Combined utilization of untimed single urine of MCP-1 and TWEAK as a potential indicator for proteinuria in lupus nephritis

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Abstract

The aim of this study was to determine whether combined utilization of untimed single urine monocyte chemoattractant protein 1 (uMCP-1) and tumor necrosis factor (TNF)-like weak inducer of apoptosis (uTWEAK) could serve as a screening test for proteinuria in patients with lupus nephritis (LN).

A case–control study that contained 39 biopsy-proven LN patients, 20 non-LN systemic lupus erythematosus (SLE) patients, and 10 healthy controls (HCs) were carried out. Correlations between uMCP-1, uTWEAK, and traditional clinical markers were analyzed by Spearman correlation test. Diagnostic values of uMCP-1, uTWEAK, and urine albumin/creatinine ratio (uACR) in the assessment of proteinuria were investigated by receiver operating characteristic (ROC) curves.

Biopsy-proven LN patients showed higher levels of uMCP-1 and uTWEAK than non-LN patients. uMCP-1 and uTWEAK were elevated in renal active patients (rSLEDAI ≥4). Both uMCP-1 and uTWEAK showed significant correlation with patients’ rSLEDAI, 24-hour urine proteinuria (24hr UP), and anti-double-stranded DNA (anti-dsDNA) antibodies. No correlations of these 2 biomarkers between cystatin C (Cys-C), creatinine (Cr), and blood urea nitrogen (BUN) were observed. An algorithm combining the moderate sensitivity of uMCP-1 and high specificity of uTWEAK displayed great specificity and sensitivity for proteinuria screening.

Both uMCP-1 and uTWEAK were positively correlated with the impairments of LN, and the combined utility of untimed single uMCP-1 and uTWEAK might be used as potential predictors for proteinuria in LN.

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Most cited references 33

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The KDIGO guideline for glomerulonephritis is designed to assist health-care providers in treating patients with glomerular diseases. A guideline is not a set of rules but is intended to allow the practitioner to make an informed decision based on the available evidence. Due to its general nature and the variability of strength of the available studies, it is often difficult to directly apply a guideline to the care of an individual patient. This commonly relates to the limited generalizability of the evidence, i.e., does not cover every clinical scenario. To underscore this point, we have introduced within the context of the glomerulonephritis guideline cases with specific features to illustrate the constant need for clinical judgment. These vignettes are intended to demonstrate how the best treatment plans should be individualized and take into account patient preference and clinical acumen, as well as the best available evidence.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: April 2018

Publication date (Electronic): 20 April 2018

Volume: 97

Issue: 16

Electronic Location Identifier: e0343

Affiliations

[a ]Department of Clinical Immunology, Branch of Immune Cell Biology, State Key Discipline of Cell Biology, PLA Specialized Research Institute of Rheumatology & Immunology, Xijing Hospital, Fourth Military Medical University

[b ]National Translational Science Center for Molecular Medicine

[c ]Department of Cell Biology, State Key Discipline of Cell Biology, Fourth Military Medical University, Xi’an, China.

Author notes

[∗ ]Correspondence: Ping Zhu, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi’an 710032, Shaanxi Province, China (e-mail: zhuping@ 123456fmmu.edu.cn ).

Article

Publisher ID: MD-D-17-05976 Accession ID: 00343

DOI: 10.1097/MD.0000000000010343

PMC ID: 5916697

PubMed ID: 29668584

SO-VID: 4b6d4cc5-ac3c-439a-8ee5-d0cfb227fafc

License:

This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0

History

Date received : 27 September 2017

Date revision received : 15 December 2017

Date accepted : 9 March 2018

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Keywords: lupus nephritis,proteinuria,urinary monocyte chemoattractant protein 1 (umcp-1),urinary tnf-like weak inducer of apoptosis (utweak)

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Keywords: lupus nephritis, proteinuria, urinary monocyte chemoattractant protein 1 (umcp-1), urinary tnf-like weak inducer of apoptosis (utweak)

Combined utilization of untimed single urine of MCP-1 and TWEAK as a potential indicator for proteinuria in lupus nephritis : A case–control study

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Most cited references 33

Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

Measuring agreement in method comparison studies.

The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines--application to the individual patient.

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