الفهرس | Only 14 pages are availabe for public view |
Abstract Systemic lupus erythematosus (SLE) is a systemic autoimmune disease where nephritis accounts for a substantial degree of the morbidity and mortality. Glomerulonephritis is one of the commonest and most serious manifestations of SLE. Although renal biopsy is the most accurate assessment modality for LN activity and chronicity, it is invasive and not practical for clinical use in the regular monitoring of lupus nephritis (LN). Other surrogate markers, such as the activity of the urine sediment, urine protein excretion, serum creatinine concentration, creatinine clearance or C3 and C4 complement levels, often are only abnormal when significant renal disease has already occurred.Emerging biomarkers with potential diagnostic value in LN that have recently been reported include serum levels of various cytokines, mediators, adhesion molecules, and gene expression profiles in urine cells.Novel urine biomarkers (UBMs) have been described that can assist with diagnosing active LN and anticipate LN flares.We assess the role of urinary CP prediction of active LN and to correlate its level with disease activity and renal status after six month of induction therapy.A total of 45 cases were included in this study. They were equally divided into three groups; control group, lupus non-nephritis and lupus nephritis with 15 cases in each group. The lupus nephritis group included 9 patients who were treated with steroids/endoxan while the other 6 patients were treated with steroid/MMF induction The analysis of Roc curves showed that CP/creatinine ratio can discriminate patients with LN from those without nephritis and from healthy control subjects (P<0.001)When we compared two induction methods of cyclophosphamide (Induction 1) VS MMF (induction 2), we found that there was no statistical significance for age and sex between the two groups. There was no statistical significance between both groups for all comparison aspects CP/creatnine could not predict the response to induction therapy.Renal biopsy is still the gold standard of LN diagnosis and assessing treatment efficacy.Urine CP correlated with active LN. It was not correlated with response to treatment in our study but in other studies it was. This may be related to small sample size.CP may be correlated with specific histopathology in LN. we correlated urine CP in our study to activity index and chronicity index, but not to each item separately.CP/creatinine ratio can assist with diagnosing active LN and anticipate LN flares.CP/creatinine ratio can discriminate patients with LN from those without nephritis and from healthy control subjects. |