iRICELL: THE MODERN GENERATION OF URINALYSIS

SPEAKER: MR. PATRICK JOHN S. TAYAG

HISTORY C. Adults-400 mL/Day
• UA beginning of laboratory medicine • Polyuria - Increase in urine output
• Seen in Egyptian Hieroglyphics, such as "Edwin Smit A. Adults more than 2.5 L/Day
Surgical Papyrus • Often associated with:
o Diabetes Mellitus
o Diabetes Insipidus

DIABETES MELLITUS
• Cause by a defect either in the Pancreatic production of
Insulin or
• In the function of Insulin, resulting to increased glucose
concentration
• High Specific Gravity (diluted)

DIABETES INSIPIDUS
• Results from a decrease in the production or function of
Antidiuretic Hormone
• Low Specific Gravity (diluted)

SPECIMEN COLLECTION
• color charts - 1140 AD • Container
o Wide mouth, flat bottom, clear
o Recommended capacity 50 mL

SPECIMEN LABELING
• Patient's name
• Gender
• Age
• Date & Collection time
• Identification Number

SPECIMEN INTEGRITY
• Must be delivered to Laboratory promptly & tested within
2 Hours
• A Specimen that cannot be delivered & tested within 2
hours should be refrigerated (2-8°C)

TYPES OF URINE SPECIMEN

REASON FOR PERFORMING URINALYSIS SAMPLE TYPE SAMPLING PURPOSE
1. Diagnosis of Disease Random No specific time Routine
2. Screening Asymptomatic population for undetected specimen most common, screening,
disorders taken anytime of chemical & FEME
day
3. Monitoring the progress of disease and effectiveness of
Morning sample First urine in the Pregnancy test,
therapy
morning, most microscopic test
URINE FORMATION concentrated
• Kidney - Ultrafiltrate of Plasma Clean catch Discard first few Culture
midstream ml, collect the
URINE COMPOSITION rest
• Water-95% 24 hours All the urine used for
• Solutes-5% passed during quantitative and
o Consists of Urea & other organic & Inorganic the day and night qualitative
Chemicals and next day Ist analysis of
sample is substances
PRIMARY ORGANIC SUBSTANCE IN URINE collected
• Creatinine Postprandial 2 hours after Determine
• Uric Acid meal glucose in
diabetic
MAJOR INORGANIC SOLID DISSOLVED IN URINE monitoring
• Chloride Supra-pubic Needle aspiration Obtaining sterile
• Sodium aspired urine
• Potassium

URINE VOLUME
• Oliguria - Decreased in urine output
A. Infants - Less than 1 mL/kg/hr
B. Children - Less than 0.5 mL/kg/hr

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 MACROSCOPIC EXAMINATION iRICELL
• Volume
• Color iQ 200 iChem VELOCITY
• Odor
• Clarity

CHEMICAL EXAMINATION OF URINE

• Proteins
• Glucose
• Ketones
• Blood
• Urobilinogen
• Nitrite
• Bilirubin
• Bile Salts
• pH
• Specific Gravity • Fully Integrated System
• Leukocyte esterase o One Sample/one system
• Ascorbic Acid – for interference detection o One LIS connection
o Consolidated reporting
• Fully Automated Urinalysis
o No sample preparation
o Walkaway convenience
o Auto-reflex to urine microscopy
o Auto-release of normal patient results
o On-screen verification of patient results

iRICELL MODELS
¡RICELL3000pro includes ¡WARE
• Microscopy: 101 samples/hour
• Chemistry: 210 samples/hour

¡RICELL3000plus
• Microscopy: 101 samples/hour
• Chemistry: 210 samples/hour
MICROSCOPIC EXAMINATION
• Well mixed urine is centrifuged in low speed (about iRICELL2000pro includes iWARE
2000-3000 rpm) for 5 to 10 minutes • Microscopy: 70 samples/hour
• A drop of sediment is poured onto a glass slide and • Chemistry: 210 samples/hour
coverslip is place over it.
¡RICELL2000plus
• Microscopy: 70 samples/hour
• Chemistry: 210 samples/hour

¡RICELL1500*
• Microscopy: 40 samples/hour
• Chemistry: 210 samples/hour

iCHEM VELOCITY
• First result in less than two minutes, then every 15
seconds for the succeeding samples.
• Throughput of 210 samples/hour
• 300-strip load capacity with continuous strip-loading
capability
• 2.0 mL minimum sample volume
• Ascorbic acid, a potential interfering substance for
glucose, blood, leukocyte and nitrite
• 10,000 patient record storage capacity
• Easy-to-read visual strips
o *vChem Urine strips
• Urine Analytes Measurement - Endpoint Imaging
(Reflectance Photometry)
• A CMOS camera takes a digital color picture of each
chemistry strip as the chemistry strip develops, and
measure reflectance.

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 Clinical significance:

• Normal = Negative
• High doses of Vitamin C can cause false negative

iChem Velocity test strip has a dedicated test pad to alert the
operator of high concentration of ascorbic acid present in the
sample.

