Detection significance of urine sediment red blood cells,white blood cells and casts analysis in patients with immunoglobulin A nephropathy

Zhan Yanting; Chen Lijuan; Li Caizhen

doi:10.3969/j.issn.1674-7151.2025.01.008

Abstract：Objective To explore the detection significance of urine sediment red blood cells,white blood cells and casts analysis in patients with immunoglobulin A nephropathy(IgAN).Method The 80 IgAN patients admitted to Longyan People's Hospital from January 2021 to December 2023 were selected as study subjects and included in IgAN group.According to the pathological results of renal biopsy,IgAN patients were classified into Lee grades,including 13 cases of Lee grade Ⅰ,35 cases of Lee grade Ⅱ,19 cases of Lee grade Ⅲ and 13 cases of Lee grade Ⅳ.In addition,35 healthy individuals undergoing physical examinations during the same period were included in control group.The general information[including age,gender,blood pressure,albumin(ALB),hemoglobin(Hb),serum creatinine(SCr)and glomerular filtration rate(GFR)]and urine samples of all subjects were collected.Using urine sediment microscopy,the red blood cells,white blood cells and casts were detected,and the differences in levels of above indicators between IgAN group and control group,as well as IgAN patients with different Lee grades were compared.Spearman correlation analysis was used to investigate the relationship between number of red blood cells,white blood cells and casts in urine sediment and Lee grades.Results The levels of diastolic blood pressure,systolic blood pressure and SCr in IgAN group were significantly higher than those in control group,while the levels of ALB,Hb and GFR were significantly lower than those in control group[diastolic blood pressure(mmHg;1 mmHg≈0.133 kPa):85.74±9.38 vs.76.35±6.07;systolic blood pressure(mmHg):137.68±18.35 vs.113.90±14.14;SCr(μmol/L):140.66±40.15 vs.70.21±7.26;ALB(g/L):37.37±6.64 vs.47.57±7.85);Hb(g/L):120.62±17.51 vs.141.36±15.76;GFR(mL·min-1·1.73 m-2):62.01±15.32 vs.108.86±26.17;all P<0.05],and there were no statistically significant differences in age and gender between the two groups.The urinary sediment red blood cells,white blood cells and casts in IgAN group were significantly higher than those in control group[red blood cells(cells/μL):20.18±4.72 vs.3.37±1.06;white blood cells(cells/μL):61.69±15.21 vs.5.54±1.38;casts(cells/μL):0.47±0.12 vs.0.21±0.06;all P<0.05].There were statistically significant differences in the number of red blood cells,white blood cells,and casts in urine sediment among patients with different Lee grades.The numbers of red blood cells in Lee grade Ⅱ,Ⅲ and Ⅳgroups were significantly higher than that in Lee gradeⅠ group(cells/μL:19.34±3.22,21.79±3.63,23.25±3.88 vs.17.02±2.83,all P<0.05),and the numbers of red blood cells in Lee grade Ⅲ and Ⅳ groups were significantly higher than that in Lee grade Ⅱ group(cells/μL:21.79±3.63,23.25±3.88 vs.19.34±3.22,both P<0.05).The number of white blood cells and casts in Lee grade Ⅲ and Ⅳ groups were significantly higher than those in Lee gradeⅠgroup[white blood cells(cells/μL):64.63±10.76,68.08±11.35 vs.55.91±9.33;casts(cells/μL):0.49±0.08,0.52±0.09 vs.0.42±0.07;all P<0.05],and the number of white blood cells and casts in Lee grade Ⅳ group were significantly higher than those in Lee gradeⅡ group[white blood cells(cells/μL):68.08±11.35 vs.59.87±9.98;casts(cells/μL):0.52±0.09 vs.0.46±0.08;both P<0.05].The Spearman correlation analysis results showed that the numbers of red blood cells,white blood cells and casts in urine sediment were positively correlated with Lee grading(r values were 0.561,0.579,0.533,respectively,all P<0.001).Conclusions There is a correlation between the numbers of red blood cells,white blood cells and casts in urine sediment and the pathological grading of IgAN patients.Detecting these indicators could help clarify the histopathological changes in tissues of IgAN patients.