{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:00:59Z","timestamp":1786122059361,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sysmex Asia Pacific Company","award":["1\/2023"],"award-info":[{"award-number":["1\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Differentiating glomerular from non-glomerular hematuria remains challenging. Automated urine analyzers with red blood cell (RBC) discrimination algorithms may provide an adjunct to conventional urine microscopy. We evaluated the diagnostic performance of the UF-5000 analyzer for detecting glomerular hematuria (GH). Methods: In this cross-sectional diagnostic study, patients with hematuria were classified into a GH group with biopsy-proven glomerular disease and a non-glomerular hematuria (NGH) group with non-glomerular causes confirmed by clinical, radiological, and\/or pathological evaluation. Urine specimens were analyzed by a technician, a nephrology fellow, and the UF-5000 analyzer. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis and multivariable logistic regression. Results: A total of 201 patients were included, comprising 101 in the GH group and 100 in the NGH group. Urinary RBC distribution (URD) from UF-5000 analyzer was significantly higher in the GH group (66.3 \u00b1 23.6 vs. 12.6 \u00b1 19.8%; p &lt; 0.0001). URD demonstrated the highest diagnostic performance among evaluated UF-5000 parameters, with an area under the ROC curve (AUC) of 0.946 (95% CI 0.914\u20130.979). The optimal Youden-derived URD cutoff \u2265 25% yielded 91.1% sensitivity and 89.0% specificity for identifying GH. Compared with microscopy, URD showed higher sensitivity than technician-performed microscopy (91.1% vs. 60.4%; p &lt; 0.001) and similar performance to fellow-performed microscopy (91.1% vs. 83.2%; p = 0.237). Performance remained consistent across RBC count strata and major glomerular disease subtypes. Conclusions: URD was strongly associated with GH and demonstrated good discriminatory performance in this biopsy-based cohort. Automated urinary RBC analysis may complement conventional urine microscopy in hematuria evaluation.<\/jats:p>","DOI":"10.3390\/diagnostics16162491","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:01:36Z","timestamp":1786089696000},"page":"2491","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary Red Blood Cell Distribution for Detection of Glomerular Hematuria: A Biopsy-Based Comparison with Direct Microscopy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7438-499X","authenticated-orcid":false,"given":"Nuttasith","family":"Larpparisuth","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paweena","family":"Kanogpotjananont","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanit","family":"Reesukumal","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Methawoot","family":"Khemmongkol","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2271-1026","authenticated-orcid":false,"given":"Gahwin","family":"Ruchikajorndech","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanchira","family":"Janwijit","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peenida","family":"Skulratanasak","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1093\/ndt\/gfx189","article-title":"Glomerular disease frequencies by race, sex and region: Results from the International Kidney Biopsy Survey","volume":"33","author":"Hogan","year":"2018","journal-title":"Nephrol. 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