Measuring proteinuria 12 months into a clinical trial is the best way to predict long-term renal outcomes in lupus nephritis patients, according to results of a study by Dr. Maria Dall’Era and her associates.
The study measured three different biomarkers and their predictive value towards long-term renal outcomes: proteinuria, serum creatinine (SCr), and urine red blood cells (uRBCs). Proteinuria achieved 81% sensitivity and 78% specificity, SCr had 58% sensitivity but 83% specificity, and uRBCs had the lowest overall predictive ability, with 62% sensitivity and 64% specificity. Combining SCr with proteinuria did not improve accuracy, and combining uRBCs with proteinuria, SCr, or both combined significantly worsened sensitivity.
Proteinuria alone should be the only biomarker clinical trials use to measure renal outcomes in LN patients in a clinical trial, and uRBCs should not be included in any way, the researchers noted.
Find the full article at Arthritis & Rheumatology (doi:10.1002/art.39026).