Value of urine microscopy in predicting histological changes in the kidney: double blind comparison.

Abstract

Fresh, first morning specimens of urine from 22 consecutive patients were examined by quantitative microscopy on the morning of renal biopsy; the renal biopsy samples were evaluated "blindly." Five patients showed no abnormality in the biopsy samples but eight had minimal, one mild, six moderate, and two severe histological changes. Comparison of the results of quantitative microscopy of urine with the presence or absence of histological evidence of disease showed that sensitivity was 88%, specificity 83%, accuracy 86%, positive predictive value 93%, and negative predictive value 71%.When combined with microscopy of a second urine specimen these values were 100%, 50%, 87%, 85%, and 100% respectively. There was a significant relation between number of casts and severity of the histological changes (p <0 01). Comparison of renal functional abnormalities with histological findings gave values of 64%, 100%, 73 %, 100%, and 50% respectively.

Clinical prevalence of glomerular hematuria: A nine‐year retrospective study

“…Gyory and al. 29 investigated the correlation between dysmorphic RBCs and a decrease in renal function in 22 patients undergoing a renal biopsy. For one-look US, they found sensitivity of 53%, specificity of 60%, accuracy of 55%, positive predictive value of 82%, and negative predictive value of 27%.…”

Asymptomatic microscopic or dipstick haematuria in adults: which investigations for which patients? A review of the evidence

“…Coulter analysis is less helpful in patients with low‐grade haematuria. Detection of red cell casts by microscopy of freshly voided first‐morning urine was shown to be highly sensitive for the presence of renal disease in a small series of patients undergoing renal biopsy for suspected renal disease [142]. This technique is under‐used, but requires trained observers and has not been validated in AMH.…”