Introduction:
Tubuloglomerular injury is a critical factor in predicting the progression of lupus nephritis (LN), a kidney complication of systemic lupus erythematosus. 24 hours urinary total protein (UTP) and urinary neutrophil gelatinase-associated lipocalin (NGAL) have emerged as potential biomarkers for predicting renal response after MMF induction therapy in LN.
Methods:
This Quasi experimental study was conducted in two tertiary level hospitals, enrolling active LN patients with biopsy proven diagnoses. Urine samples for 24 hours UTP and NGAL measurement using ELISA were collected at two time points: baseline and after a 6-month follow-up with MMF induction therapy.
Results:
A total of 30 active LN patients were enrolled in the study with mean age 28.53 ± 7.45 years and predominance of female patients (90%). Following six months of MMF induction therapy, 54% of patients acheived complete response, while 23% had partial response and another 23% had no response. Notably, baseline 24 hours UTP (mean 2.76±1.48) and urinary NGAL (37.12 ± 25.33) were significantly decreased at the 6 month follow up (P value <0.001). There was a statistically significant association between baseline and follow-up S. albumin levels (p = 0.002), urine RBC (p = 0.002), ESR (p <0.001), creatinine (p<0.001). Mean urinary NGAL in no response, partial response and complete response groups was 72.19±26.45, 35.62±6.08, 22.42±11.84 respectively (p <0.01). Nausea, UTI and herpes zoster infection were more frequently (10%) reported side effects by participants after MMF therapy.
Conclusions:
This study provides valuable information regarding demographics, treatment response in patients with class III/IV lupus nephritis. More than half of the patients had complete response, about one-fourth showed partial response and about one-fourth showed no response. These findings offer valuable insights into optimizing LN management, tailoring treatment strategies, and ultimately improving patient care and renal outcome.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.