Michelle Remião Ugolini-Lopes1, Samara S Gavinier2, Elaine Leon2, Vilma Trindade Viana2, Eduardo Ferreira Borba2, Eloisa Bonfá2. 1. Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Arnaldo 455 - 3rd floor - Room 3190 CEP, São Paulo, SP, 1246-903, Brazil. michelleugolini@gmail.com. 2. Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Arnaldo 455 - 3rd floor - Room 3190 CEP, São Paulo, SP, 1246-903, Brazil.
Abstract
BACKGROUND/ OBJECTIVE: Recent studies observed an association between increased serum uric acid (SUA) levels and renal damage in lupus. However, the predictive value of UA for the development of long-term renal dysfunction in lupus nephritis (LN) is still unknown. The aim of this study was to evaluate if SUA may be a predictor of long-term renal outcome in LN. METHODS: Eighty biopsy-proven LN patients > 7 years of follow-up were selected. SUA levels were measured in sera stored at - 70 °C. All patients had serum stored from LN baseline, and 32 also had stored serum from 6 and 12 months after LN. Renal outcome was addressed after 7 years of follow-up to determine if SUA could be a predictor of long-term renal outcome. A good long-term renal outcome in 7 years was defined as a creatinine clearance (CrCl) ≥ 90.0 mL/min/1.73 m2, and poor if CrCl < 90 mL/min/1.73 m2. Patients were divided in two groups according to the renal outcome to assess whether SUA levels at different time points of follow-up could differentiate such groups. An ROC curve was plotted to assess accuracy. RESULTS: SUA levels at baseline and 6 months were not able to differentiate good from poor long-term renal outcomes in LN (respectively p = 0.37, p = 0.28), but at 12 months (p = 0.02), they could clearly differentiate the two groups. ROC curve (12 months) accuracy was 0.76. SUA cutoff was 6.05 mg/dL (sensitivity = 0.67, specificity = 0.89, positive predictive value = 0.85, negative predictive value = 0.73). CONCLUSION: SUA levels < 6.05 mg/dL at 12 months of follow-up is a predictor of good long-term renal outcome in lupus nephritis. KEY POINTS: • Previous studies reported an association between increased serum uric acid level and short-term renal damage in lupus patients. • The predictive value of serum uric acid for the development of long-term renal dysfunction in lupus nephritis was never assessed. • At 12 months of follow-up serum uric acid clearly differentiated good from poor long-term renal outcome in lupus nephritis. • SUA level < 6.05 mg/dL at 12 months of follow-up was a predictor of good long-term renal outcome in lupus nephritis.
BACKGROUND/ OBJECTIVE: Recent studies observed an association between increased serum uric acid (SUA) levels and renal damage in lupus. However, the predictive value of UA for the development of long-term renal dysfunction in lupus nephritis (LN) is still unknown. The aim of this study was to evaluate if SUA may be a predictor of long-term renal outcome in LN. METHODS: Eighty biopsy-proven LN patients > 7 years of follow-up were selected. SUA levels were measured in sera stored at - 70 °C. All patients had serum stored from LN baseline, and 32 also had stored serum from 6 and 12 months after LN. Renal outcome was addressed after 7 years of follow-up to determine if SUA could be a predictor of long-term renal outcome. A good long-term renal outcome in 7 years was defined as a creatinine clearance (CrCl) ≥ 90.0 mL/min/1.73 m2, and poor if CrCl < 90 mL/min/1.73 m2. Patients were divided in two groups according to the renal outcome to assess whether SUA levels at different time points of follow-up could differentiate such groups. An ROC curve was plotted to assess accuracy. RESULTS:SUA levels at baseline and 6 months were not able to differentiate good from poor long-term renal outcomes in LN (respectively p = 0.37, p = 0.28), but at 12 months (p = 0.02), they could clearly differentiate the two groups. ROC curve (12 months) accuracy was 0.76. SUA cutoff was 6.05 mg/dL (sensitivity = 0.67, specificity = 0.89, positive predictive value = 0.85, negative predictive value = 0.73). CONCLUSION:SUA levels < 6.05 mg/dL at 12 months of follow-up is a predictor of good long-term renal outcome in lupus nephritis. KEY POINTS: • Previous studies reported an association between increased serum uric acid level and short-term renal damage in lupuspatients. • The predictive value of serum uric acid for the development of long-term renal dysfunction in lupus nephritis was never assessed. • At 12 months of follow-up serum uric acid clearly differentiated good from poor long-term renal outcome in lupus nephritis. • SUA level < 6.05 mg/dL at 12 months of follow-up was a predictor of good long-term renal outcome in lupus nephritis.
Authors: C Reátegui-Sokolova; Manuel F Ugarte-Gil; Rocío V Gamboa-Cárdenas; Francisco Zevallos; Jorge M Cucho-Venegas; José L Alfaro-Lozano; Mariela Medina; Zoila Rodriguez-Bellido; Cesar A Pastor-Asurza; Graciela S Alarcón; Risto A Perich-Campos Journal: Clin Rheumatol Date: 2017-01-18 Impact factor: 2.980
Authors: D T Boumpas; H A Austin; E M Vaughn; J H Klippel; A D Steinberg; C H Yarboro; J E Balow Journal: Lancet Date: 1992-09-26 Impact factor: 79.321
Authors: Michelle R Ugolini-Lopes; Luciana Parente C Seguro; Maitê Xavier F Castro; Danielle Daffre; Alex C Lopes; Eduardo F Borba; Eloisa Bonfá Journal: Lupus Sci Med Date: 2017-06-12
Authors: Claudia Elera-Fitzcarrald; Cristina Reátegui-Sokolova; Rocio Violeta Gamboa-Cardenas; Mariela Medina; Francisco Zevallos; Victor Román Pimentel-Quiroz; Jorge Mariano Cucho-Venegas; José Alfaro-Lozano; Zoila Rodriguez-Bellido; Cesar Augusto Pastor-Asurza; Risto Alfredo Perich-Campos; Graciela S Alarcón; Manuel Francisco Ugarte-Gil Journal: Lupus Sci Med Date: 2020-02-05