TEST CONC. NEEDED REACTS WITH

Blood ≥ 9 mg/dL H2 0 2
Bilirubin ≥ 25 mg/dL Diazonium salt
Nitrite ≥ 25 mg/dL Diazonium salt
Glucose ≥ 50 mg/dL H2 0 2

• Every 15 seconds the strip is moved over to the next

iCHEM VELOCITY CONSUMABLES
position on a conveyor.
iChem VELOCITY Wash Solution
• The "Munsell mask" provides a self-calibration reference
• 2 bottles (part number 800-7217)
• 12 month Shelf Life; 90 day open-vial
• Room Temperature storage
• Liquid, ready-to-use
• Approximately 1272 tests/7L bottle

Irispec CA/CB/CC Controls

• Part number 800-7702

• 9 vial (3 CA, 3 CB, 3 CC)
• 2-8°C storage
• Urine Specific Gravity - measured by refractive index • 1 Box of controls is good for 45 days-3 sets (15 day open
o Refractometer and a linear photodiode array vial)
o Refractive index changes according to the specific
gravity of the sample. iChem VELOCITY Strips
o Not measured by using a strip pad.
• Part number 800-7204
• Urine Color and Clarity - Color Clarity Module
• 100 strips/vial
o A Color and Clarity Module contains a narrow
• Room Temperature storage
tubular flowcell.
• 12 month shelf life, 5 day on- board stability
o The sample is illuminated with a white light and a
photodiode array sensor measures: iQ200 URINE MICROSCOPY SYSTEMS
- The amplitude of light scattered within the • Digital Flow Morphology with Auto-Particle Recognition
flowcell to determine the clarity of the sample. o Auto-classifies 12 particles
- The tone and hue (gradation or variety of o 27-particle sub-classification on screen
color) of the sample, to determine color • Direct testing from unspun specimens
• Standalone or connected to iChemVELOCITY
EACH PADS CONTAIN CHEMICALS TO TEST FOR:
• Multiple throughput options
• Bilirubin
o IQ200SPRINT = 101 samples/hour
• Urobilinogen
o ¡Q200ELITE = 70 samples/hour
• Ketones
o IQ200SELECT = 40 samples/hour
• Ascorbic acid
• Glucose iQ200 AUTOMATED SERIES
• Protein full automation with minimal microscopic work
• Blood
• PH AUTOMATED CLASSIFICATION:
• Nitrite • RBC
• Leukocyte esterase • WBC
• Compensation pad (highly pigmented sample) • WBC clumps
• Specific gravity (refractometer) • Squamous epithelial cells
• Color and Clarity (on board) • Non-squamous epithelial cells
• Hyaline casts
ASCORBIC ACID DETECTION • Unclassified casts
Ascorbic acid • Crystals
Identifies potential interference with: • Bacteria
• Glucose • Yeast
• Blood • Sperm
• Bilirubin • Mucus
• Nitrite

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Subcassifications: HIGH QUALITY IMAGING

• Unclassified casts
o Granular, cellular, waxy, broad, RBC, WBC,
epithelial cell, fatty casts
• Crystals
o Calcium phosphate, uric acid, calcium carbonate,
leucine, cystine, tyrosine, amorphous calcium
oxalate, triple phosphate
• Non-squamous epithelial cells
o Renal, transitional
• Yeast
o Budding yeast, yeast with pseudohyphae
• Other
o RBC clumps, fat, oval fat bodies, trichomonas,
dysmorphic RBCs

UNIQUE FEATURES
DIGITAL IMAGE FLOW CAPTURE
Hydrodynamic focusing

• Sample passes through flow cell surrounded by iQ

Lamina
• Microscope objective amplified particles
• Digital camera captures 500 pictures (24
frames/second)
PARTICLE DETECTION
• Patented algorithms isolate individual particles
• Fluid dynamics align and position particles

FEATURE EXTRACTION
• Individual particles are isolated and analyzed for specific
features by Auto Particle Recognition (APR) software

PARTICLE CLASSIFICATION
The neural network is called Auto-Particle Recognition
(APRTM) and is designed to classify urine particles.

• Auto-classifies particles by matching the particle

numerical values with the auto-classifications hard
coded values
• 12 auto-classifications, 27 sub-classifications
• Neural network trained using over 26,000 known particle
images
• *CRYS was the original term, however its since been
changed to UNCX.

iQ 200 CONSUMABLES
iQ Control / Focus Set

• 2 Focus, 1 set of Positive/Negative controls (part number

800-3104)
• 8 month Shelf Life; 30 day open vial
• 2-8°C storage
• Liquid, ready-to-use
• Approximately 41 uses / Set

iQ Calibrator Pack

• 4 bottles (part number 800-3103)

• 8-month Shelf Life; 24 hour open vial
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• 2-8°C storage
• Liquid, ready-to-use
• monthly calibrations

Iris System Cleanser

• 4 bottles/pack (part number 800-3203)

• 18 month Shelf Life
• Room Temperature storage
• Liquid, ready-to-use
• Approximately 140 uses/425ml bottle

Iris Diluent Pack

• 4 bottles/pack (part number 800-3202)

• 12 month Shelf Life
• Room Temperature storage
• Liquid, ready-to-use
• Approximately 79 uses / 475mL bottle

BENEFITS OF IRIS AUTOMATION

Increased Laboratory Productivity

• Reduces manual steps in workflow

o No sample preparation
o Auto-release of results
o No manual counting and result data entry
o Minimal Microscopic review

The Value of Increased Productivity

• Increase laboratory productivity beyond the urine bench

• Faster turnaround time of results
• Improve staff satisfaction
o Minimize sample handling
o Load samples and walk away
▪ *Productivity benefit beyond urinalysis

Standardization of Workflow Processes

• Eliminate technique-dependent manual steps in the

workflow
• Dramatically reduce the need for manual microscopic
analysis
• Minimize technologist-to-technologist variability
• Create an electronic record of urine sediment analysis
o Results and image archiving & retrieval capability

The Value of Standardized Processes

• Increase consistency of patient results

• Faster turnaround time of results back to the physician
supports
• improved time to diagnosis • Traceability to patient urine
sediment analysis data, for review
• or consultation
o *Clinical Outcomes

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