MORPHOLOGY OF ERYTHROCYTES IN URINE:SIGNIFICANCE AND MECHANISM OF POLYMORPHISM FORMATION
ZHANG Jin-hong LI Lei-shi Department of Nephrology, The Jin ling Hospital, Department of Nephrology, The Jin ling Hospital, Nanjing, Jiangsu, China.
Urine specimens from patients with a variety of urinary tract diseases and from healthy subjects were examined by phase-contrast microscopy. Urinary erythrocytes showed polymorphism in 68/69 patients with glomerulone-phritis while in 53/55 patients with nonglomerular lesions of the urinary tract, haematuria was characterised by isomorphism The morphologic patterns of urinary erythrocytes in 17 uremic patients varied with the underlying lesions. In 45 healthy individuals, urinary erythrocytes were also polymorphic although counts were less than 8000 cells/ml. After taking a treadmill exercise test, the urinary erythrocyte counts in 31 normal subjects increased significantly without any change in cell morphology. Administration of frusemide to patients with glomerular bleeding altered urinary erythrocyte morphology from polymorphism to isomorphism with increased numbers of uniform cells appearing in the urine. Possible mechanisms of erythrocyte polymorphism were investigated in vivo and in vitro The results indicated that polymorphism resulted from exposure to sequential changes in osmolality during passage of erythrocytes through the renal tubules. Scanning electron microscopy of erythrocytes confirmed the lindings seen on light microscopy