Rapid Detection of Pyuria by Leukocyte Esterase Activity FREE

Rodney K. Kusumi, MD; Penelope J. Grover; Calvin M. Kunin, MD

[+] Author Affiliations

Reprint requests to Ohio State University Hospital, 410 W Tenth Ave, Columbus, OH 43210 (Dr Kusumi).

JAMA. 1981;245(16):1653-1655. doi:10.1001/jama.1981.03310410031022

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ABSTRACT

ABSTRACT | REFERENCES

To evaluate whether leukocyte esterase activity is a useful biochemical marker of pyuria, we examined urine from 20 healthy volunteers, 47 patients with renal disease, and 399 specimens from 72 hospitalized patients with catheters. Microscopic quantification of leukocytes (centrifuged sediment and volumetric chamber count) was compared with esterase activity in the urine. The three tests were closely correlated. The coefficients were esterase vs chamber,.85; esterase vs sediment,.74; and chamber vs sediment,.82. The chamber count and esterase test were more sensitive than the sediment in detecting pyuria. Using ten or more cells per cubic millimeter as denoting significant pyuria, the esterase test gave a sensitivity of 87.9% and a specificity of 94.3%. Esterase activity did not require intact cells and was not affected by urinary pH, protein, bacteriuria, underlying disease, renal function, or receipt of a variety of drugs.

(JAMA 1981;245:1653-1655)

REFERENCES

ABSTRACT | REFERENCES

Houghton BJ, Pears MA: Cell excretion in normal urine . Br Med J 1957;;1:622-625.

Little PJ: A comparison of the urinary white cell concentration with the white cell excretion rate . Br J Urol 1964;;36:360-363.

Rindler-Ludwig R, Schmalze F, Braunsteiner H: Esterases in human neutrophil granulocytes: Evidence for their protease nature . Br J Haematol 1974;;27:57-64.

Raub WP: Enzymes and isoenzymes in urine , in Current Problems in Clinical Biochemistry: Enzymes in Urine and Kidney . Bern, Switzerland, Verlig Hans Huber 1968;, pp 17-83.

Sokal RR, Rohlf FJ: Biometry . San Francisco, WH Freeman & Corp, 1969;, pp 561-566.

Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co Inc, 1956;, pp 184-193, 202-213.

Gadeholt H: Quantitative estimation of urinary sediment, with special regard to sources of error . Br Med J 1966;;1:1547-1549.

Winkel P, Statland BE, Jorgensen K: Urine microscopy: An ill-defined method, examined by a multifactorial technique . Clin Chem 1974;; 20:436-439.

Triger DR, Smith JWG: Survival of urinary leucocytes . J Clin Pathol 1966;;19:443-447.

Block EB, Nyun K: The importance of counting pus cells in the urine . South Med J 1916;;9:972-973.

Addis T: The number of formed elements in the urinary sediment of normal individuals . J Clin Invest 1926;;2:409-415.

Dukes C: The examination of urine for pus . Br Med J 1928;;1:391-393.

Stansfeld JM: The measurement and meaning of pyuria . Arch Dis Child 1962;;37:257-262.

Alwall N: Pyuria: Deposit in high-power microscopic field-wbc/hpf versus wbc/mm3 in counting chamber . Acta Med Scand 1973;;194:537-540.

Mabeck CE: Studies in urinary tract infections . Acta Med Scand 1969;;186:193-198.

Keeson AM, Talbott JM, Gyory AZ: Microscopic examination of urine . Lancet 1978;;2:809-812.

Brumfitt W: Urinary cell counts and their value . J Clin Pathol 1965;;18:550-555.

Eine kooperative studie an elf zentren: Leukozyten-Nachweis im urin mit einem teststreifen . Dtsch Med Wochenschr 1979;;104:1236-1240.

Kunin CM, Chesney RW, Craig WA, et al: Enzymes as a marker of renal injury and disease: Studies of N-acetyl-B-glucosaminidase in the general population and in patients with renal disease . Pediatrics 1978;;62:751-760.

Chan LK, Oliver DO: Simple method for early detection of peritonitis in patients on continuous ambulatory peritoneal dialysis . Lancet 1979;;2:1336-1337.

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