Cardiovascular disease (CV dz) is common in SLE and lupus nephritis (LN), but premature atherosclerosis risk does not appear to be linked to classic CV risk factors like hypertension. Up to 80% of children with SLE develop kidney dz, which is also associated with increased risk for CV dz and death compared to those without renal involvement. Hepcidin (Hp) is an iron-regulatory protein which may contribute to atherosclerosis and is elevated in autoimmune dz. Pulse wave velocity (PWV) is a validated indicator of arterial stiffness, an early marker of CV risk, in children and is increased in children with SLE vs. healthy controls. Our objective was to quantify Hp and PWV in children with SLE and to determine if those with biopsy-proven lupus nephritis (LN) have higher Hp levels and higher PWV compared to those without kidney dz.

Methods:

Cross-sectional analysis with Hp measured via ELISA assay. Arterial stiffness quantified by carotid-femoral PWV. Pearson chi2/paired t testing or Wilcoxan rank sum test for comparison of proportions, means, or median.

Results:

The cohort (n=16) was 93.8% female and 68.8% black with mean (SD) age of 15.2 (3.6) yrs. 37.5% (n=6) had LN. Overall mean (SD) Hp was 53.9 (47.8) ng/mL, median (IQR) 34.4 (18.9, 91.9) ng/mL. Both Hepcidin levels and PWV were higher in the subjects with LN.

Conclusion:

In this pilot analysis, serum Hp and PWV were both elevated in subjects with LN compared to those with SLE alone. No significant differences in blood pressure, a traditional CV risk factor, were noted. This suggests Hp may be a mediator of morbid CV changes in LN and warrants further study.