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01-03-2014 | Original Article

Urine biomarkers for monitoring juvenile lupus nephritis: a prospective longitudinal study

Authors: Louise Watson, Kjell Tullus, Clarissa Pilkington, Christine Chesters, Stephen D. Marks, Paul Newland, Caroline A. Jones, Michael W. Beresford

Published in: Pediatric Nephrology | Issue 3/2014

Abstract

Background

In juvenile-onset systemic lupus erythematosus (JSLE), renal involvement (lupus nephritis) is frequently seen and can result in long-term morbidity. This prospective longitudinal study aimed to identify the utility of standard and/or novel biomarkers for monitoring and predicting lupus nephritis in a real world setting.

Methods

Using an unselected JSLE cohort, urine samples were collected during routine clinical review. Protein concentrations of urinary monocyte chemo-attractant protein 1 (uMCP1) and neutrophil gelatinase-associated lipocalin (uNGAL) were analysed along with standard disease activity markers, and were compared with current and subsequent disease activity.

Results

JSLE patients (n = 64; median age 14.1 years) were seen at 3 (interquartile range: 2–5) clinical reviews over 364 (182–532) days. Multivariate analysis demonstrated uMCP1 and serum C3 as independent variables (p < 0.001) for active renal disease at the time of the current review. uMCP1 was an excellent predictor of improved renal disease over time (AUC: 0.81; p = 0.013). uNGAL was a good predictor of worsened renal disease activity (AUC 0.76; p = 0.04) over time.

Conclusion

Biomarkers (uMCP1, serum C3) can indicate current renal involvement in JSLE, whilst uMCP1 and uNGAL are able to predict subsequent renal disease activity changes. Moving towards biomarker-led monitoring may improve the renal outcome for our patients.

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Title: Urine biomarkers for monitoring juvenile lupus nephritis: a prospective longitudinal study
Authors: Louise Watson
Kjell Tullus
Clarissa Pilkington
Christine Chesters
Stephen D. Marks
Paul Newland
Caroline A. Jones
Michael W. Beresford
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 3/2014
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-013-2668-4

At a glance: The STEP trials

Springer Medicine

Urine biomarkers for monitoring juvenile lupus nephritis: a prospective longitudinal study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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