Session Information
Title: Systemic Lupus Erythematosus - Clinical Aspects I - Renal, Malignancy, Cardiovascular Disease
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Lupus nephritis(LN) is frequently associated with a poor long-term prognosis. Current non-invasive blood and urine tests do not reliably predict the course of LN. The objective of this study was to evaluate the performance of candidate urine biomarkers in predicting future kidney function in adults and children with LN. The biomarker candidates studies were liver-type fatty acid binding protein (L-FABP), albumin (Alb), and monocyte chemoattractant protein 1 (MCP-1).
Methods:
L-FABP, Alb and MCP-1 were measured by ELISA in urine from 70 adults and 29 children collected at the time of enrollment into prospective observational LN cohorts. Urine analytes were normalized to urine creatinine and logarithmically transformed. The association of each analyte to renal function loss (RFL), defined as a sustained increase of ≥ 25% in serum creatinine (SCr; adults) or a decrease in eGFR of ≥ 20% (children), was determined using a fixed effect model after adjusting for the age group (adult vs. child). Logistical models were used to predict the presence of RFL using each biomarker or a combination of all three biomarkers. Biomarker performance in predicting RFL was assessed as the area under reciever operating characteristic curve (AUC) corresponding to the logistical model.
Results:
8 children and 22 adults had RFL during the mean follow-up period of 6.1 months and 60 months, respectively. Overall patients with RFL showed significantly higher levels of L-FABP, ALB and MCP-1 than those without RFL (Table). The AUC using the combination of urine L-FABP, Alb and MCP-1 was 0.73, higher than those using any single biomarker as the predictor (all about 0.64).
Conclusion:
Urine L-FABP, Alb and MCP-1 are associated with RFL. The combination of these biomarkers was a better predictor of RFL than any individual biomarker.
|
Patient type |
Biomarker/Cr$ |
Renal function loss$ |
Preserved renal function$ |
p-value |
|
All patients with LN |
N |
30 |
69 |
– |
|
LFABP |
1.96 ± 1.45 |
1.23 ± 1.62 |
0.038 |
|
|
Albumin |
5.82 ± 2.31 |
4.54 ± 2.23 |
0.012 |
|
|
MCP-1 |
6.05 ± 1.14 |
4.77 ± 2.58 |
0.014 |
|
|
Adults with LN |
N |
22 |
48 |
– |
|
LFABP |
1.69 ± 1.26 |
1.28 ± 1.69 |
0.326 |
|
|
Albumin |
5.90 ± 2.14 |
5.01 ± 2.01 |
0.100 |
|
|
MCP-1 |
5.98 ± 1.16 |
4.80 ± 2.70 |
0.061 |
|
|
Children with LN |
N |
8 |
21 |
– |
|
LFABP |
2.67 ± 1.75 |
1.09 ± 1.48 |
0.022 |
|
|
Albumin |
5.59 ± 2.86 |
3.41 ± 2.36 |
0.047 |
|
|
MCP-1 |
6.25 ± 1.16 |
4.70 ± 2.34 |
0.108 |
|
|
$ Values are mean + standard deviation |
||||
Disclosure:
K. Abulaban,
None;
B. H. Rovin,
Teva Pharmaceuticals,
2,
Questcor,
2,
Biogen Idec,
5,
ONyx,
5,
lilly,
9,
celtic,
9;
S. Nelson,
None;
H. Song,
None;
P. Kimmel,
None;
J. Kusek,
None;
H. Feldman,
None;
V. Ramachandran,
None;
M. Bennett,
None;
J. Ying,
None;
H. Brunner,
,
,
.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/candidate-urinary-biomarkers-may-predict-the-future-development-of-renal-functional-loss-with-lupus-nephritis-in-children-and-adults/