Lupus Science & Medicine
Figure 1 (A) UBs were significantly higher in patients who did not achieve PERR (n=18) at 24±3 months after the LN flare as compared with those who did (n=47). For all graphs, the symbols represent the determination from a single individual, columns the median and the bars IQR. (B–D) Correlations between proteinuria and the UBs. (B) whole cohort, (C) subcohort of patients who did not achieve PERR and (D) subcohort of patients who achieved PERR. The colour and the size of the circle represent the R value. CD163, cluster of differentiation 163; LN, lupus nephritis; MCP-1, monocyte chemoattractant protein-1; PERR, primary efficacy renal response; PF4, platelet factor 4; sVCAM, soluble vascular cell adhesion molecule; UB, urinary biomarker.
Univariable and multivariable analyses using stan- dardised values are shown in online supplemental table 2. The findings were similar to those for the non- standardised values, except anti-dsDNA abs, which lost significance for the association with a 30% eGFR decline. Univariable analysis in patients with baseline biopsy- proven LN (full cohort n=50; PERR subcohort n=36) yielded results consistent with those including patients without biopsy at flare (online supplemental table 3). The ability of UB levels to discriminate between patients at risk for an adverse long-term renal outcome For this analysis, we included the subcohort of patients who achieved PERR 24±3 months after the LN flare and had enough urine to process urinary creatinine to correct
the UB (n=47). ROC curves were created for the UBs and conventional biomarkers that demonstrated a significant association with the renal outcomes on the multivariable analysis (CD163, MCP-1, adiponectin, PF4, anti-dsDNA abs and C3), and their ability to predict development of a subsequent LN flare within 3 years and a 30% decline in eGFR within 5 years was examined (online supplemental figure 1). 11 of the analysed patients (23%) experienced their LN flare within the next 3 years and 5 (11%) devel- oped this decline in eGFR within the next 5 years. Subsequent LN flares Four of the biomarkers examined (CD163, MCP-1, anti- dsDNA abs and C3) had a significant association with LN flares. MCP-1 yielded the highest AUC point estimate
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Baker R, et al . Lupus Science & Medicine 2026; 13 :e001724. doi:10.1136/lupus-2025-001724
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