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Objective: Monocyte chemoattractant protein-1 (MCP-1) is reported to be associated with lupus nephritis (LN) activity. We therefore investigated urinary MCP-1 (uMCP-1) in patients with biopsy proven LN.
Methods: This was a cross-sectional observational study in which uMCP-1 levels and the standard parameters of LN activity were measured in these patients.
Results: One hundred patients were recruited: 47 with active and 53 inactive LN. uMCP-1 levels were increased in those with active LN [9,317.5 pg/mg creatinine (5,48.3-40,170)] compared to those with inactive LN [3,682 pg/ mg creatinine (0-23,866)] (p<0.001). uMCP-1 correlated with proteinuria (r=0.39, p=0.001), serum albumin (r=-0.35, p=0.001) and SLEDAI-2K (renal) (r=0.39, p=0.001). Area under receiver operating characteristic (AUROC) curve for uMCP-1 was 0.82 (p=0.001) compared with 0.50 (p=0.95), 0.37 (p=0.50), 0.43 (p=0.26) for anti-ds-DNA Ab, C3 and C4 respectively. AUROC for proteinuria was 0.94 (p<0.001) and for SLEDAI-2K (renal) was 0.96 (p<0.001). Only proteinuria and SLEDAI-2K (renal) were independent predictors of LN activity.
Conclusions: uMCP-1 may provide further adjunctive evidence if the clinical diagnosis of LN activity remains uncertain and facilitate improved grading of renal disease activity in this complex disease thus leading to improved treatment and outcome. Serial measurements of uMCP-1 are indicated.