Introduction
At present, urinalysis is one of the laboratory inspection items with the largest range of medical clinical applications. The use of urine analyzers for routine urine testing is a scientific method for the detection of various biochemical indicators and formed components in the patient’s urine. The inspection method has the characteristics of convenience, rapidity and high sensitivity. With the continuous updating of science and technology, the means of urine testing are also constantly innovating.
Microscopy-based urine particle analysis has made great strides over the past few decades, enabling high-throughput clinical laboratories. Urine flow cytometry is an alternative to automated microscopy, and more thorough analysis of flow cytometry data enables rapid differentiation of the urinary microbiome. Automated urinalysis can be used for urinary tract screening as well as diagnosis and monitoring of various renal and urological disorders, while automation and workflow simplification have led to mechanical integration of dipstick readers and particle analysis in urinalysis.
What Has Changed In The Urine Analyzer?
1.Test Paper Technology
The classic dye-conjugated albumin test strip with complementary metal oxide semiconductor (CMOS) improves the analytical sensitivity, allows the quantification of albuminuria and determines the albumin:creatinine ratio, which facilitates the assessment of albuminuria, and can obtain Leukocyte esterase and peroxidase activity.
2.Automatic Microscope
Some automated microscopes such as the iQ200 Analyzer classify and quantify cells and particles in uncentrifuged urine using a single laminar flow of the specimen through the lens of a charged-coupled device camera. Hundreds of digital camera captures are evaluated by recognition software, each Particles are classified according to characteristics such as shape, contrast and texture. After classification by the instrument, the operator is able to reclassify or correct the acquired images to the correct category. Counting results equal or exceed conventional brightfield microscopy or earlier flow cytometry techniques, but require a trained expert to reclassify findings.
3.Flow Cytometry
Urine particle flow cytometry (UFC) improves counting precision and accuracy and significantly reduces labor compared to visual microscopy. UFCs have been compared with chamber counts, quantitative urine microscopy, sediment counts, dipsticks, bacterial cultures, and urine densities, and clinical studies using UFCs have focused on the diagnosis, monitoring, and exclusion of urinary tract infections, kidney disease. Flow cytometry can reduce the number of samples cultured, thereby greatly reducing workload, time and cost, and can report negative results earlier, thereby greatly reducing unnecessary empiric antibiotic prescriptions. We therefore conclude that the suitability of flow cytometry for screening negative urine samples depends largely on population characteristics and the definition of a negative urine culture. A limitation of automated urine analyzers compared to culture is that they count both live and dead bacterial particles, resulting in higher particle counts.
4.Dilution Parameters
Correction for urinary dilution becomes increasingly necessary as assay imprecision increases significantly over time. Since fluid rehydration is a major preanalytical confounding factor in urinalysis, a number of reference parameters were introduced to assess urine dilution and hydration. The most commonly used reference analytes are specific gravity, conductivity, and urine creatinine measurements, and conductivity measurements are integrated into flow cytometry instruments. Specific gravity can be measured using a refractometer or test paper.
5.Matrix-assisted Laser Desorption Ionization Time-of-flight (MALDI-TOF) Mass Spectrometry
Several studies have explored direct analysis of urine samples using MALDI-TOF MS, thereby eliminating the time lag required for pathogen identification, and this technique has been suggested as a rapid and reliable method for bacterial identification. It is unclear whether MALDI-TOF MS is adequate for UTI diagnosis, as screening is required to increase the yield of positive samples. For direct analysis of urine, initial sample preparation steps are required to remove cellular debris, WBC, and mucus and to collect bacteria. Therefore, improved algorithms are needed to interpret the spectra of bacterial assemblies for direct urine testing of these samples.
6.Miniaturization and Portability
One notable trend in urine analysis instrumentation is the development of miniaturized and portable devices. These compact analyzers offer the advantage of point-of-care testing, allowing for rapid and convenient on-site analysis.They integrate advanced technologies such as microfluidics, biosensors, and smartphone connectivity, enabling real-time monitoring and remote data transmission.Miniaturized urine analysis instruments have the potential to revolutionize healthcare delivery by providing immediate results, particularly in resource-limited settings and home-based care scenarios.
7.Automation and High-throughput Screening
Automation has significantly improved the efficiency and accuracy of urine analysis. High-throughput screening systems, equipped with robotics and advanced algorithms, enable the analysis of a large number of samples in a short period. These instruments streamline laboratory workflows, reduce human errors, and enhance result reproducibility. Moreover, automated urine analysis platforms can handle complex analyses such as multiparametric testing, facilitating comprehensive diagnostic assessments in a single run.
8.Integration of Molecular Diagnostics
The integration of molecular diagnostics techniques into urine analysis instrumentation has expanded the scope of diagnostic capabilities.Molecular assays, including polymerase chain reaction (PCR) and nucleic acid amplification, enable the detection of specific genetic markers associated with infectious diseases, cancers, and genetic disorders.The incorporation of molecular testing in urine analysis instruments offers non-invasive and cost-effective alternatives to traditional diagnostic methods, opening new avenues for early disease detection and personalized medicine.
9.Advanced Data Analysis and Artificial Intelligence
Recent advancements in data analysis and artificial intelligence (AI) have revolutionized the interpretation of urine analysis results. AI algorithms can analyze large datasets, identify patterns, and generate predictive models, aiding in disease diagnosis, prognosis, and treatment decisions.Machine learning techniques enable the development of intelligent urine analysis instruments that continuously learn and adapt, enhancing accuracy and clinical utility.The integration of AI in urine analysis instruments has the potential to transform patient care by providing more precise and personalized diagnostic insights.
Conclusion
These technological breakthroughs have improved the speed, accuracy, and diagnostic capabilities of urine analysis, enabling early disease detection, personalized medicine, and efficient healthcare delivery.Further research and development in this field hold tremendous potential for enhancing patient outcomes and revolutionizing diagnostic practices.With ongoing innovations, urine analysis instruments are poised to become indispensable tools in the clinical setting, contributing to better patient care and improved public health.
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