Boddeüs, J.A. (2012) De beoordeling van het urinesediment: Is er een verschil in de beoordeling tussen laborant ennefroloog en heeft dit consequenties voor de diagnose? thesis, Medicine.
Full text available on request.Abstract
Introduction: The urinary sediment is an important test that can help to diagnose diseases of the kidneys and urinary tract. When examining the urinary sediment, a report of the detected cells and elements is made. The interpretation of this report is up to the clinician. From the assumption that nephrologists and laboratory review the urinary sediment different, we examined whether there is a difference in the assessment of the urinary sediment between nephrologist and laboratory and whether this has consequences for the accuracy of the diagnosis given using these reports. Methods: In this study 45 urinary sediments were reviewed by both laboratory and nephrologist A. Using these reports a diagnosis was given by two different nephrologists (A and B). These diagnoses were compared with the gold standard, the diagnosis made by the clinician, to assess accuracy of diagnosis. The reporting of the various cells and elements were compared. The agreement between the diagnoses made by both nephrologists was also examined. Results: No significant difference was found in the accuracy of the diagnosis given using the various reports (p = 0.180 and p = 1.0). The report shows that there is a significant difference in the reporting of erythrocytes (p = 0.009), round epithelium (p = 0.006), granular casts (p = 0.001), hyaline casts (p = 0.004) and dysmorphic erythrocytes (p = 0.008 ). The agreement between the 1st and 2nd diagnosis of nephrologist A given its own assessment is strong (κ = 0.803), the agreement in diagnoses between nephrologist A and B using the different reports is fair (κ = 0.555 / κ = 0.503). Conclusion: Although no statistically significant difference can be proved in the accuracy of diagnoses, there is a tendency that the assessment of the urinary sediment by the nephrologist leads to more accuracy than the assessment by the laboratory. The nephrologist is better able to recognize red-cell dysmorphia and different cellcasts. The difference in the reporting of the various cells and elements is of particular importance in making renal diagnostics.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Kleij, F.G.H. van der and Scheper Ziekenhuis Emmen, interne geneeskunde |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1140 |
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