, Alagrund, K, Lehtonen, M, Tohmola, N, Pihlajamaa, T, Kouri, VP, et al.. Verification of UriSed 3 PRO automated urine microscope in regional laboratory environment. Clin Chim Acta 2021;515:96–103. https://doi.org/10.1016/j.cca.2021.01.005.Search in Google Scholar PubMed

18. Delanghe, J, Speeckaert, M. Preanalytical requirements of urinalysis. Biochem Med (Zagreb) 2014;24:89–104. https://doi.org/10.11613/bm.2014.011.Search in Google Scholar PubMed PubMed Central

19. Colombo, JP. Diagnostic Urinaire en Biochimie Clinique. Rotkreuz: LABOLIFE; 1994.Search in Google Scholar

20. Wangsiripaisan, A, Gengaro, PE, Edelstein, CL, Schrier, RW. Role of polymeric Tamm-Horsfall protein in cast formation: oligosaccharide and tubular fluid ions. Kidney Int 2001;59:932–40. https://doi.org/10.1046/j.1523-1755.2001.059003932.x.Search in Google Scholar PubMed

21. McQueen, EG. The nature of urinary casts. J Clin Pathol 1962;15:367–73. https://doi.org/10.1136/jcp.15.4.367.Search in Google Scholar PubMed PubMed Central

22. Oyaert, MN, Himpe, J, Speeckaert, MM, Stove, VV, Delanghe, JR. Quantitative urine test strip reading for leukocyte esterase and hemoglobin peroxidase. Clin Chem Lab Med 2018;56:1126–32. https://doi.org/10.1515/cclm-2017-1159.Search in Google Scholar PubMed

23. Hannemann-Pohl, K, Kampf, SC. Automation of urine sediment examination: a comparison of the Sysmex UF-100 automated flow cytometer with routine manual diagnosis (microscopy, test strips, and bacterial culture). Clin Chem Lab Med 1999;37:753–64. https://doi.org/10.1515/cclm.1999.116.Search in Google Scholar PubMed

24. Guder, W, Hofmann, W. Differentiation of proteinuria and haematuria by single protein analysis in urine. Clin Biochem 1993;26:277–82. https://doi.org/10.1016/0009-9120(93)90125-p.Search in Google Scholar PubMed

25. Oyaert, M, Speeckaert, M, Boelens, J, Delanghe, JR. Renal tubular epithelial cells add value in the diagnosis of upper urinary tract pathology. Clin Chem Lab Med 2020;58:597–604. https://doi.org/10.1515/cclm-2019-1068.Search in Google Scholar PubMed

26. Perazella, MA. The urine sediment as a biomarker of kidney disease. Am J Kidney Dis 2015;66:748–55. https://doi.org/10.1053/j.ajkd.2015.02.342.Search in Google Scholar PubMed

27. De Rosa, R, Grosso, S, Lorenzi, G, Bruschetta, G, Camporese, A. Evaluation of the new Sysmex UF-5000 fluorescence flow cytometry analyser for ruling out bacterial urinary tract infection and for prediction of Gram negative bacteria in urine cultures. Clin Chim Acta 2018;484:171–18. https://doi.org/10.1016/j.cca.2018.05.047.Search in Google Scholar PubMed

28. Alenkaer, LK, Pedersen, L, Szecsi, PB, Bjerrum, PJ. Evaluation of the sysmex UF-5000 fluorescence flow cytometer as a screening platform for ruling out urinary tract infections in elderly patients presenting at the Emergency Department. Scand J Clin Lab Invest 2021;81:379–84. https://doi.org/10.1080/00365513.2021.1929441.Search in Google Scholar PubMed

29. Langereis, JD. Neutrophil integrin affinity regulation in adhesion, migration, and bacterial clearance. Cell Adhes Migrat 2013;7:476–81. https://doi.org/10.4161/cam.27293.Search in Google Scholar PubMed PubMed Central


Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/cclm-2023-0327).


Received: 2023-01-19
Accepted: 2023-06-09
Published Online: 2023-06-22
Published in Print: 2023-11-27

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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