Abstract
Aim: Urinalysis is an important laboratory exam that gives helpful information for the diagnosis of
urinary tract disease.
Objective: Te purpose of this study was to compare automated method results of test strips, microscopic
analysis and counts with the manual methods.
Material and Methods: Urine samples (n=275) were analyzed by I-Chem® Velocity (iQ200
®
). White
and red blood cells (WBC/RBC) counts by iQ200
®
were compared with manual methods (Neubauer
and KCell). Leukocyte esterase and hemoglobin detection provided by the test strips were also analyzed.
Results: Leukocyte esterase was positive in 59.6% with 315,800±608,413 WBC/ml and negative in
40.4% with 24,838±34,152 WBC/ml (p<0.001). Hemoglobin was detected in 29.8% of the samples with
1,275,537±7,394,959 RBC/ml and negative in 70.2% with 26,316±46,424 RBC/ml (p=0.019). Te iQ200
®
detected RBC in 159 samples, being 97.5% isomorphic cells and 2.5% unclassifed iQ200
®
detected casts
in 33 samples, classifying 36.4% as no inclusions and 63.6% with inclusions. Comparison of WBC/
RBC counts between Neubauer and K-cell
®
were equivalent (R
2
=0.87 and 0.75). Comparison of WBC/
RBC counts between iQ200 and manual methods showed higher values to the automation. Conclusion:
Automated methods, such as iQ200
®
, seems to be a reliable tool for urinalysis in daily clinical practice,
reducing the execution time and providing more accuracy. Distinction between isomorphic and
dysmorphic RBC, casts and crystals identifcation still depend on microscopic examination. Te use of
automated device in urinalysis is a good practice, but it requires careful evaluation, taking into account
the population, the volume of the analysis and the availability of skilled professional.
Comparison between Manual Methods and Automated Analyzer iQ200
®
Iris Diagnostics): A Study for the Optimization of Urinalysis
Publication History:
Received: July 30, 2015
Accepted: October 30, 2015
Published: November 01, 2015
Keywords:
Urinalysis, Neubauer Chamber,
KCell
®
Blade, iQ200
®
Methodology Open Access
Summary
Te purpose of this study was to compare automated method
results of test strips, microscopic analysis and counts with the manual
methods, using urine samples (n=275) analyzed by iQ200
®
. White
and red blood cells (WBC/RBC) counts by iQ200
®
were compared
with manual methods (Neubauer and KCell). Leukocyte esterase and
hemoglobin detection provided by the test strips were also analyzed.
We suggest that automated methods, such as iQ200
®
, seems to be a
reliable tool for urinalysis in daily clinical practice, but the distinction
between isomorphic and dysmorphic RBC, casts and crystals
identifcation still depend on microscopic examination.
Introduction
Renal diseases are an important public health problem worldwide.
Early recognition and management of these diseases are considered
good strategies to reduce the progression to end-stage renal disease
(ESRD) and, consequently, the number of chronic kidney disease
(CKD) patients undergoing renal replacement therapy [1-5].
Te Kidney Early Evaluation Program (KEEP
®
) recommends
the use of urinalysis in daily clinical settings and underlines the
importance of detecting hematuria and proteinuria as primary signs
of kidney disease. Furthermore, the evaluation of urinary erythrocyte
morphology has been considered crucial to diferentiate a glomerular
from a non-glomerular disease [6,7].
Te symptoms caused by renal or lower urogenital tract pathologies
have many similarities, which reinforce urinalysis is a valuable tool for
the initial evaluation of the genitourinary system. In addition, despite
of probably being one of the most ancient diagnostic tests used in
*
Corresponding Author: Prof. Aline Borsato Hauser, Clinical Analysis
Department, Sector of Health Sciences, Universidade Federal do Paraná, Rua
Lothario Meissner, 632 Curitiba, PR 80210-170, Brazil,Tel.+55 41 33604084;
E-mail: alinehauser@ufpr.br
Citation: Henneberg JR, Henneberg R, Nascimento AJ, Kussen G, Barreto FC
(2015) Comparison between Manual Methods and Automated Analyzer iQ200
®
Iris Diagnostics): A Study for the Optimization of Urinalysis. Int J Lab Med Res 2:
108. doi: http://dx.doi.org/10.15344/2455-4006/2015/108
Copyright: © 2015 Henneberg et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
medicine, urine examination continues to be an attractive option
to obtain information on corporal homeostasis by means of a quick
and easy collecting method. Urinalysis by manual method, using
standard volume of urine and several types of chamber to count
urinary elements, has been performed in many clinical. More recently,
the burden of urinary specimens begs for automation and recent
technological advances have turned the automated urine testing a
reliable tool that has reduced the execution time for the analysis[8-10].
Whereas both the manual and automation methods have
advantages and disadvantages, the present study sought to compare
the results obtained by using automated urinalysis (iQ200
®
) and
manual methods (Neubauer Chamber and K-Cell
®
Blades) in order
to analyze counts as well as the ability to detect and identify urinary
elements for the purpose of aid in the diagnosis of renal diseases.
Material and Methods
Two hundred seventy-fve urine specimens obtained from patients
(n= 275; age: 46.5±18.7 years; 215 (78.2%) females) at the Diagnosis
International Journal of
Laboratory Medicine & Research
José Ricardo Henneberg
1
, Railson Henneberg
1
, Aguinaldo José do Nascimento
1
, Gislene Kussen
2
, Fellype Carvalho Barreto
3
and Aline
Borsato Hauser
1*
1
Clinical Analysis Department, Universidade Federal do Paraná, Brazil
2
Pharmaceutical Biochemistry of the Clinical Hospital, Universidade Federal do Paraná, Brazil
3
Center for Health and Biological Sciences, Pontifícia Universidade Católica do Paraná, Brazil
Int J Lab Med Res IJLMR, an open access journal
ISSN: 2455-4006 Volume 1. 2015. 108
Henneberg et al., Int J Lab Med Res 2015, 1: 108
http://dx.doi.org/10.15344/2455-4006/2015/108