Predicting decline of kidney function in lupus nephritis using urine biomarkers

K. M. Abulaban, H. Song, X. Zhang, P. L. Kimmel, J. W. Kusek, R. G. Nelson, H. I. Feldman, R. S. Vasan, J. Ying, Michael Mauer, G. L. Nelsestuen, M. Bennett, H. I. Brunner, B. H. Rovin

Research output: Contribution to journalArticle

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Abstract

Objective To evaluate candidate biomarkers to predict future renal function decline (RFD) in children and adults with lupus nephritis (LN). Methods At the time of enrollment into prospective observational LN cohort studies liver-type fatty acid binding protein (LFABP), albumin, monocyte chemoattractant protein-1 (MCP-1), uromodulin, transferrin, and hepcidin were measured in urine samples of two cohorts of patients with LN, one followed at a pediatric (cohort-1; n = 28) and one at an adult institution (cohort-2; n = 69). The primary outcome was RFD, defined in cohort-1 as a decrease in estimated glomerular filtration rate (eGFR) of ≥20% and in cohort-2 as a sustained increase of ≥25% in serum creatinine concentration (SCr), both from baseline. Results All patients (n = 97) had normal eGFR or SCr at the time of urine collection at baseline. RFD occurred in 29% (8/28) of patients in cohort-1 during a mean follow-up of 6.1 months, and in 30% (21/69) of those in cohort-2 during a mean follow-up of 60 months. Individually, in cohort-1, levels of MCP-1, transferrin, LFABP, and albumin were higher in the RFD group than those who maintained renal function, with statistical significance for LFABP and albumin. In cohort-2 the RFD group also had higher levels of urine MCP-1 and albumin than others. The combination of LFABP, MCP-1, albumin, and transferrin had good predictive accuracy for RFD in both cohorts (area under the ROC curve = 0.77-0.82). Conclusion The combinatorial urine biomarker LFABP, MCP-1, albumin, and transferrin shows promise as a predictor of renal functional decline in LN, and warrants further investigation.

Original languageEnglish (US)
Pages (from-to)1012-1018
Number of pages7
JournalLupus
Volume25
Issue number9
DOIs
StatePublished - Aug 1 2016

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Lupus Nephritis
Fatty Acid-Binding Proteins
Biomarkers
Urine
Chemokine CCL2
Kidney
Albumins
Transferrin
Glomerular Filtration Rate
Creatinine
Uromodulin
Hepcidins
Urine Specimen Collection
Serum
ROC Curve
Area Under Curve
Cohort Studies
Pediatrics

Keywords

  • SLE
  • biomarker
  • kidney injury
  • lupus nephritis
  • renal function decline

Cite this

Abulaban, K. M., Song, H., Zhang, X., Kimmel, P. L., Kusek, J. W., Nelson, R. G., ... Rovin, B. H. (2016). Predicting decline of kidney function in lupus nephritis using urine biomarkers. Lupus, 25(9), 1012-1018. https://doi.org/10.1177/0961203316631629

Predicting decline of kidney function in lupus nephritis using urine biomarkers. / Abulaban, K. M.; Song, H.; Zhang, X.; Kimmel, P. L.; Kusek, J. W.; Nelson, R. G.; Feldman, H. I.; Vasan, R. S.; Ying, J.; Mauer, Michael; Nelsestuen, G. L.; Bennett, M.; Brunner, H. I.; Rovin, B. H.

In: Lupus, Vol. 25, No. 9, 01.08.2016, p. 1012-1018.

Research output: Contribution to journalArticle

Abulaban, KM, Song, H, Zhang, X, Kimmel, PL, Kusek, JW, Nelson, RG, Feldman, HI, Vasan, RS, Ying, J, Mauer, M, Nelsestuen, GL, Bennett, M, Brunner, HI & Rovin, BH 2016, 'Predicting decline of kidney function in lupus nephritis using urine biomarkers', Lupus, vol. 25, no. 9, pp. 1012-1018. https://doi.org/10.1177/0961203316631629
Abulaban KM, Song H, Zhang X, Kimmel PL, Kusek JW, Nelson RG et al. Predicting decline of kidney function in lupus nephritis using urine biomarkers. Lupus. 2016 Aug 1;25(9):1012-1018. https://doi.org/10.1177/0961203316631629
Abulaban, K. M. ; Song, H. ; Zhang, X. ; Kimmel, P. L. ; Kusek, J. W. ; Nelson, R. G. ; Feldman, H. I. ; Vasan, R. S. ; Ying, J. ; Mauer, Michael ; Nelsestuen, G. L. ; Bennett, M. ; Brunner, H. I. ; Rovin, B. H. / Predicting decline of kidney function in lupus nephritis using urine biomarkers. In: Lupus. 2016 ; Vol. 25, No. 9. pp. 1012-1018.
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abstract = "Objective To evaluate candidate biomarkers to predict future renal function decline (RFD) in children and adults with lupus nephritis (LN). Methods At the time of enrollment into prospective observational LN cohort studies liver-type fatty acid binding protein (LFABP), albumin, monocyte chemoattractant protein-1 (MCP-1), uromodulin, transferrin, and hepcidin were measured in urine samples of two cohorts of patients with LN, one followed at a pediatric (cohort-1; n = 28) and one at an adult institution (cohort-2; n = 69). The primary outcome was RFD, defined in cohort-1 as a decrease in estimated glomerular filtration rate (eGFR) of ≥20{\%} and in cohort-2 as a sustained increase of ≥25{\%} in serum creatinine concentration (SCr), both from baseline. Results All patients (n = 97) had normal eGFR or SCr at the time of urine collection at baseline. RFD occurred in 29{\%} (8/28) of patients in cohort-1 during a mean follow-up of 6.1 months, and in 30{\%} (21/69) of those in cohort-2 during a mean follow-up of 60 months. Individually, in cohort-1, levels of MCP-1, transferrin, LFABP, and albumin were higher in the RFD group than those who maintained renal function, with statistical significance for LFABP and albumin. In cohort-2 the RFD group also had higher levels of urine MCP-1 and albumin than others. The combination of LFABP, MCP-1, albumin, and transferrin had good predictive accuracy for RFD in both cohorts (area under the ROC curve = 0.77-0.82). Conclusion The combinatorial urine biomarker LFABP, MCP-1, albumin, and transferrin shows promise as a predictor of renal functional decline in LN, and warrants further investigation.",
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AU - Abulaban, K. M.

