Urine analyzers both automated and manual are used in clinical settings from Maurice Sidney's blog

It is one of the most frequently performed tests in the clinical laboratory, and it is a urine analyzer analysis. The manual microscopic sediment examination method, on the other hand, is time-consuming, labor-intensive, and lacks standardization in high-volume laboratories. A comparison of the concordance of analyses between manual microscopic examination and two different automatic microscopic urine analysis sediment analyzers was carried out in this study.

Design and implementation methods

The Iris iQ200 ELITE (Iris Diagnostics, USA) and Dirui FUS-200 (DIRUI Industrial Co., China) automatic urine analyzer sediment analyzers, as well as manual microscopic examination, were used to analyze the microscopic urine analysis samples. In this study, the degree of concordance (Kappa coefficient) as well as the rates within the same grading were assessed.

As a result,

The degree of concordance between the two instruments was greater than the degree of concordance between the manual microscopic method and the individual devices for erythrocytes, leukocytes, epithelial cells, bacteria, crystals, and yeasts. In the case of casts, there was no agreement between any of the methods.

Final Thoughts

For erythrocytes, leukocytes, and epithelial cells, the results from the automated analyzers were consistent with the results obtained through microscopic examination. In order to avoid any error or uncertainty, some images (particularly dysmorphic cells, bacteria, yeasts, casts and crystals) must be manually examined under a microscope by trained personnel in order to be evaluated for accuracy and precision. As a result, further development of the software programs that are used in automatic urine sediment analysers is required in order to recognize urinary shaped elements with greater accuracy. Systems that automate repetitive tasks are beneficial in terms of time savings and standardization.

When performed correctly, a  sediment analysis is a reliable indicator of the health of the renal and genitourinary systems. A urinalysis is performed when there is a possibility of urinary tract infection or urinary stone formation; non-infectious renal disease secondary to systemic diseases such as rheumatic diseases, hypertension, toxaemia of pregnancy, or the adverse effects of drugs; non-infectious post-renal disease; in pregnant women and patients with diabetes mellitus or metabolic disorders who may have proteinuria, glycosuria, ketosis, or acidosis/alkalos

In accordance with the European Urinalysis Guidelines, the traditional strategy involves two steps.1st and foremost,There is a visual inspection and a dipstick test performed in the first step. If the results of the semi-quantitative dipstick tests for hemoglobin, leukocyte esterase activity, nitrite, and protein are negative, the urine analyzer samples are excluded from further investigation. During the second step, microscopic urine analysis samples are subjected to further examination by microscopy to determine whether there is erythrocyturia, leukocyturia, bacteriuria, or proteinuria present. Screening by dipstick alone, which has low sensitivity and negative predictive value, increases the risk of missing infections and other urinary diseases, primarily because of the low sensitivity and negative predictive value of the first step.