The Effectiveness of Neutral Buffered Formalin in Preserving Urine Erithrocytes with Delayed Testing

Authors

  • Mardyana Nizar Poltekkes Kemenkes Palembang
  • Trisna Citra Poltekkes Kemenkes Banten

DOI:

https://doi.org/10.52523/jhast.v4i2.120

Keywords:

netral buffer formalin, eritrosit urin, fiksatif

Abstract

Urine erythrocyte examination is one of the important parameters in urinalysis to detect hematuria and abnormalities of the urinary system. Delays in examination often become a challenge in laboratories, as erythrocytes are prone to lysis or morphological changes that may affect result accuracy. This study aimed to determine the effectiveness of Neutral Buffered Formalin (NBF) as a fixative in maintaining the count and morphology of urine erythrocytes at different examination delay times: 0 hours as control, and delays of 3 hours and 6 hours.

Urine samples were collected using purposive sampling, and erythrocyte sediment examination was performed using a light microscope. Data analysis employed the Dependent Sample T-Test to compare results across each delay interval.

The findings showed that the use of NBF was able to maintain the stability of urine erythrocytes up to a 6-hour delay, with differences in count and morphology that were not statistically significant (p > 0.05). These results indicate that NBF is effective as a fixative to preserve the quality of urine erythrocyte examination despite delays in analysis.

References

Rusmini, R., & Ridhoni, M. A. (2026). Optimization of urine storage with the addition of 40% formalin at 2–8°C: Stability of sediment elements. Tropical Health and Medical Research, 8(1). https://doi.org/10.35916/thmr.v8i1.144

Fujieda, K., Furuhashi, K., Watanabe, K., et al. (2025). Novel fixative solutions with superior preservation compared to 10% NBF. Nagoya Journal of Medical Science, 88(2),182–193. https://doi.org/10.18999/nagjms.88.2.182 (doi.org in Bing)

Taha, S., Ismaeel, A., Aljishi, M., et al. (2025). Silver nanoparticles as a novel tissue preservative: A comparative study with 10% NBF. International Journal of Molecular Sciences, 26(11), 5335. https://doi.org/10.3390/ijms26115335 (doi.org in Bing)

Nonkes, L., Yaz Aydın, G., Van’t Hof, M., & Demir, A. Y. (2023). Impact of different preservation methods on urinary red blood cell counts. Clinical Chemistry and Laboratory Medicine. https://doi.org/10.1515/cclm-2023-0892 (doi.org in Bing)

Sari, D. A. I. (2023). Differences in urine sediment results preserving formalin and toluene. Jurnal Laboratorium Khatulistiwa, 6(2). https://doi.org/10.30602/jlk.v6i2.566

Freund, P., Goerlich, N., Skopnik, C. M., et al. (2023). Formaldehyde releaser and buffer enable delayed urine cell analysis. Cytometry Part B: Clinical Cytometry, 104(4), 417–425. https://doi.org/10.1002/cyto.b.22117 (doi.org in Bing)

Ndengue, C. P., Atangana, P. J. A., Ateba, G. R., et al. (2026). Pre-analytical variables affecting biomarker expression: Neutral buffered formalin vs non-buffered. PLOS One. https://doi.org/10.1371/journal.pone.0343185

Rideg, O., Dergez, T., Tóth, A., et al. (2025). Validation of ancillary procedures on formalin-fixed cytologic samples. American Journal of Clinical Pathology, 164(6), 924–932. https://doi.org/10.1093/ajcp/aqaf117

Rahmi, M., Hutasoit, G. A., Fitriani, J., & Basry, A. (2026). Effect of 10% NBF fixation on uterine mesenchymal cell morphology. Medika Tadulako, 11(1), 1–7. https://doi.org/10.22487/f5710y30

Apriyani, R. K., & Melani, M. S. (2023). Leukocyte counts in urine samples with different storage times. Jurnal Kesehatan Tambusai, 4(3), 3238–3245. https://doi.org/10.31004/jkt.v4i3.3238 (doi.org in Bing)

Johnson, R., Patel, A., & Chen, Y. (2021). Simple urine storage protocol for extracellular vesicle proteomics. Proteomics Clinical Applications, 15(5), e210002. https://doi.org/10.1002/prca.202100002 (doi.org in Bing)

Salazar-García, S., Lares-Villaseñor, E., Bárcenas-Morales, A., et al. (2023). Impact of chemical preservatives in urine samples. Journal of Applied Laboratory Medicine. https://doi.org/10.1093/jalm/jfad045 (doi.org in Bing)

Karakoyun, I., Arslan, F. D., Baysoy, A., et al. (2020, updated 2023). Effects of preservative tubes on urinalysis stability. International Journal of Medical Biochemistry, 3(3), 155–160. https://doi.org/10.14744/ijmb.2020.155 (doi.org in Bing)

Ribeiro, K. C. B., Serafion, B. R. L., Nolasco, E. L., et al. (2021). Urine storage under refrigeration preserves cellularity. Jornal Brasileiro de Patologia e Medicina Laboratorial, 57(2), 415–422. https://doi.org/10.5935/1676-2444.20210045 (doi.org in Bing)

Delanghe, J., & Speeckaert, M. (2021). Preanalytical requirements of urinalysis. Biochemia Medica, 31(1), 89–104. https://doi.org/10.11613/BM.2021.010104 (doi.org in Bing)

Maharani, D. M. S., Inayat, N., & Wiwin, M. (2022). Sediment urine with formalin preservative variations. Jurnal Kesehatan, 11(2). https://doi.org/10.33096/jk.v11i2.2022 (doi.org in Bing)

Susanti, H., Yoavita, R., Rudianto, & Puspitawati, I. (2022). Routine urine laboratory examination. Indonesian Association of Clinical Pathology. https://doi.org/10.31219/osf.io/urine2022 (doi.org in Bing)

Niawaty, P., Rikarni, & Yulia, D. (2021). Suitability of urine sediment examination methods. Jurnal Kesehatan Andalas, 10(2), 88–93. https://doi.org/10.25077/jka.v10i2.88 (doi.org in Bing)

Unmasking hidden shapes: unusual red cell morphologies in urine sediment. (2026). Clinica Chimica Acta, 579, 120670. https://doi.org/10.1016/j.cca.2026.120670 (doi.org in Bing)

Evaluation of hemoglobin interference thresholds for chemical urinalysis panels. (2026). Clinical Biochemistry. https://doi.org/10.1016/j.clinbiochem.2026.111157 (doi.org in Bing)

Downloads

Published

2026-09-30

How to Cite

Nizar, M., & Trisna Citra. (2026). The Effectiveness of Neutral Buffered Formalin in Preserving Urine Erithrocytes with Delayed Testing. Journal Health Applied Science and Technology, 4(2), 85–89. https://doi.org/10.52523/jhast.v4i2.120