A Systemic Review and Meta-analysis of Using Dysmorphic Red Blood Cells for Diagnosis Hematuria due to Glomerular Disorders for the Clinical Utilization

Abstract

This study was a literature review and meta-analysis assessing the clinical efficacy of dysmorphic red blood cells (dRBCs) for use in diagnosing of glomerular hematuria. In methodology, publications conducted before 2022 were searched and enrolled from online accessible database including PubMed^®, ScienceDirect^®, Scopus and Thai journal online, respectively. Glomerular hematuria was confirmed using renal biopsy. A total of 285 articles published locally and internationally were identified, 10 of which were found to meet the study objectives. Based on the statistical analysis, the results revealed that counting of acanthocyte was more effective to diagnose glomerular hematuria than counting of total dRBCs. Moreover, comparison of cut off value also demonstrated that the greater-than or equal to 20% was the practical value to be used in clinic, because this cut off showed the highest efficacy to distinguish glomerular hematuria. In conclusion, these data indicated that improvement of the glomerular hematuria diagnostic workup should focus on assessment of acanthocyte, which appears to be more efficient and easier to identify than the determination of other dRBCs.