AU - Song, H.

AU - Zhang, X.

AU - Kimmel, P. L.

AU - Kusek, J. W.

AU - Nelson, R. G.

AU - Feldman, H. I.

AU - Vasan, R. S.

AU - Ying, J.

AU - Mauer, Michael

AU - Nelsestuen, G. L.

AU - Bennett, M.

AU - Brunner, H. I.

AU - Rovin, B. H.

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N2 - Objective To evaluate candidate biomarkers to predict future renal function decline (RFD) in children and adults with lupus nephritis (LN). Methods At the time of enrollment into prospective observational LN cohort studies liver-type fatty acid binding protein (LFABP), albumin, monocyte chemoattractant protein-1 (MCP-1), uromodulin, transferrin, and hepcidin were measured in urine samples of two cohorts of patients with LN, one followed at a pediatric (cohort-1; n = 28) and one at an adult institution (cohort-2; n = 69). The primary outcome was RFD, defined in cohort-1 as a decrease in estimated glomerular filtration rate (eGFR) of ≥20% and in cohort-2 as a sustained increase of ≥25% in serum creatinine concentration (SCr), both from baseline. Results All patients (n = 97) had normal eGFR or SCr at the time of urine collection at baseline. RFD occurred in 29% (8/28) of patients in cohort-1 during a mean follow-up of 6.1 months, and in 30% (21/69) of those in cohort-2 during a mean follow-up of 60 months. Individually, in cohort-1, levels of MCP-1, transferrin, LFABP, and albumin were higher in the RFD group than those who maintained renal function, with statistical significance for LFABP and albumin. In cohort-2 the RFD group also had higher levels of urine MCP-1 and albumin than others. The combination of LFABP, MCP-1, albumin, and transferrin had good predictive accuracy for RFD in both cohorts (area under the ROC curve = 0.77-0.82). Conclusion The combinatorial urine biomarker LFABP, MCP-1, albumin, and transferrin shows promise as a predictor of renal functional decline in LN, and warrants further investigation.

AB - Objective To evaluate candidate biomarkers to predict future renal function decline (RFD) in children and adults with lupus nephritis (LN). Methods At the time of enrollment into prospective observational LN cohort studies liver-type fatty acid binding protein (LFABP), albumin, monocyte chemoattractant protein-1 (MCP-1), uromodulin, transferrin, and hepcidin were measured in urine samples of two cohorts of patients with LN, one followed at a pediatric (cohort-1; n = 28) and one at an adult institution (cohort-2; n = 69). The primary outcome was RFD, defined in cohort-1 as a decrease in estimated glomerular filtration rate (eGFR) of ≥20% and in cohort-2 as a sustained increase of ≥25% in serum creatinine concentration (SCr), both from baseline. Results All patients (n = 97) had normal eGFR or SCr at the time of urine collection at baseline. RFD occurred in 29% (8/28) of patients in cohort-1 during a mean follow-up of 6.1 months, and in 30% (21/69) of those in cohort-2 during a mean follow-up of 60 months. Individually, in cohort-1, levels of MCP-1, transferrin, LFABP, and albumin were higher in the RFD group than those who maintained renal function, with statistical significance for LFABP and albumin. In cohort-2 the RFD group also had higher levels of urine MCP-1 and albumin than others. The combination of LFABP, MCP-1, albumin, and transferrin had good predictive accuracy for RFD in both cohorts (area under the ROC curve = 0.77-0.82). Conclusion The combinatorial urine biomarker LFABP, MCP-1, albumin, and transferrin shows promise as a predictor of renal functional decline in LN, and warrants further investigation.

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