3. agile - affordable - accurate
Urinalysis is a noninvasive biopsy, which provides information about the health status
of the urinary tract and the kidney
๏ easy and painless sampling
Urinalysis
Physical
Examination
โข Volume
โข Color
โข Odor
โข Turbidity
Chemical
Examination
โข pH
โข Blood (RBC)
โข Leukocytes
โข Nitrite
โข Protein
โข Bilirubin
โข Urobilinogen
โข Glucose
โข Ketones
โข Ascorbic acid
โข Specific gravity
โข Microalbumin
โข Creatinine
Microscopic
Examination
โข Identification and
quantification of formed
elements
โข ๏ cellular structures
โข ๏ non-cellular structures
(casts, crystals,
organisms, artefacts)
4. agile - affordable - accurate
Urine sediment
โข Verification of positive urine test strip results
๏ Infection (Leucocytes)
๏ Bacteriuria (Nitrite)
๏ Proteinuria (Protein)
๏ Hematuria (Blood)
โข Localization and differentiation of formed elements:
๏ Renal
๏ Postrenal
๏ Referral to a specialist (Follow up)
โข Clarification of differences between chemical and microscopic examination
๏ Lysis of RBCs and WBCs
๏ Bacteria without nitrate reductase
๏ Influence by sample collection and storage
โข Diagnosis and monitoring of medical treatment (Identification and quantification)
5. agile - affordable - accurate
Semi-automated evaluation vs. Manual microscopy
Sediment analysis isโฆ
โฆ the least standardized
โฆ the most time-consuming
โฆ part of routine urinalysis
โข Manual sample preparation of the sample
๏ time consuming ( ~ 20 min.), exposure to potential biohazards
โข Particle recognition is operator dependent
๏ limited precision, low reproducibility, significant trained human resources needed
โข Manual data handling error
โข Many materials necessary (e.g. centrifuge, centrifuge tubes, microscope, etc.)
6. agile - affordable - accurate
Semi-automated evaluation vs. Manual microscopy
Sample preparation
1 min
Centrifugation
5 min +
(~3 min)
Decant and
resuspend
2 min
Preparation
object carrier
1 min
Manual
microscopy
2 - 6 min
Sample preparation and
automatic evaluation
1 min
โข Manual microscopy
โข Semi-automatic sediment analyse
๏ In Total: 10-20 minutes per sample
๏ Materials: Centrifuge, Centrifuge tubes, single-use pipettes, object carrier, cover
glasses, Microscope
๏ In Total: 1 minute per sample, Throughput: 60 sample/ hour (15 images/sample)
๏ Materials: Urilyzerยฎ Cell cuvettes, pipetting tips
7. agile - affordable - accurate
Urilyzerยฎ Cell
Gentle centrifugation
Sensitive particles (e.g. Erythrocytes, casts) are gently moved to the
optical plane of the cuvette without influence to the sample composition
High-quality automated microscopy
Integrated microscope for automatic generation of HPF-like brightfield
images. Auto focus and exposure of each image guarantees highest
quality
Automated image evaluation
Precise particle detection and differentiation in a few seconds by AIEM
software (Artificial Intelligence-based Evaluation Module).
High accuracy and reproducibility
Increases the reproducibility and accuracy of urine sediment analysis
based on the gold standard method
8. agile - affordable - accurate
Complete routine urinalysis within 3 minutes
First morning urine
Doctorโs office, emergency departments or smaller
laboratories
Urine test strip analysis
Urilyzerยฎ 100 Pro or visually
Urine sediment analysis
Urilyzerยฎ Cell
Positive for Hemoglobin, Protein,
Nitrite, Leucocytes, Bacteria
Suspicion of e.g. urinary tract
infection or kidney diseased
9. agile - affordable - accurate
Urine particles โ Red blood cells (Erythrocytes)
โข Normal:
โข Round, non-nucleated biconcave disc (~ 7ยตm)
โข ๏ Ghost cells in hypotonic (diluted) urine
โข ๏ Crenated in hypertonic (concentrated) urine
โข Dysmorphic (with glomerular membrane
damage)
Appearance
(a few cells in normal sample)
โข Yeast
โข Oil droplets
โข Air bubbles
โข WBC (crenated RBCs)
Look-alikes
โข Physical examination: Color, clarity
โข Chemical examination: Erythrocytes (Blood)
Urinalysis
correlation
Source: Description of Urinary Sediment
Constituents (J. Neuendorf, 2020)
10. agile - affordable - accurate
Urine particles โ White blood cells (Leucocytes)
โข Larger than RBCยดs (~ 12 ยตm)
โข Mainly Neutrophil Granulocytes ๏ contain a
segmented nucleus
Appearance
(a few cells in normal sample)
โข Crenated RBCs
โข Renal tubular epithelial cells
Look-alikes
โข Physical examination: Odor, clarity
โข Chemical examination: Leucocytes
Urinalysis
correlation
Source: Description of Urinary Sediment
Constituents (J. Neuendorf, 2020)
11. agile - affordable - accurate
Excursion: Urine test strips vs. Urine sediment
Fresh sample, low pH, Sample not fresh, high pH,
high specific gravity: low specific gravity:
= intact cells = cells lysed
๏ no release Hemoglobin / Esterase ๏ Hemoglobin / Esterase released
= Sediment > test strip = Sediment < test strip
hypertonic isotonic hypotonic
13. agile - affordable - accurate
Urine particles โ Casts
โข Origin in the kidney
โข Hyaline casts: Colorless matrix
normal up to a certain amount
โข Pathological casts: Incorporated components
Indication of renal disease
Appearance
(few hyaline casts may be
normal in case of exercises,
fever, dehydration)
โข Mucus, cell clumps, clumps of small crystals
Look-alikes
โข Physical examination: Color
โข Chemical examination: Protein, detection of
incorporated components
Urinalysis
correlation
PAT
Source: Description of Urinary Sediment
Constituents (J. Neuendorf, 2020)
14. agile - affordable - accurate
Urine particles โ Crystals
โข High variation in the appearance
โข Formation in the kidney due to precipitation of
urine solutes (pH, temperature depended)
โข Normally not present in the urine
Appearance
(few crystals may be in
normal sample)
Acid / neutral urine Alkaline urine
Source: Description of Urinary Sediment
Constituents (J. Neuendorf, 2020)
15. agile - affordable - accurate
Urine particles โ Other particles
โข Bacteria: Normally not present in the urine
๏ May indicate urinary tract infection
โข Yeast ๏ May indicate urinary tract infection
โข Parasites: E.g. Trichomonas, Schistosomas
โข Sperms
โข Mucus
โข Lipids
Source: Description of Urinary Sediment
Constituents (J. Neuendorf, 2020)
17. agile - affordable - accurate
Urine sediment โ Sample collection and handling
First morning urine
โข Urine was retained in the bladder for approximately 8 hours
โข Most concentrated urine of the day
โข Most acid specimen ๏ cells and casts are more stable
Sample should be analyzed within 2 hours
โข Otherwise it has to be stored at + 2 โ 8 ยฐC
โข But: high concentrated salts may crystallize and interfere the recognition of other
important formed elements (when sample gets cool)
Sample handling
โข Proper mixing of the sample before measurement
โข Sample collection in sterile, disposable plastic containers
18. agile - affordable - accurate
agile - affordable - accurate
We look forward to the opportunity to work with you.
