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Diagnostic impact of dysmorphic red blood cells on evaluating microscopic hematuria: the urologist's perspective.

DC Field Value Language
dc.contributor.author구교철-
dc.contributor.author나군호-
dc.contributor.author이광석-
dc.contributor.author정병하-
dc.contributor.author최아란-
dc.contributor.author홍성준-
dc.date.accessioned2017-02-27T08:08:40Z-
dc.date.available2017-02-27T08:08:40Z-
dc.date.issued2016-
dc.identifier.issn0301-1623-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/147098-
dc.description.abstractPURPOSE: Dysmorphic red blood cells (dRBCs) are indicative of glomerular disease and considered a first step in evaluating microscopic hematuria (MH). The predominance of dRBCs does not preclude urological disease; however, some contemporary guidelines advise nephrological evaluation without further urological evaluation, in contrast to the American Urological Association guideline. We investigated the feasibility and safety of omitting urological evaluation in patients presenting with MH. METHODS: A retrospective analysis was performed on 411 consecutive patients who presented with MH between January 2012 and December 2014. MH was defined as ≥3 RBCs per high-power field. All patients received full urological and nephrological evaluations including history and physical assessment, renal function, urine cytology, %dRBC, cystoscopy, computed tomography (CT) imaging, and renal biopsy when indicated. RESULTS: The median %dRBC was higher in patients with glomerular disease than in those with urological disease (40.4 vs. 21.1 %; p < 0.001). Among patients exhibiting %dRBC ≥ 40, 33/97 (34.0 %) had urological and 28/97 (28.9 %) had glomerular diseases. Urological diseases included 9/33 (27.3 %) clinically meaningful malignancies and 17/33 (51.5 %) conditions requiring immediate treatment. The rate of malignancy was comparable between %dRBC groups (p = 0.087). Among patients with final diagnoses who exhibited %dRBC ≥ 40, 32/61 (52.5 %) treatment-requiring conditions would have been unrecognized had cystoscopy and/or CT not been performed. For predicting glomerular disease, the presence of proteinuria demonstrated higher AUC than %dRBC ≥ 40 (0.77 vs. 0.65; p < 0.001). CONCLUSIONS: Identification of %dRBC ≥ 40 had modest diagnostic value in identifying glomerular disease, and concomitant presence of proteinuria was more indicative of glomerular origin in patients presenting with MH. Urological evaluation should not be omitted in these patients considering the prevalence of treatment-requiring urological disease.-
dc.description.statementOfResponsibilityrestriction-
dc.format.extent1021~1027-
dc.languageEnglish-
dc.publisherSpringer-
dc.relation.isPartOfINTERNATIONAL UROLOGY AND NEPHROLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHCohort Studies-
dc.subject.MESHErythrocyte Count-
dc.subject.MESHErythrocytes, Abnormal/pathology*-
dc.subject.MESHFemale-
dc.subject.MESHHematuria/blood-
dc.subject.MESHHematuria/diagnosis*-
dc.subject.MESHHumans-
dc.subject.MESHKidney Diseases/diagnosis*-
dc.subject.MESHKidney Diseases/epidemiology-
dc.subject.MESHKidney Glomerulus/pathology*-
dc.subject.MESHKidney Glomerulus/physiopathology-
dc.subject.MESHLogistic Models-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultivariate Analysis-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHROC Curve-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Assessment-
dc.subject.MESHSensitivity and Specificity-
dc.subject.MESHUrologists-
dc.titleDiagnostic impact of dysmorphic red blood cells on evaluating microscopic hematuria: the urologist's perspective.-
dc.typeArticle-
dc.publisher.locationNetherlands-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Urology-
dc.contributor.googleauthorKyo Chul Koo-
dc.contributor.googleauthorKwang Suk Lee-
dc.contributor.googleauthorAh Ran Choi-
dc.contributor.googleauthorKoon Ho Rha-
dc.contributor.googleauthorSung Joon Hong-
dc.contributor.googleauthorByung Ha Chung-
dc.identifier.doi10.1007/s11255-016-1265-4-
dc.contributor.localIdA00188-
dc.contributor.localIdA01227-
dc.contributor.localIdA02668-
dc.contributor.localIdA03607-
dc.contributor.localIdA04105-
dc.contributor.localIdA04402-
dc.relation.journalcodeJ01177-
dc.identifier.eissn1573-2584-
dc.identifier.pmid27020444-
dc.identifier.urlhttp://link.springer.com/article/10.1007/s11255-016-1265-4-
dc.subject.keywordDysmorphism-
dc.subject.keywordErythrocytes-
dc.subject.keywordGuideline-
dc.subject.keywordHematuria-
dc.subject.keywordNeoplasms-
dc.contributor.alternativeNameKoo, Kyo Chul-
dc.contributor.alternativeNameRha, Koon Ho-
dc.contributor.alternativeNameLee, Kwang Suk-
dc.contributor.alternativeNameChung, Byung Ha-
dc.contributor.alternativeNameChoi, Ah Ran-
dc.contributor.alternativeNameHong, Sung Joon-
dc.contributor.affiliatedAuthorKoo, Kyo Chul-
dc.contributor.affiliatedAuthorRha, Koon Ho-
dc.contributor.affiliatedAuthorLee, Kwang Suk-
dc.contributor.affiliatedAuthorChung, Byung Ha-
dc.contributor.affiliatedAuthorChoi, Ah Ran-
dc.contributor.affiliatedAuthorHong, Sung Joon-
dc.citation.volume48-
dc.citation.number7-
dc.citation.startPage1021-
dc.citation.endPage1027-
dc.identifier.bibliographicCitationINTERNATIONAL UROLOGY AND NEPHROLOGY, Vol.48(7) : 1021-1027, 2016-
dc.date.modified2017-02-24-
dc.identifier.rimsid47130-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers

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