الفهرس 
Lupus Nephritis (LN)Only 14 pages are availabe for public view
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Abstract
Lupus nephritis (LN) is a feature of systemic lupus erythematosus (SLE) and is linked to poor clinical outcome in lupus patients.
The objectives of this study were to evaluate the diagnostic value of serum sCD163 for active lupus nephritis and its correlation to other serum and urinary markers. To evaluate the value of serum sCD163 in the discrimination between renal and non-renal lupus activity and between proteinuria of lupus versus non-lupus etiology.
This study was a comparative controlled cross-sectional study that was conducted at Pediatric Allergy, Immunology, Rheumatology, Nephrology and Dialysis Units, Children’s hospital, Ain Shams University, Cairo, Egypt. The study was conducted after getting the approval from the Research Ethics Committee, the Faculty of Medicine, Ain Shams University (FMASU REC) no. MS 758/2021. It included 60 participants, who were divided equally into 4 groups, (15 per group): group 1: SLE with active LN, group 2: Lupus patients without renal affection, group 3: patients with non-lupus renal disease, not on hemodialysis, meanwhile group 4: was a healthy control.
The most prevalent histopathological class of LN was class V (46.6%), followed by proliferative nephritis (classes III and IV) (40%), while only 2/15 (13.3%) patients had class II. The serum level sCD163 were comparable among the studied LN classes.
Serum sCD163, was high in patients with SLE, with or without LN, compared to other groups, however it reached the highest levels in LN group, supporting the association of that biomarker with LN activity and its ability to be used as a non-invasive biomarker of LN.
Serum sCD163 was significantly higher in lupus patients with renal BILAG A, B comparing to BILAG E (p <0.001) but was comparable among lupus patients with renal BILAG A and BILAG B (p= 0.690). There was no correlation between sCD136 and SLEDAI scores.
Discriminative a cutoff value of serum CD163 > 12 ng/mL could differentiate between SLE patients with renal versus non-renal activity, meanwhile a value > 4.4 ng/mL could differentiate between SLE LN patients and those with non-lupus renal disease, with sensitivity of 100% and specificity of 100%, which indicated high accuracy.
Serum sCD163 was positively related to urinary protein excretion, and negatively correlated with eGFR. These correlations could directly link the clinical importance of serum level of sCD163 in assessing renal affection in SLE patients especially in those having LN.
To conclude, serum sCD163 is a potential non-invasive biomarker for renal affection in LN patients, where it could differentiate between renal and non-renal lupus activity. Limitations of this study included the cross sectional study design, small sample size which didn’t allow equal or adequate representation of different classes of LN, lack of renal histopathological finding among patient with non-renal SLE, lack of inactive LN groups, renal biopsy were not necessary taken at time of enrollment so the findings doesn’t reflect the actual disease activity upon investigation by serum sCD163, the correlation to urinary CD163 would have provided more information, in addition to the lack of gender matching among groups. Wider scale longitudinal studies are recommended with recruitment of large numbers of active LN cases with inclusion of adequate numbers of all histological classes of LN to validate the results of this study. Investigation of the predictive value of serum sCD163 is needed as well as investigating serum sCD163 in relation to urinary levels and comparing their values to other potential LN biomarkers are also needed.