Enhancing Glomerular Hematuria Identification in Automated Urinalysis Using a Light Gradient Boosting Machine-Based Model: A Diagnostic Accuracy Study.

Journal: Annals of laboratory medicine
Published Date: Dec 17, 2025

Abstract

BACKGROUND: Glomerular hematuria (GH) is a key parameter assessed during urine analysis that is poorly identified using the automated UF-5000 system, which may misclassify GH and delay the detection of underlying glomerular diseases. We developed a light gradient boosting machine (LightGBM)-based model to improve GH detection using automated urinalysis data. METHODS: We included 5,444 urine samples from patients with positive urinary occult blood results. All samples were manually classified into non-glomerular hematuria (NGH), GH, mixed hematuria, and non-hematuria groups, based on microscopic examination. We assessed 65 parameters using UF-5000 and UC-3500 analyzers and compared their performance with that of LightGBM, extreme gradient boosting, random forest, and logistic regression models. The final model was validated through 10-fold cross-validation with an independent test set and then compared with the performance of UF-5000. SHapley Additive exPlanations were applied to identify key predictive parameters. RESULTS: Employing the LightGBM model substantially improved GH recognition accuracy to 44% during validation and 37% during testing (versus 16% and 11% achieved with the UF-5000 model, respectively). Sensitivity for GH increased from 0.3 in the UF-5000 model to 0.7 in the LightGBM model. A similar increasing trend was observed for the negative predictive value (0.6 to 0.9), accuracy (0.5 to 0.8), and Cohen's kappa agreement (0.4 to over 0.6). Key predictive parameters included red blood cell count, forward scatter peak in surface channel, and urinary protein level. CONCLUSIONS: This interpretable LightGBM-based model offers a substantial improvement in automated GH identification and is a promising tool for classifying hematuria sources.

Authors

  • Rongrong Wang
    Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • Jia Xu
    Key Laboratory of Flexible Electronics (KLOFE) & Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing Tech University (Nanjing Tech), 30 South Puzhu Road, Nanjing, 211816, P.R. China.
  • Jing Jin
    College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
  • Jingdi Zhang
    School of Pharmacy, Hengyang Medical College, University of South China, Hengyang, China.
  • Ziyang Huang
    College of Computer and Data Science, Fuzhou University, Fuzhou 350108, China.
  • Peng Xia
    State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, P.R. China.
  • Ye Guo
    Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • Yongzhe Li
    School of Nuclear Science and Technology, University of Science and Technology of China, Hefei, 230026, China.

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