Abstract: TH-OR067
Urine Neutrophil Gelatinase-Associated Lipocalin to Predict Renal Response after Induction Therapy in Active Lupus Nephritis
Session Information
- Immunology, Inflammation, and the Glomerulus: The Cutting Edge
November 02, 2017 | Location: Room 294, Morial Convention Center
Abstract Time: 05:42 PM - 05:54 PM
Category: Glomerular
- 1005 Clinical Glomerular Disorders
Authors
- Satirapoj, Bancha, Phramongkutklao hospital, Bangkok, Thailand
- Kitiyakara, Chagriya, Ramathibodi Hospital, Bangkok, Thailand
- Avihingsanon, Yingyos, King Chulalongkorn Memorial hospital, Chulalongkorn University, Bangkok, Thailand
- Supasyndh, Ouppatham, Phramongkutklao hospital, Bangkok, Thailand
Background
Tubulointerstitial injury is important to predict the progression of lupus nephritis (LN). Urine neutrophil gelatinase-associated lipocalin (NGAL) has been reported to detect worsening LN disease activity. Thus, urine NGAL may predict renal outcomes among lupus patients.
Methods
We conducted a prospective multi-center study among active LN patients with biopsy-proven. All patients provided urine samples for NGAL measurement by ELISA collected from all patients at baseline and at 6-month follow-up after induction therapy.
Results
In all, 75 active LN patients were enrolled (mean age 31.8±9.9 years, median UPCR 4.8 g/g creatinine level with interquartile range (IQR) 2.5 to 8.4 and mean estimated glomerular filtration rate (GFR) 89.1±36.3 mL/min/1.73 m2). At baseline measurement, median urinary NGAL in complete response, partial response and nonresponse groups was 11.8 (IQR; 6.2, 23.5), 18.9 (IQR; 8.9, 43.1), and 78.9 (IQR; 23.2, 118.4) ng/mL, respectively (P=0.004). Urinary NGAL (ng/mL) correlated positively with proteinuria and correlated negatively with serum complement C3 level. Based on ROC analysis, urinary NGAL (AUC; 0.769, 95%CI 0.603-0.935) outperformed conventional biomarkers (serum creatinine, urine protein, and GFR) in differentiating complete and partial response groups from the nonresponse group. The urine NGAL cutoff value in the ROC curve, 28.07 ng/mL, discriminated nonresponse with 75% sensitivity and 66.7% specificity.
Conclusion
Urine NGAL at baseline performed better than conventional markers in predicting a clinical response to treatment of active LN except serum complement C3 level. It may have the potential to predict poor response after induction therapy.
Funding
- Other NIH Support