Many high-volume labs have a dedicated coagulation track, and then it can be worked over to all the manual needs there are for esoteric testing and coagulation. Can you see urinalysis doing something similar?
Meagan Seeger (WDL): Yes, I could see urinalysis going in a similar direction. Having an entire cell dedicated to urinalysis would also likely streamline workflows.
Rob Fratino, there are many options, differences among customers, countries, reimbursement schemes. What are you taking into consideration as you look at centralized urinalysis at Siemens?
Rob Fratino (Siemens Healthineers): It’s the variability—different geographies, different sites. The conversation on TLA unearths that different sites take different approaches where urinalysis is more tied to a microbiology department versus the core lab and other facilities. Having high-volume workcells as opposed to a total lab automation track might make more sense for a more decentralized lab rather than for a community hospital, which may have everything consolidated in a single location.
There’s variability too in automation and test menus. We’re still seeing increasing calls for albumin and creatinine testing outside the U.S., particularly in Japan and Western Europe. We continue to monitor those trends, including what the pharma industry is doing and how the emergence of new drugs or the application of existing drugs are having a trickle-down effect on urinalysis testing in terms of interferences or overall demand. I’ve seen the pharma industry in the U.S. advocate for urine albumin-to-creatinine ratio screening on daytime television, which I never thought I’d see. Changing dynamics are at play, particularly with the pharma industry and its interaction with urinalysis.
Is that because of side effects from drugs that are affecting the urinalysis?
Rob Fratino (Siemens Healthineers): Yes. We’ve been getting more and more inquiries about the potential for GLP-1 interference in urinalysis samples. On the flip side, GLP-1 could also be used to prevent kidney disease, so you’re potentially seeing a higher degree of screening to determine if a patient is a candidate for a GLP or other pharmaceuticals on the market.
I assume GLPs are a significant new breaking front in urinalysis and other chemistries?
Rob Fratino (Siemens Healthineers): Yes, and it’s a bit uncharted. We’re in a reactive standpoint now as more data are collected and more of the population is brought online with these new pharmaceuticals. It is a critical point and one that we have to continue to monitor to ensure our customers have the full information they need to perform urinalysis at the expected standard.
Jason Anderson, what are you seeing in terms of increasing orders, changing orders, or changing protocols?
Jason Anderson (Sysmex): I don’t see any seismic shifts in urinalysis ordering patterns or protocols at this time. However, some forward‑thinking laboratories have expressed interest in investigating and potentially refining reflex rules for specific patient populations to optimize test utilization and improve outcomes in those populations. With new therapies entering the market, the ability to accurately monitor treatment protocols, for example, in IgA nephropathy, will become increasingly important. Accurately detecting small red cells or dysmorphic red cells in a standardized way may provide improved guidance in assessing glomerular health and limiting further degradation.
As labs begin to consider evaluating particles like atypical cells and analytes not currently routinely measured through automated methods—such as those relevant for bladder cancer treatment—there is growing potential for new analytes to emerge in the future, which could positively impact urinalysis ordering patterns.