{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:06:01Z","timestamp":1789031161448,"version":"build-2803163510"},"reference-count":7,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The assessment of dysmorphic red blood cells (RBCs) is of significant clinical interest in the evaluation of haematuria, particularly as a key tool for suggesting a possible glomerular origin. However, its actual utility depends on cautious, context-based interpretation supported by well-defined technical requirements. The lack of universal standardization, interobserver variability, and the influence of preanalytical factors continue to contribute to the heterogeneous implementation of this test in clinical practice. This document provides recommendations aimed at optimizing its use in the clinical laboratory. It reviews the underlying pathophysiological basis, principal indications, and the preanalytical and analytical conditions required to ensure reliable evaluation, as well as its integration with other findings from urinalysis and renal biochemistry. In this regard, erythrocyte dysmorphism should not be considered an isolated test, but rather a complementary parameter whose diagnostic performance improves when interpreted alongside proteinuria or albuminuria, renal function, the presence of pathological casts, and the patient\u2019s clinical context. Furthermore, the importance of a selective approach is emphasized, prioritizing clinical scenarios with higher diagnostic yield, such as persistent microhaematuria, haematuria associated with proteinuria, or suspected glomerular disease. Finally, guidance criteria are proposed for reporting and for integration into multidisciplinary clinical algorithms. Overall, these recommendations aim to promote a more rational, harmonized, and clinically meaningful use of dysmorphic RBC counts within advanced urinalysis.<\/jats:p>","DOI":"10.1515\/almed-2026-0048","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:55:29Z","timestamp":1782730529000},"page":"171-178","source":"Crossref","is-referenced-by-count":0,"title":["Recommendations for optimizing the use of dysmorphic red blood cell counts in the clinical laboratory"],"prefix":"10.1515","volume":"7","author":[{"given":"Oscar D.","family":"Pons-Belda","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Can Misses , Eivissa , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Ferri","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital General Universitario Dr. Balmis , Alicante , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Almer\u00eda-Lafuente","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Universitario Miguel Servet , Zaragoza , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-3219","authenticated-orcid":false,"given":"Cristina","family":"Izquierdo-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Universitario Puerta de Hierro , Majadahonda , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Luis-Lima","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Complejo Hospitalario Universitario de Canarias , Tenerife , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-8608","authenticated-orcid":false,"given":"Miriam","family":"Menacho-Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Universitario Ram\u00f3n y Cajal , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Rom\u00e1n-Cabezas","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Universitario Virgen del Rocio , Sevilla , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"S\u00e1enz-Valls","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Universitario Ram\u00f3n y Cajal , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Togores-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital HM Modelo , A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-6006","authenticated-orcid":false,"given":"Patricia","family":"Fern\u00e1ndez-Riejos","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory , Hospital Universitario Virgen de la Macarena , Sevilla , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"2026091008070964705_j_almed-2026-0048_ref_001","doi-asserted-by":"crossref","unstructured":"Ingelfinger, JR. Hematuria in adults. N\u00a0Engl J Med 2021;385:153\u201363. https:\/\/doi.org\/10.1056\/nejmra1604481.","DOI":"10.1056\/NEJMra1604481"},{"key":"2026091008070964705_j_almed-2026-0048_ref_002","doi-asserted-by":"crossref","unstructured":"Kouri, TT, Hofmann, W, Falbo, R, Oyaert, M, Schubert, S, Gertsen, JB, et al.. European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). The EFLM European Urinalysis Guideline 2023. Clin Chem Lab Med 2024;62:1653\u2013786. https:\/\/doi.org\/10.1515\/cclm-2024-0070.","DOI":"10.1515\/cclm-2024-0070"},{"key":"2026091008070964705_j_almed-2026-0048_ref_003","doi-asserted-by":"crossref","unstructured":"Cohen, RA, Brown, RS. Clinical practice. Microscopic hematuria. N\u00a0Engl J Med 2003;348:2330\u20138. https:\/\/doi.org\/10.1056\/nejmcp012694.","DOI":"10.1056\/NEJMcp012694"},{"key":"2026091008070964705_j_almed-2026-0048_ref_004","doi-asserted-by":"crossref","unstructured":"Saha, MK, Massicotte-Azarniouch, D, Reynolds, ML, Mottl, AK, Falk, RJ, Jennette, JC, et al.. Glomerular hematuria and the utility of urine microscopy: a review. Am J Kidney Dis 2022;80:383\u201392. https:\/\/doi.org\/10.1053\/j.ajkd.2022.02.022.","DOI":"10.1053\/j.ajkd.2022.02.022"},{"key":"2026091008070964705_j_almed-2026-0048_ref_005","unstructured":"Fogazzi, GB. The urinary sediment: an integrated view, 3rd ed. Milano: Elsevier; 2010."},{"key":"2026091008070964705_j_almed-2026-0048_ref_006","doi-asserted-by":"crossref","unstructured":"Cavanaugh, C, Perazella, MA. Urine sediment examination in the diagnosis and management of kidney disease: core curriculum 2019. Am J Kidney Dis 2019;73:258\u201372. https:\/\/doi.org\/10.1053\/j.ajkd.2018.07.012.","DOI":"10.1053\/j.ajkd.2018.07.012"},{"key":"2026091008070964705_j_almed-2026-0048_ref_007","doi-asserted-by":"crossref","unstructured":"K\u00f6hler, H, Wandel, E, Brunck, B. Acanthocyturia\u00a0\u2013\u00a0a characteristic marker for glomerular bleeding. Kidney Int 1991;40:115\u201320. https:\/\/doi.org\/10.1038\/ki.1991.188.","DOI":"10.1038\/ki.1991.188"}],"container-title":["Advances in Laboratory Medicine \/ Avances en Medicina de Laboratorio"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/almed-2026-0048\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/almed-2026-0048\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:07:52Z","timestamp":1789027672000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/almed-2026-0048\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,7]]},"published-print":{"date-parts":[[2026,9,9]]}},"alternative-id":["10.1515\/almed-2026-0048"],"URL":"https:\/\/doi.org\/10.1515\/almed-2026-0048","relation":{},"ISSN":["2628-491X"],"issn-type":[{"value":"2628-491X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}