Cytological method of research in the diagnosis of urinary pathology in liver cirrhosis
https://doi.org/10.51523/2708-6011.2023-20-1-02
Abstract
Objective. To determine the possibilities of cytological method of urine cellular sediment examination for diagnosis and differential diagnosis of renal and urinary tract pathology in liver cirrhosis.
Materials and methods. A standard observational study of 50 inpatients with liver cirrhosis was performed. Cytological preparations of urine sediment were prepared by liquid cytology and cytocentrifugation methods and after fixation were
Results. Cytological study of cellular urine sediment in hospitalized patients with cirrhosis revealed dysmorphic (leached) erythrocytes in 31% of cases, statistically significantly more frequently in patients with decompensation of the disease and 30-day mortality (p<0,05). Microflora in the urine was found in 63% of patients, more often of mixed nature (27%). In 46% of patients with decompensated liver cirrhosis, including acute renal injury, cytological preparation of urinary sediment is represented by multicellular elements with the presence of superficial and deep urothelium and renal epithelium.
Conclusions. Cytological method of studying the cellular urine sediment is an accessible, informative and cheap diagnostic method, the possibilities of which are to determine the presence and origin of cellular elements (urothelium of the surface and deep layers, altered erythrocytes), microflora and its source (genital tract, urinary tract), which, in combination with other methods, allows to verify the diagnosis of the patient and to carry out differential diagnosis of acute tubular necrosis and hepatorenal syndrome.
About the Authors
E. G. Malaeva
Gomel State Medical University
Belarus
Belarus
Ekaterina G. Malaeva, Candidate of Medical Sciences, Associate Professor, Head of the Department of Internal Diseases No.1 with the Courses of Endocrinology and Hematology
Gomel
L. P. Zaitseva
Gomel Regional Clinical Oncological Dispensary
Belarus
Belarus
Larisa P. Zaytseva, Head of the Centralized Cytological Laboratory
Gomel
A. S. Knyazyuk
Gomel State Medical University
Belarus
Belarus
Andrey S. Knyazyuk, Candidate of Medical Sciences, Associate Professor at the Department of Urology
Gomel
O. V. Osipkina
Gomel State Medical University
Belarus
Belarus
Olga V. Osipkina, Head of the Research Laboratory
Gomel
References
1. Huang Y, Cai J, Ha F, Guo B, Xin S, Duan Z, et al. Characteristics of acute kidney injury and its impact on outcome in patients with acute-on-chronic liver failure. BMC Gastroenterol. 2022;22(1):231. DOI: https://doi.org/10.1186/s12876-022-02316-8
2. Atteberry P, Biederman B, Jesudian A, Lucero C, Brown RS Jr, Verna E, et al. Mortality, sepsis, and organ failure in hospitalized patients with cirrhosis vary by type of infection. J Gastroenterol Hepatol. 2021;36(12):3363-3370. DOI: https://doi.org/10.1111/jgh.15633
3. Lingiah VA, Pyrsopoulos NT. Bacterial infections in cirrhotic patients in a tertiary care hospital. J Clin Transl Hepatol. 2021;9(1):32-39. DOI: https://doi.org/10.14218/JCTH.2020.00076
4. Velez JCQ, Therapondos G, Juncos LA. Reappraising the spectrum of AKI and hepatorenal syndrome in patients with cirrhosis. Nat Rev Nephrol. 2020;16(3):137-155. DOI: https://doi.org/10.1038/s41581-019-0218-4
5. Gupta K, Bhurwal A, Law C, Ventre S, Minacapelli CD, Kabaria S, et al. Acute kidney injury and hepatorenal syndrome in cirrhosis. World J Gastroenterol. 2021;27(26):3984-4003. DOI: https://doi.org/10.3748/wjg.v27.i26.3984
6. Chancharoenthana W, Leelahavanichkul A. Acute kidney injury spectrum in patients with chronic liver disease: where do we stand? World J Gastroenterol. 2019;25(28):3684-3703. DOI: https://doi.org/10.3748/wjg.v25.i28.3684
7. Allegretti AS, Solà E, Ginès P. Clinical application of kidney biomarkers in cirrhosis. Am J Kidney Dis. 2020;76(5):710-719. DOI: https://doi.org/10.1053/j.ajkd.2020.03.016
8. Simonetto DA, Gines P, Kamath PS. Hepatorenal syndrome: pathophysiology, diagnosis, and management. BMJ. 2020;370:m2687. DOI: https://doi.org/10.1136/bmj.m2687
9. Udgirkar S, Rathi P, Sonthalia N, Chandnani S, Contractor Q, Thanage R, et al. Urinary neutrophil gelatinase-associated lipocalin determines short-term mortality and type of acute kidney injury in cirrhosis. JGH Open. 2020;4(5):970-977. DOI: https://doi.org/10.1002/jgh3.12377
10. Jaques DA, Spahr L, Berra G, Poffet V, Lescuyer P, Gerstel E, et al. Biomarkers for acute kidney injury in decompensated cirrhosis: a prospective study. Nephrology (Carlton). 2019;24(2):170-180. DOI: https://doi.org/10.1111/nep.13226
11. Wycislo KL, Piech TL. Urinary tract cytology. Vet Clin North Am Small Anim Pract. 2019;49(2):247-260. DOI: https://doi.org/10.1016/j.cvsm.2018.11.002
12. Abedini A, Zhu YO, Chatterjee S, Halasz G, Devalaraja-Narashimha K, Shrestha R, et al. Urinary single-cell profiling captures the cellular diversity of the kidney. J Am Soc Nephrol. 2021;32(3):614-627. DOI: https://doi.org/10.1681/ASN.2020050757
13. de Melo CVB, Tavares MB, Fernandes PN, Dos Santos Silva CA, Couto RD, Oliveira MB, et al. Urinary cytology: a potential tool for differential diagnosis of acute kidney injury in patients with nephrotic syndrome. BMC Res Notes. 2020;13(1):401. DOI: https://doi.org/10.1186/s13104-020-05244-6
14. Malaeva EG, Zaitseva LP, Nadyrov EA, Los DM Cytological research method in the diagnosis of urinary tract infections: opportunities and prospects. Actual problems of medicine: Sat. scientific. Art. Rep. scientific.-practice. conf. with internat. particip.; 2022 November 10; Gomel: GomSMU, 2022;3:187-190.
15. Bagshaw SM, Bellomo R. Urine abnormalities in acute kidney injury and sepsis. Contrib Nephrol. 2010;165:274-283. DOI: https://doi.org/10.1159/000313767
16. Zaitseva LP, Nadyrov EA, Los DM. Evaluation of the economic efficiency of the liquid cytology method in the study of cellular urine sediment. Laboratory diagnostics. Eastern Europe. 2022;11(4):497–505. DOI: https://doi.org/10.34883/PI.2022.11.4.009
Review
For citations:
Malaeva E.G., Zaitseva L.P., Knyazyuk A.S., Osipkina O.V. Cytological method of research in the diagnosis of urinary pathology in liver cirrhosis. Health and Ecology Issues. 2023;20(1):16-25. (In Russ.) https://doi.org/10.51523/2708-6011.2023-20-1-02
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