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Lupus. 2016 Aug;25(9):1012-8. doi: 10.1177/0961203316631629. Epub 2016 Feb 11.

Predicting decline of kidney function in lupus nephritis using urine biomarkers.

Author information

1
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA Department of Pediatrics, Helen DeVos Childrens Hospital, Michigan State University, Grand Rapids, USA.
2
Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, USA.
3
National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
4
National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, USA.
5
Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA.
6
Preventive Medicine and Cardiology Sections, and Department of Medicine, Boston University School of Medicine, Boston, USA.
7
Department of Environmental Health, University of Cincinnati, Cincinnati, USA.
8
Department of Pediatrics, University of Minnesota, Minneapolis, USA.
9
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
10
Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, USA Brad.Rovin@osumc.edu.

Abstract

OBJECTIVE:

To evaluate candidate biomarkers to predict future renal function decline (RFD) in children and adults with lupus nephritis (LN).

METHODS:

At the time of enrollment into prospective observational LN cohort studies liver-type fatty acid binding protein (LFABP), albumin, monocyte chemoattractant protein-1 (MCP-1), uromodulin, transferrin, and hepcidin were measured in urine samples of two cohorts of patients with LN, one followed at a pediatric (cohort-1; n = 28) and one at an adult institution (cohort-2; n = 69). The primary outcome was RFD, defined in cohort-1 as a decrease in estimated glomerular filtration rate (eGFR) of ≥20% and in cohort-2 as a sustained increase of ≥25% in serum creatinine concentration (SCr), both from baseline.

RESULTS:

All patients (n = 97) had normal eGFR or SCr at the time of urine collection at baseline. RFD occurred in 29% (8/28) of patients in cohort-1 during a mean follow-up of 6.1 months, and in 30% (21/69) of those in cohort-2 during a mean follow-up of 60 months. Individually, in cohort-1, levels of MCP-1, transferrin, LFABP, and albumin were higher in the RFD group than those who maintained renal function, with statistical significance for LFABP and albumin. In cohort-2 the RFD group also had higher levels of urine MCP-1 and albumin than others. The combination of LFABP, MCP-1, albumin, and transferrin had good predictive accuracy for RFD in both cohorts (area under the ROC curve = 0.77-0.82).

CONCLUSION:

The combinatorial urine biomarker LFABP, MCP-1, albumin, and transferrin shows promise as a predictor of renal functional decline in LN, and warrants further investigation.

KEYWORDS:

SLE; biomarker; kidney injury; lupus nephritis; renal function decline

PMID:
26873651
PMCID:
PMC4945408
DOI:
10.1177/0961203316631629
[Indexed for MEDLINE]
Free PMC Article

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