Lupus & antiphospholipid syndrome
Urinary markers differentially associate with kidney inflammatory activity and chronicity measures in patients with lupus nephritis
Authors' conclusion
Longitudinal predictions suggested that patients with baseline NIH-AI scores of ≥8 were most sensitive to improvement over 6-12 months.
Study context
- Population
- Patients with lupus nephritis (LN) (urine at baseline and over 1 year), with SLE, non-LN kidney disease biopsy controls and healthy donorsHealthy donors (HDs) 18, LN 42, SLE 17, biopsy controls 9
- Comparison
- Urinary biomarker algorithms predicting National Institutes of Health Activity Index (NIH-AI) and National Institutes of Health Chronicity Index (NIH-CI) scores
- Outcome
- Prediction of LN activity (NIH-AI) and chronicity (NIH-CI)
Methodological detailspreliminary and hypothesis-generating, urine proteomics, stepwise, univariate and multivariate logistic regression
- Preliminary and hypothesis-generating
- Urine proteomics
- Stepwise, univariate and multivariate logistic regression
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity | False-positive rate (FPR) | Accuracy |
|---|---|---|---|---|
| NIH-AI algorithm | 93% | 93% | 7% | 93% |
| NIH-CI algorithm | 88% | 96% | 4% | 93% |
Sensitivity
NIH-AI algorithm93%
NIH-CI algorithm88%
Specificity
NIH-AI algorithm93%
NIH-CI algorithm96%
False-positive rate (FPR)
NIH-AI algorithm7%
NIH-CI algorithm4%
Accuracy
NIH-AI algorithm93%
NIH-CI algorithm93%
Further findings
Urinary analytes quantifiable and overexpressed vs HDs
- Urine analytes identified from LN, SLE and biopsy control patients
- 112
- Proteins associated with NIH-AI
- 30
- Proteins associated with NIH-CI
- 26
- Analytes common to both
- 4
Pathway analysis and kidney biopsy immunohistochemistry (IHC)
- Granulocyte- and macrophage-associated pathways identified; presence of these cells confirmed by IHC in kidney biopsies
Original publication
Urinary markers differentially associate with kidney inflammatory activity and chronicity measures in patients with lupus nephritis. Lupus Sci Med. Published 30 January 2023. doi:10.
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