Differentiating glomerular from non-glomerular hematuria: role of urinary albumin-total protein ratio

Authors

  • SK Md Ershad Registrar, Department of Nephrology, National Institute of Kidney Diseases & Urology, Dhaka, Bangladesh
  • Rafi Nazrul Islam Department of Nephrology & Dialysis, BIRDEM General Hospital, Dhaka, Bangladesh
  • Mohammad Farhadul Haque Deputy Director Hospital, Shaheed Monsur Ali Medical College Hospital, Uttara, Dhaka - 1230, Bangladesh
  • Shah Md Zakir Hossain Assistant Professor, Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Md Zayeed Ahsan Medical Officer, Department of Nephrology & Dialysis, National Institute of Kidney Diseases & Urology, Dhaka, Bangladesh
  • Mohammad Syfur Rahman Assistant Professor, Department of Nephrology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh
  • Anirban Kishor Singha Registrar, Department of Nephrology, Kurmitola General Hospital, Dhaka, Bangladesh
  • Shahida Mullah Junior Consultant (Nephrology, Current Charge), Department of Internal Medicine, Sarkari Karmachari Hospital, Fulbaria, Dhaka, Bangladesh
  • Asif Mahmud Clinical Fellow ST3+ Medicine & Specialities, Worcestershire Royal Hospital, United Kingdom
  • Md Rezaul Alam Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/birdem.v12i1.57226

Keywords:

dysmorphic red cells, hematuria, phase-contrast microscopy

Abstract

Background: Hematuria is one of the most common and early signs of diseases related to genitourinary system and can be classified as either glomerular or non-glomerular in origin. Percentage of dysmorphic RBC (%dRBC) in urine has been in practice as a diagnostic tool for differentiating glomerular from non-glomerular hematuria. Recent studies indicate that, urinary albumin-total protein ratio (uAPR) can also be used as a diagnostic tool in this regard. This study aimed to evaluate the sensitivity and specificity of uAPR as a diagnostic tool for detecting glomerular hematuria in comparison to %dRBC in urine.

Methods: This cross-sectional study enrolled 96 patients with hematuria. Fresh urine samples were collected from each subject to determine the %dRBC and to calculate uAPR. Receiver operating characteristic curve analysis was done on these results to evaluate the sensitivity and specificity of uAPR and %dRBC in differentiating glomerular from non-glomerular hematuria.

Results: uAPR and %dRBC were significantly (p<0.001) higher among patients with glomerular hematuria than non-glomerular hematuria. At the cutoff value of 0.57 mg/mg, uAPR showed sensitivity of 81.8% and specificity of 95.5%. At the cutoff value of 22.5%, %dRBC showed sensitivity of 54.5% and specificity of 86.4%.

Conclusion: uAPR has higher sensitivity and specificity than %dRBC in differentiating glomerular from nonglomerular hematuria and can be used as a diagnostic tool.

BIRDEM Med J 2022; 12(1): 51-56

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Published

2021-12-30

How to Cite

Md Ershad, S., Islam, R. N. ., Haque, M. F. ., Hossain, S. M. Z. ., Ahsan, M. Z. ., Rahman, M. S. ., Singha, A. K. ., Mullah, S. ., Mahmud, A. ., & Alam, M. R. . (2021). Differentiating glomerular from non-glomerular hematuria: role of urinary albumin-total protein ratio. BIRDEM Medical Journal, 12(1), 51–56. https://doi.org/10.3329/birdem.v12i1.57226

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Original Articles