[01] Bashir Abdrhman Bashir, Hematology Department, Faculty of Medical Laboratory Sciences, Port Sudan Ahlia College, Port Sudan, Sudan. [02] Maisa Ahmed Badneen, Clinical Chemistry Department, Port Sudan Hospital for Surgery & Hemodialysis, Ministry of Health, Red Sea State, Sudan. [03] Mohammed Omer Gibreel, Hematology Department, Faculty of Medical Laboratory Sciences, Port Sudan Ahlia College, Port Sudan, Sudan.

Background: Hematuria is a prevalent finding encountered during manual routine urine examination in the laboratory. Two principle characters can be watched, microscopic and macroscopic hematuria. It tends to be clear for genuine urological conditions. Dysmorphic red blood cells (dRBCs) in urine deposit may be a successful incentive in the diagnosis of the glomerular and non-glomerular origin of hematuria. A cross-sectional observational study was enlisted to assess the capacity of dRBCs to perceive glomerular inception from another kidney hindrance. Methods: We have appraised 170 consecutive patients with hematuria at Dr. Awaad Medical Center, Red Sea State, Sudan from June 2017 to July 2018. Renal ultrasonography and urinalysis were performed. The statistical statements were analyzed using SPSS version 24.0 for windows. Results: Roughly 10/170 (5.9%) had gross hematuria, 49/170 (28.8%) had microscopic hematuria with clinical symptoms, 56/170 (32.9%) had microscopic hematuria with proteinuria, and 55/170 (32.4%) had isolated hematuria. The causes of hematuria were highlighted as (72.9% non-glomerular and 19.5% glomerular). dRBCs were encountered in 122/170 (71.8%) (P = 0.000) of an entire group of patients with hematuria. fRBCs were also detected in 99/170 (58.2%) of patients (P = 0.000) of an entire group of patients with hematuria. Of 170 patients, 50 (29.4%) had > 16.6 dRBCs and 47 (27.6%) had ≥ 12.0 fRBCs. dRBCs was sensitive (66.7%), specific (68.8%), with a positive predictive value (90.2%) for glomerular disease. Hematuria outcomes expressed as urinary tract infection (UTI) in (37.6%), followed by glomerulonephritis (19.5%), cystitis (18.2%), pyelonephritis (10.0%), and renal stones (7.6%). Conclusion: Urinary dRBCs > 16.6 in Urine sediment test was an extensive prognostic for glomerular illness, however, in joined with proteinuria it is explicit characteristic of the glomerular starting point. fRBCs were revealed to the non-glomerular origin. Dysmorphic RBCs persist in healthy subjects denotes a glomerular source. UTI, glomerulonephritis, and cystitis were considered the prevalent outcomes of hematuria in this report.

Hematuria, dRBCs, Glomerular Disease, Albuminuria, Port Sudan

[01] Yafi FA, Aprikian AG, Tanguay S, Kassouf W. Patients with microscopic and gross hematuria: practice and referral pattern among primary care physicians in a universal health care system. Can Urol Assoc J. 2011; 5 (2): 97 – 01. [02] Koo KC, Lee KS, Choi AR, Rha KH, Hong SJ, Chung BH. Diagnostic impact of dysmorphic red cells on evaluating microscopic hematuria: the urologists perspective. Int Urol Nephrol. 2016; 48 (7): 1021 – 7. [03] Tesser Poloni J, Bosan IB, Garigali G, Fogazzi GB. Urinary Red Blood Cells: not only Glomerular or non-glomerular. Nephron Clin Pract 2012; 120: c36–c41. [04] Sultana T, Sultana T, Rahman MQ, Ahmed ANN Evaluation of Hematuria and use of phase contrast microscope: A short review. J Dhaka Med Coll. 2011; 20 (1): 63 – 7. [05] Feld LG, War WR, Perez LM, Joesph DB. Hematuria. An Integrated medical and surgical approach. Pediatr CLi North Am. 1997; 44 (5): 1191 – 210. [06] Crop MJ, de Rijke YB, Verhagen PC, Crnsberg K, Zietse R. Diagnostic value of urinary dysmorphic erythrocyte in clinical practice. Nephron Clin Pract. 2011; 115: c203-c212. [07] Cohen RA, Brown RS. Microscopic hematuria. N Engl J Med. 2003; 2330-2337. [08] Fogazzi GB, Edefonti A, Garigali G, Giani M, Zolin A, Raimondi S, Mihatsch MJ, Messa P: Urine erythrocyte morphology in patients with microscopic haematuria caused by a glomerulopathy. Pediatr Nephrol. 2008; 23: 1093–1100. [09] Hamadah AM, Gharaibeh K, Mara KC, Thompson KA, Lieske JC, Said S et al. Urinalysis for the diagnosis of glomerulonephritis: role of dysmorphic red blood cells. Nephrol Dial Transplant. 2018; 33 (8): 1397-1403. [10] Wollin T, Laroche B, Posy K. Canadian guidelines for management of asymptomatic microscopic hematuria in adults. Can Urol Assoc J. 2009; 3: 77-80. [11] Grossfeld GD, Litwin MS, Wolf JS, Hricak H, Shuler CL, Agerter DC, Carroll PR: Evaluation of asymptomatic microscopic hematuria in adults: The American Urological Association best practice policy-part I: definition, detection, prevalence, and etiology. Urology. 2001; 57: 599 -603. [12] Huussen J, Koene RA, Meuleman EJ, Hilbrands LB: Diagnostic approach in patients with asymptomatic haematuria: efficient or not? Int J Clin Pract. 2006; 60: 557–561. [13] Wang YY, Savige J: The epidemiology of thin basement membrane nephropathy. Semin Nephrol. 2005; 25: 136–139. [14] Dong ZY, Wang YD, Qiu Q, Kai H, Zhang L, Wu J, Zhu HY et al. Dysmorphic erythrocytes are Superior to hematuria for indicating non-diabetic renal disease in type 2 diabetics. J Diabetes Investig. 2016; 7 (1): 115-20. [15] Chu-Su, Y, Shukuya K, Yokoyama T, Lin WC, Chiang CK, Lin CW. Enhancing the Detection of Dysmorphic Red Blood Cells and Renal Tubular Epithelial Cells with a Modified Urinalysis Protocol. Sci. Rep. 2017; 7: 40521. [16] Shayanfar N, Tobler U, von Eckardstein A, Bestmann L: Automated urinalysis: first experiences and a comparison between the IrisiQ200 urine microscopy system, the Sysmex UF-100 flow cytometer and manual microscopic particle counting. Clin Chem Lab Med 2007; 45: 1251–1256.