Diagnostic Value of Urine Renal Tubular Epithelial Cell and Pathological Cast Detection for Renal Injury in Hyperbilirubinemia
10.3969/j.issn.1671-7414.2025.01.035
- VernacularTitle:尿液肾小管上皮细胞和病理管型检测对高胆红素血症肾损伤的诊断价值
- Author:
Wanni WANG
1
;
Yabin CHEN
;
Jie MIAO
Author Information
1. 福建医科大学附属泉州第一医院检验科,福建泉州 362000
- Publication Type:Journal Article
- Keywords:
renal tubular epithelial cells;
pathological cast;
hyperbilirubinemia;
renal injury
- From:
Journal of Modern Laboratory Medicine
2025;40(1):185-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the diagnostic value of Sysmex UF5000 urine analyzer detection of renal tubular epithelial cells (RTEC) and pathological cast (Path. CAST) in urine to screen for hyperbilirubinemia-induced renal injury. Methods A retrospective analysis was conducted on the urine sediment analysis results of patients with hyperbilirubinemia who visited the Quanzhou First Hospital from February 2023 to January 2024. According to the occurrence of renal injury,they were divided into a non-renal injury group(n=174)and a renal injury group(n=84). Compared the RTEC levels and the positive rate of Path. CAST in urine between two groups. Receiver operating characteristic(ROC) curve analysis was used to evaluate the diagnostic performance of RTEC screening for hyperbilirubinemia-induced renal injury,and further analyzed the sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV) of RTEC and Path.CAST single or combined screening. Results The RTEC[5.2(3.2～12.3)/μl]level in the renal injury group,and the positive rate of Path.CAST positivity rate (36.90％),which was significantly higher than that of the non-renal injury group[1.3 (0.7～2.2)/μl,3.45％],the differences were statistically significant (Z/x2=-10.215,51.620,all P<0.001). RTEC could effectively screen patients with renal injury in hyperbilirubinemia,with an AUC (95％CI) of 0.892 (0.846～0.939) and an optimal cut-off value of 3.15/μl for screening. The Youden index was 0.688. When RTEC>3.15/μl or Path.CAST positive was used,its sensitivity and NPV for screening for hyperbilirubinemia-induced renal injury were the highest,with 83.33％ and 91.57％,respectively. When Path.CAST positive was used as the screening condition,its specificity and PPV were the highest,with 96.55％ and 83.78％,respectively. Conclusion Urinary RTEC can effectively screen for renal injury caused by hyperbilirubinemia when RTEC ≤ 3.15/μl or Path.CAST is negative,the possibility of renal injury caused by hyperbilirubinemia can be ruled out.
