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Thomas L. Campbell, MD
University of Rochester Rochester, NY

JAMA. 1985;254(13):1723.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Shaw et al₁ advocate using leukocyte esterase-measuring dipsticks for "routine urinalyses" and reading the results at five minutes to increase the sensitivity of detecting abnormal urine sediment. They define abnormal sediment as any red blood cells, casts, yeast, or more than three white blood cells (WBCs) per high-power field. These recommendations are based upon several assumptions regarding the use of clinical tests that need to be examined more closely.

The authors have chosen spun-urine microscopy as the "gold standard" for measuring formed elements in the urine. However, for pyuria, spun-urine microscopy is unreliable and correlates poorly with leukocyte excretion rates (number of WBCs per hour) and hemocytometer chamber techniques (number of WBCs per cubic millimeter).² Leukocyte esterase dipsticks correlate better with pyuria by hemocytometry than by spun-urine microscopy³ and may be more reliable than spun-urine microscopy.

The author's definition of abnormal urine sediment appears . . . [Full Text PDF of this Article]

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