Urinary sediment cast scoring index for acute kidney injury: a pilot study.
Urinary sediment cast scoring index for acute kidney injury: a pilot study.
复制标题
DOI：
10.1159/000166605
复制
发表时间：
2008
影响因子：
--
通讯作者：
Patel, Samir S.
中科院分区：
文献类型：
--
作者：
Chawla, Lakhmir S.;Dommu, Aaron;Berger, Alexandra;Shih, Shirley;Patel, Samir S.
尿液显微镜检查是一种有用的诊断工具，然而，肾脏科医生制备和检查尿沉渣的方式是可变的。我们开发了一种急性肾损伤（阿基）管型评分指数（CSI），以标准化尿液显微镜检查。此外，我们试图评估该评分系统的精确度。收集了30例符合急性肾小管坏死综合征的阿基患者的尿液。样品制备均匀且标准化。指导对样本制备设盲的3名肾病学家使用阿基CSI对每张载玻片进行分级。随后，在另外18名阿基患者中测试了阿基CSI，以确定该评分是否可以预测非肾脏恢复。观察者间一致性指数为99.80%，变异系数为1.24%。在90个配对的观察结果中，98.8%落在平均值的2个标准差内，表明具有良好的一致性。阿基CSI预测非肾脏恢复的受试者操作特征曲线下面积为0.79。阿基CSI是一种简单、新颖、可靠的评分系统，用于对尿液显微镜检查中存在的上皮细胞和颗粒管型的程度进行分级。标准化的阿基CSI有可能将尿管型分析纳入阿基诊断的先进领域。这些初步数据支持阿基CSI可能有助于预测肾脏结局的观点。
Urine microscopy is a useful diagnostic tool; however, the manner in which nephrologists prepare and examine urinary sediment is variable. We developed an acute kidney injury (AKI) cast scoring index (CSI) in order to standardize urinary microscopy. Further, we sought to assess the precision of this scoring system. Urine from 30 patients with AKI consistent with the syndrome of acute tubular necrosis were collected. Sample preparation was uniform and standardized. A panel of 3 nephrologists blinded to the sample preparation were instructed to grade each slide using the AKI CSI. Subsequently, the AKI CSI was then tested in another 18 patients with AKI to determine if this score could predict nonrenal recovery. The interobserver agreement index was 99.80%, with a coefficient of variation of 1.24%. Of the 90 paired observations, 98.8% fell within 2 standard deviations of the mean, signifying good agreement. The receiver operator characteristic area under the curve for AKI CSI to predict nonrenal recovery was 0.79. AKI CSI is a simple, novel, reliable scoring system to grade the degree of epithelial cell and granular casts present on urine microscopy. A standardized AKI CSI has the potential to incorporate urinary cast analysis into the advancing field of AKI diagnostics. These preliminary data endorse the notion that the AKI CSI may be useful in predicting renal outcomes.
登录
查看更多内容
影响因子：
19.6
作者：
Zhou, H.;Pisitkun, T.;Star, R. A.
通讯作者：
Star, R. A.
影响因子：
168.9
作者：
Mishra, J;Dent, C;Devarajan, P
通讯作者：
Devarajan, P
影响因子：
3
作者：
Marcussen, N;Schumann, J;Kjellstrand, C
通讯作者：
Kjellstrand, C
影响因子：
4.9
作者：
SCHENTAG, JJ;GENGO, FM;JUSKO, WJ
通讯作者：
JUSKO, WJ
影响因子：
19.6
作者：
Mehta, RL;Pascual, MT;Chertow, GM
通讯作者：
Chertow, GM