الفهرس 
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Abstract
Lupus nephritis is considered the most serious complication of systemic lupus erythematosus, and almost 30% will develop nephritis during the course of the disease. Sixty percent of lupus nephritis patients will end in end stage renal disease, requiring the need of either dialysis or renal transplantation.
Risk factors for developing nephritis remain unclear. Early diagnosis and therefore rapid initiation of treatment will massively help the prognosis of lupus nephritis disease. Renal biopsy till our present day remains the gold standard for diagnosis and staging of lupus nephritis, regardless its invasiveness and possible complications.
The complex pathogenesis of the disease makes it hard to be identified by a single biomarker, but rather by a panel of peptide biomarkers which is known as peptide profiling. This could be accomplished through untargeted high throughput proteomics.
The aim of the current work is to evaluate the role of mass spectrometry in the study of urinary proteome pattern of lupus nephritis and to recognize a disease specific peptide pattern that can be validated for lupus nephritis and thus providing a non-invasive diagnostic tool for lupus nephritis.
Patients admitted to rheumatology and nephrology department during one year duration between June 2016 to June 2017 were included in this study. Exclusion criteria were patients less than 16 years of age, those with a history of renal insufficiency other than lupus nephritis, or subjects with end stage renal disease and those with recent urinary tract infections or any other associated autoimmune disease.
All patients included in this study gave their informed consent and had thorough clinical evaluation, ANA, anti-dsDNA, C3 and C4 measurement. Those with suggestive evidence of nephritis had renal biopsy and were diagnosed accordingly.
Patients were then divided in to three groups; group I (Lupus nephritis), group II (SLE without nephritis) and group III (healthy controls). Each group included 40 patients. Urine sampling was done and the following investigations were performed:
• Spot protein to creatinine ratio.
• Urinary proteomic profiling using magnetic beads separation and MALDI-TOF-MS.
Analysis of the data by using ClinProTools software was done to generate a specific peptide pattern that can be validated for lupus nephritis. Using GA algorithm, five peaks were integrated in the pattern to differentiate between lupus nephritis and controls (4309, 1913, 6192, 5217 and 3284). This model has achieved 87.3% sensitivity and 79.5% specificity. GA was also used to determine a differentiating model between LN and SLE