Ann Lab Med 2019; 39(1): 15-22  https://doi.org/10.3343/alm.2019.39.1.15
Progress in Automated Urinalysis
Matthijs Oyaert, M.Sc., and Joris Delanghe, M.D., Ph.D.
Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
Corresponding author: Joris Delanghe, M.D.
https://orcid.org/0000-0002-5702-6792
Department of Laboratory Medicine, Ghent University Hospital, C. Heymanslaan10, 9000, Ghent, Belgium
Tel: +32-9-332-29-56
Fax: +32-9-332-49-85
E-mail: joris.delanghe@ugent.be
Received: March 15, 2018; Revised: April 13, 2018; Accepted: August 29, 2018; Published online: January 1, 2019.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
New technological advances have paved the way for significant progress in automated urinalysis. Quantitative reading of urinary test strips using reflectometry has become possible, while complementary metal oxide semiconductor (CMOS) technology has enhanced analytical sensitivity and shown promise in microalbuminuria testing. Microscopy-based urine particle analysis has greatly progressed over the past decades, enabling high throughput in clinical laboratories. Urinary flow cytometry is an alternative for automated microscopy, and more thorough analysis of flow cytometric data has enabled rapid differentiation of urinary microorganisms. Integration of dilution parameters (e.g., creatinine, specific gravity, and conductivity) in urine test strip readers and urine particle flow cytometers enables correction for urinary dilution, which improves result interpretation. Automated urinalysis can be used for urinary tract screening and for diagnosing and monitoring a broad variety of nephrological and urological conditions; newer applications show promising results for early detection of urothelial cancer. Concomitantly, the introduction of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) has enabled fast identification of urinary pathogens. Automation and workflow simplification have led to mechanical integration of test strip readers and particle analysis in urinalysis. As the information obtained by urinalysis is complex, the introduction of expert systems may further reduce analytical errors and improve the quality of sediment and test strip analysis. With the introduction of laboratory-on-a-chip approaches and the use of microfluidics, new affordable applications for quantitative urinalysis and readout on cell phones may become available. In this review, we present the main recent developments in automated urinalysis and future perspectives.
Keywords: Automated microscopy, Flow cytometry, Urinalysis, Microfluidics, Test strip analysis, Laboratory on a chip, Urinary tract infections



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