Journal of the Korean Pediatric Society 1994;37(1):40-46.
Published online January 15, 1994.
Urinary Red Cell Volume in the Diagnosis of Glomerular and Non-Glomerular Heaturia in children
Jong Sul Kwon2, Dong Seok Kim2, Myung Sung Kim2, Joon Sik Kim2, Chin Moo Kang2, Dong Seok Jeon1
1Department of Clinical Pathology, Keimyung University, School of Medicine, Taegu, Korea
2Department of Pediatrics, Keimyung University, School of Medicine, Taegu, Korea
요 적혈구 용적변화에 의한 소아혈뇨의 감별진단
권종설2, 김동석2, 김명성2, 김준식2, 강진무2, 전동석1
1계명대학교 의과대학 임상병리학교실
2계명대학교 의과대학 소아과학교실
Abstract
Hematuria is a important clinical sign that is a consequence of significatn renal, urologic or sytemic disease. Recently the morphology of the red cell in hematuria has been used to indicate a renal or non-renal source and also the measurement of red cell volume by red cell analyzer has been used to distinguish glomerular from non-glomerular hematuria. In this study, the MCV(mean corpsular red cell voume), RDW(red cell distributio width) and HDW(hemoglobin distribution width) were measured using H-1 system in 57 children with hematuria to assess the diagnostic usefulness of the urinary red cell analyzer in the differentation of glomerular and non-glomerular hematuria. The patient were divided into two groups as glomerular disease (40 cases) and non- glomerular disease (17 cases) and the location of the bleeding was confirmed by renal biopsy, radiology and the clinical findings. The results were as follows. 1) The urinary red cell MCV was lower in patients with glomerular disease than that in patients with non- glomerular disease (79.89¡¾12.0fL vs. 90.93¡¾9.71fL vs. 90.93¡¾9.71fL; p<0.01) 2) The urinary RDW and HDW were significantly highter in glomerular diseases that those in non-glomerular diseases (RDW; 19.86¡¾11.28% vs 11.34¡¾5.88%, HDW; 3.37¡¾2.07gm vs. 1.86¡¾1.43gm). 3) The urinary red cell MCV was correlated well with the RDW and HDW while there was no correlation between the urinary red cell MCV and the urinary SG or Ph. 4) The sensitivity, specificity and positive predictability of the urinsary MCV were 37.8%, 94.1% and 93.7% and those of RDW were 62.5%, 82.3% an 89.2%. 5) The sensitivity, specificity and positive predictability of the urinary HDW were 42.5%, 88.2% and 89.4%. We concluded from above data that the measurement of the urinary MCV, RDW and HDW would be useful as a primary non-invasive screening test in differentation of glomerular and non-glomerular hematuria in children.
Key Words: Hematuria, Urinary red cell volume, Red cell analyzer


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