Preanalytical factors influencing urine sediment quality

master's thesis

• Title: Predanalitički utjecaji na kvalitetu mokraćnog sedimenta
• Author: Amalija Bunjevac
• Mentor: Nada Vrkić (mentor)
• Committee member: Nada Vrkić (predsjednik povjerenstva)
• Committee member: Milena Jadrijević-Mladar Takač (član povjerenstva)
• Committee member: Roberta Petlevski (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2016-07-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

Analiza mokraće je integralni dio rutinskog rada laboratorija. Kvalitativna analiza mokraće uključuje vizualni pregled, kemijsku analizu i mikroskopski pregled mokraćnog sedimenta. Za bolju standardizaciju analize mokraće Europska konfederacija laboratorijske medicine izdala je smjernice za analizu mokraće. Prema smjernicama definirani volumen mokraće, između 5 – 12 mL, potrebno je u epruveti s konusnim dnom centrifugirati 5 minuta na 400g. Supernatant je potrebno odsisati prilagođenom vakuumskom pumpom, nakon čega se dodaje supravitalna boja i sediment se promatra pod mikroskopom. Cilj ovog istraživanja bio je utvrditi imaju li vrsta epruvete i način uklanjanja supernatanta utjecaj na nalaze mokraćnog sedimenta i da li je volumen uzorka mokraće od 5 mL dovoljan za dobivanje točnog nalaza mokraćnog sedimenta. Istraživanje je provedeno u Kliničkom zavodu za kemiju KBC Sestre milosrdnice. Prikupljeno je 110 uzorka i svaki je vizualno i kemijski ispitan. Za usporedbu epruveta s okruglim i konusnim dnom korišteno je 47 uzorka, za usporedbu odlijevanja i odsisavanja supernatanta jednokratnom plastičnom kapaljkom 101 uzorak i za usporedbu 10 mL uzorka i 5 mL uzorka 100 uzorka. Rezultati istraživanja pokazali su statistički značajnu razliku u broju leukocita po vidnom polju kod usporedbe epruveta. Broj leukocita je bio niži u epruveti s konusnim dnom. Kod usporedbe načina uklanjanja supernatanta statistički značajna razlika nađena je u broju eritrocita, leukocita i stanica pločastog epitela po vidnom polju. Svi su elementi bili niži nakon odsisavanja supernatanta. Rezultati usporedbe volumena uzorka mokraće pokazali su statistički značajnu razliku u broju eritrocita, leukocita, stanica pločastog epitela i ukupnih nehijalinih cilindra po vidnom polju te u broju uzoraka u kojima su/nisu pronađeni nehijalini granulirani cilindri. Svi su elementi bili niži u mokraćnom sedimentu pripremljenom u 5 mL uzorka. Na temelju tih rezultata zaključujemo da epruveta s konusnim dnom i odsisavanje supernatanta jednokratnom plastičnom kapaljkom nisu prihvatljivi u izradi mokraćnog sedimenta i preporučeno je ukinuti praksu prihvaćanja 5 mL mokraće kao odgovarajući volumen uzorka za pripravu mokraćnog sedimenta.

Abstract (english)

Urinalysis is an integral part of rutine laboratory work. Qualitative urinalysis includes visual inspection of urine, chemical and urinary sediment examination. European Urinalysis Guidelines were given by the European Confederation of Laboratory Medicine for better standardization of urinalysis. According to the guidelines a defined volume of urine, between 5 – 12 mL, should be centrifuged at 400 g for 5 min in a conical tube. Supernatant should be removed with an adjusted vacuum tool, supravitally stained and examinated under microscope. The aim of this research was to determine do the type of the tube and the method of removal of supernatant have an effect on urinary sediment findings and is the volume of 5 mL of urine enough for accurate urinary sediment analysis. The research was conducted in KBC Sestre Milosrdnice, in the Department of Chemistry. 110 samples were collected and each one was visually and chemically examined. 47 samples were used for the comparison of round bottom and conical tube, 101 for the comparison of decanting and suction of supernatant with disposable plastic pipettes and 100 in the comparison of 10 mL and 5 mL sample volume. The results showed a statistically significant difference in the number of leukocytes per objective field in the tube type comparison. The number of leukocytes was lower in the conical tube. In the comparison of the removal of supernatant a statistically significant difference was found in the number of erythrocytes, leukocytes and squamous epithelial cells per objective field. All elements were lower after the suction of supernatant. The results of sample volume comparison showed a statistically significant difference in the number of erythocytes, leukocytes, squamous epithelial cells and total non-hyaline cast number per objective field and in the number of samples where granular cast were found/were not found. All the elements were lower in urinary sediment from 5 mL sample volume. Based on these findings we conclude that the conical tube and suction of supernatant are not acceptable for usage in urinary sediment examination. Because of the falsely lower number of parameters, which can negatively influence the provision of adequate medical care, it is recommended to stop accepting 5 mL volume sample as sufficient for urine sediment analysis.

• Keywords: mokraćni sediment; analiza mokraće; epruveta s okruglim dnom; epruveta s konusnim dnom; odlijevanje supernatanta; odsisavanje supernatanta
• Keywords (english): urine sediment; urinalysis; conical tube; round-bottom tube; decanting of supernatant; suction of supernatant
• Language: croatian
• URN:NBN: urn:nbn:hr:163:262751
• Study programme: Title: Medicinska biokemija; Study programme type: sveučilišni; Study level: integrirani preddiplomski i diplomski; Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Restricted access
• Created on: 2016-10-27 07:14:30