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[Acanthocyturia is more efficient in to differentiate glomerular from non-glomerular hematuria then dysmorphic erythrocytes].

OBJECTIVE
Our purpose was to determine which was the most reliable method for differentiating glomerular from non-glomerular (lower urinary tract) hematuria by microscopic examination of urinary red blood cells: dysmorphic red cell count or acanthocyte count. The latter is a special type of dysmorphic red cell specific to glomerular hematuria.


METHODS
Urine samples of 170 patients with hematuria [73 had renal and 97 non-renal (urological) pathology] were analyzed. Urinary sediment phase-contrast microscopy was performed to determine the percentage of dysmorphic red cells and acanthocytes in each patient. Data were correlated with the diagnosis.


RESULTS
Glomerular hematuria defined as dysmorphic red cell count > 35% showed a sensitivity and specificity of 69% and 100%, respectively. Glomerular hematuria defined as acanthocytes > 5% showed a sensitivity and specificity of 88% and 100%, respectively.


CONCLUSIONS
Phase-contrast microscopy urinary sediment acanthocyte count is more effective than dysmorphic red cell count in the diagnosis of glomerular hematuria.