Urinary Neutrophil Gelatinase-Associated Lipocalin to Monitor Lupus Nephritis Disease Activity

Susianti, Hani; Wijaya, Jullyanny W.; Rastini, Ati; Handono, Kusworini; Gunawan, Atma; Kalim, Handono

doi:10.4137/bmi.s27625

Cited by 2 publications

(2 citation statements)

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“…Previous studies had heterogenous results regarding this issue. Some studies showed a significant correlation between uNGAL with renal SLEDAI (rSLEDAI) and concluded its valuable use as a predictor of renal involvement [ 16 , 33 , 34 ]. However, other concluded that uNGAL is a strong predictor of rSLEDAI score but was not a strong predictor for total SLEDAI score [ 20 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…In juvenile SLE patients, both urine monocyte chemoattractant protein-1 (uMCP1) and serum C3 can indicate renal involvement, while both uMCP1 and uNGAL can predict subsequent renal disease activity changes [ 38 ]. Other studies showed that uNGAL can differentiate between active and inactive LN [ 34 , 39 ]. The same finding was proven as regard uKIM-1 as predictors for changes in lupus nephritis activity [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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Urinary neutrophil gelatinase-associated lipocalin (uNGAL) and kidney injury molecule-1 (uKIM-1) as markers of active lupus nephritis

et al. 2023

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Background and objectives Despite much research about lupus nephritis, none of the urinary biomarkers has been proven to be truly reflecting lupus nephritis activity, response to treatment, or prognosis. We aimed to study urinary biomarkers in lupus nephritis and test their relation to kidney damage. Patients and methods Forty patients with systemic lupus erythematosus (SLE) were divided into two graoups: (1) lupus nephritis group with biopsy-proven proliferative lupus nephritis (classes III and IV) and who did not receive immunosuppressive drugs within the preceding 3 months except for glucocorticoids and (2) lupus non-nephritis group with SLE patients without any renal manifestation. We assessed disease activity by the SLE disease activity index. uNGAL, uKim-1, uNGAL to urinary creatinine excretion (mg/dl), and uKim-1 to urinary creatinine excretion were measured in random spot urine samples at the time of renal biopsy and 6 months after the induction therapy. Results The LN group before treatment showed higher levels of uNGAL and uKIM-1 (P-value < 0.001). ROC analysis showed that uNGAL at level of > 59 has a 95 % sensitivity, a 100 % specificity, and an AUC = 0.996 in the ability to diagnose LN. While the uKIM-1 ROC showed that at level of > 1.6, it has an 85 % sensitivity, an 80 % specificity, and an AUC = 0.919. uNGAL and uKIM levels were significantly lower after treatment (P-value < 0.001). No significant correlations were found between urinary markers before and after treatment with other clinical, inflammatory, and serological markers of lupus nephritis. Conclusion uNGAL, uKIM, uNGAL/Creat ratio, and uKIM/Creat ratio can be used as a predictor and a marker of disease activity for lupus nephritis. Key Points• Renal biopsy is the current standard for diagnosis of lupus nephritis and none of the urinary biomarkers has been fully concluded to have a diagnostic power to reflect the activity or the response to treatment.• However, based on the finding of the current study, uNGAL, uKIM, uNGAL/Creat ratio, and uKIM/Creat ratio showed significant diagnostic performance and were powerful indices of renal involvement in systemic lupus patients and as markers of disease activity.

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