Reference Value Evaluation of Urine Sediment in Indonesian Adult Population Using Automated Urine Analyzer

Locally established clinical laboratory reference values are required to interpret laboratory test results for screening, diagnosis, prognosis, determining retest criteria, or as microscopic confirmation. The objective of this study was to establish urine sediments reference value using automated urine flow cytometry, examining erythrocyte, leukocyte, epithelial cells, types of epithelial cells, bacteria, casts, pathological casts, crystals, yeast, sperm, and mucus in the Indonesian population using Sysmex UF-4000. A cross-sectional study was conducted between October 2018 and April 2019 at Raden Said Sukanto National Police Hospital in Jakarta. The study involved 240 participants of clinically healthy 120 males and 120 females aged 18-65 with normal urine chemistry, hematology, blood glucose, liver function (AST, ALT), and renal function (urea, creatinine). The reference value was reported in a microliter (μL) or High-Performance Field (HPF) or Low-Performance Field (LPF). Mann-Whitney test through MedCalc software was used to determine significant differences with a p-value < 0.05. This study observed significant differences between males and females in erythrocytes, epithelial cells, epithelial cell variety, bacteria, abnormal casts, and yeast, which were higher in females. However, the mucus in LPF levels was higher in males than females, in contrast to a current reference value. Therefore, the reference value results were separated between both groups in those aspects, whereas the results of other urine sediment characteristics studied were combined. As most reference values obtained were still within the range of existing references, reference values established with Sysmex UF-4000 can be helpful.