عنوان المقالة: SP337.URINARY NEUTROPHIL GELATINASE – ASSOCIATED LIPOCALIN (uNGAL) AND MONOCYTE CHEMOATTRACTANT PROTEIN-1 (uMCP-1) IN LUPUS NEPHRITIS
د. صباح محمد الحرازي | Sabah Mohamed Alharazy | 3076
نوع النشر
مؤتمر علمي
المؤلفون بالعربي
المؤلفون بالإنجليزي
Sabah Alharazy, Norella C.T. Kong, Marlyn Mohammad, Shamsul A. Shah, Halim Gafor and Arbaiyah Báin
الملخص الانجليزي
Introduction and Aims: Several small studies have indicated a role for urine neutrophil gelatinase – associated lipocalin (uNGAL) and urine monocyte chemoattractant protein-1 (uMCP-1) as markers of lupus nephritis (LN) disease activity.We therefore compared the urinary levels of these two biomarkers in SLE patients with biopsy-proven LN. Methods: This was a prospective, cross-sectional observational study in which consecutive SLE patients with biopsy-proven LN attending the Nephrology/SLE Clinic were recruited. Two x10 ml samples of early morning urine were collected for urinalysis, urine protein creatinine ratio and for both uNGAL (ng/mg of urinary creatinine) and uMCP-1 ( pg/mg of urinary creatinine). The last two were measured from frozen stored urine at end visit using an enzyme-linked immunosorbent assay (ELISA). Their renal function test, serum albumin, urinary parameters, lupus serology and renal SLEDAI-2K (global, renal, extra-renal) were also measured. Results: Of the 100 patients recruited, 47 had active and 53 inactive LN. uNGAL levels (ng/mg creatinine) and uMCP-1 levels ( pg/mg creatinine) were significantly higher in patients with active LN compared to those with inactive renal disease (p = 0.01* and p < 0.001** respectively). Both uNGAL and uMCP-1 levels were highly associated with SLEDAI-2K (renal) (uNGAL: rsp= 0.32, p = 0.001**; uMCP-1: rsp= 0.39, p = 0.001**). Both biomarker levels also correlated with SLEDAI-2K (global) (uNGAL: rsp= 0.19, p = 0.05*; uMCP-1: rsp= 0.28, p = 0.006* ). However, there were no associations between uNGAL and uMCP-1 with SLEDAI-2K (extra-renal). Using receiver operating characteristic (ROC) curve, the area under the curve (AUC) for uNGAL was 0.83 (95% CI = 0.74 – 0.92, p = 0.001**). With a cut-off value at 91.25 ng/ mg creatinine, uNGAL had a sensitivity of 0.89 and specificity of 0.67 for prediction of LN activity. Whereas, the AUC of uMCP-1 was 0.84 (95% CI = 0.75 – 0.92, p = 0.001**). With a cut-off value at 4247 pg/ mg creatinine, uMCP-1 had a sensitivity of 0.89 and specificity of 0.61 for early diagnosis of LN activity. Conclusions: Both uNGAL and uMCP-1 were highly correlated with LN activity. Since renal flares portend a worse prognosis for the renal outcome, serial measurements of one or both these noninvasive urinary biomarkers may be of great clinical value in predicting early flares of LN thus permitting earlier intervention.
تاريخ النشر
01/05/2013
الناشر
Nephrol Dial. Transplant, Published by Oxford University Press on behalf of ERA-EDTA
رقم المجلد
28
رقم العدد
1
ISSN/ISBN
0931-0509
رابط DOI
10.1093/ndt/gft113
الصفحات
i175–i184
رابط الملف
تحميل (89 مرات التحميل)
رابط خارجي
https://academic.oup.com/ndt/article/28/suppl_1/i175/1838478
الكلمات المفتاحية
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رجوع