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Abstract: TH-PO0705

Validating the Diagnostic Performance of 20 Urine Proteins in Active Lupus Nephritis Using a Novel Luminex Panel

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Vodehnal, Sonja, University of Houston, Houston, Texas, United States
  • Ma, Yewei, University of Houston, Houston, Texas, United States
  • Petri, Michelle, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Mohan, Chandra, University of Houston, Houston, Texas, United States
Background

Existing markers lack the sensitivity and specificity needed for early detection of Lupus Nephritis (LN) and are often compared only to healthy controls (HC), limiting clinical applicability. Easy-to-assay biomarkers that can distinguish active LN (ALN) from inactive SLE (iSLE) may provide greater diagnostic utility. This study reports a head-to-head comparison of 20 urinary biomarkers previously reported in multiple studies to validate the proteins that are most discriminatory of active LN.

Methods

Luminex high-throughput proteomics was used to validate the expression levels of 20 urinary proteins in a cohort including 40 SLE (20 ALN and 20 iSLE), 17 active non-renal SLE, and 20 HC samples from JHUSOM, followed by Cr normalization

Results

All assayed proteins except NGAL were significantly increased in ALN compared HC (Figure 1). The top six urine proteins distinguishing ALN from iSLE were BAFF, CD163, L-Selectin, MCP-1, MPO, and TFPI (Figure 2). MPO and CD163 showed the highest sensitivity for ALN.

Conclusion

Out of 20 urine proteins tested, BAFF, CD163, L-selectin, MCP-1, MPO, and TFPI, demonstrated the strongest discriminatory power in distinguishing ALN from iSLE. This effort addresses a critical need for a robust, non-invasive biomarker panel capable of supporting diagnosis, monitoring disease activity, and assessing treatment response in patients with ALN. Aside from their diagnostic potential, the identified proteins allude to the potential role of M2 macrophages (CD163), neutrophils (MPO), B-cells (BAFF), and leukocyte adhesion (Selectins) in LN pathogenesis.

Figure 1 Urinary concentrations of candidate biomarkers across clinical groups.

Figure 2 Figure 2 Urine Cr-normalized biomarker levels in JHUSOM

Funding

  • NIDDK Support

Digital Object Identifier (DOI)