Introduction: Clinical and laboratory markers have limited specificity and sensitivity for predicting renal disease in Systemic Lupus Erythematosus (SLE) patients.
Aim of the Work: In this study we investigated whether urinary neutrophil gelatinase associated lipocalin (uNGAL) predicts active nephritis with or without history of biopsy-proven lupus nephritis (LN), also to find the correlation between uNGAL with serum creatinine level, creatinine clearance, anti-double-stranded (dsDNA) anti body and disease activity score in SLE patients.
Methods: Sixty-three SLE patients based on the American College of Rheumatology (ACR) criteria in this cross sectional study were divided into two groups: patients with and without nephritis. For each group disease activity was measured by SLEDAI [1,2] and then divided to low (SLEDAI<8) and high activity (SLEDAI ³8) according to Annett et al., 2003 [3]. 24 hours uNGALvalues were measured to each group. uNGAL sensitivity and specificity for identifying biopsy-proven nephritis were calculated, and a receiver operating character-istic (ROC) curve was constructed.
Results: The mean±SD of 24-hours uNGAL in patients with LN was significant higher (24.61±3.44mg/24hours) compared to patients without nephritis (16.80±3.54mg/24 hours) with p-value of (p=0.000). A significant positive corre-lation was found between serum creatinine and uNGAL (r=0.324; p=0.030), while there was significant negative correlation between Creatinine clearance and uNGAL (r=–0.310; p=0.013). uNGAL had high sensitivity (82%) and moderate specificity (67%) in patients with biopsy proven LN in comparison to that of anti-dsDNA which had low sensitivity (50%) and specificity (37%) in detection of renal flare in LN patients.
Conclusions: uNGAL predicts renal flare in LN patients with high sensitivity and specificity. Furthermore, uNGAL is a more sensitive and specific for renal flare in patients with a history of LN than anti-dsDNA antibody. So uNGAL may help in earlier diagnosis and treatment of LN with good outcomes in these patients.
Research Department
Research Journal
Med. J. Cairo Univ.
Research Member
Research Publisher
NULL
Research Rank
2
Research Vol
Vol. 83 - No. 2
Research Website
NULL
Research Year
2015
Research_Pages
pp. 281-288
Research Abstract