مورفولوژي گلبول هاي قرمز در عفونت ادراري فوقاني و تحتاني

Morphology of Red Blood Cells for Differentiating between the Upper and the Lower Urinary Tract Infection

Introduction Accurate differentiation between upper and lower urinary tract infection (UTI) requires invasive procedures. The objective of this study was to determine the morphology of RBC that originates from kidney or bladder for differentiating between upper and lower urinary tract infection. Materials UTI was induced by the injection of 0.5ml of normal saline and containing human E coli (104/cc) into the bladder of rats Methods (n=50). After 48 hours, the rat urine was drained from the bladder and analyzed for the morphology of RBC, culture and cell counter. For diagnosing pyelonephritis, both bilateral kidneys and bladder were biopsied for histopathology and culture. Results Dysmorphic RBC was detected in 33% (10/30) of the subjects with upper UTI and 13% (4/30) with lower UTI, which showed no significant difference (x2= 0.04, P=0.63 Fisher Exact Test). The mean and SD of percentage of dysmorphic RBC in the subjects with upper and lower UTI were 35±34% and 44±43%, respectively, which revealed no significant difference (t=0.55, P=0.25). In this sudy, dysmorphic RBC showed rates of 45% sensitivity and 50% specificity for upper UTI diagnosis. Conclusion Urine osmolality may influence the results of RBC morphology for differentiating between upper and lower UTI