Value of urinary transferrin, urinary ceruloplasmin and urinary neutrophil gelatinase-associated lipocalin as biomarkers in pediatric lupus nephritis

Background: Lupus nephritis is an important cause of pediatric lupus morbidity and mortality. We sought to investigate the value of urinary transferrin sectional study over a period of 6 months at the Pediatric Allergy, Immunology of 60 subjects; 40 patients with SLE and 20 age and sex-matched healthy subjects. Urinary levels of the three biomarkers (uTF, uCP and uNGAL) were measured by ELISA, in relation to other lupus clinical, urinary and serum parameters. Results: The studied patients had mean age 14.35 +/- 2.3 years and 85 % (n = 34) were females. Among patients with LN (n=20), 8 (40%) had class II, 8 (40%) class III and 4 (20%) class IV LN. We observed significantly higher uTF levels, uCP expression and uNGAL levels among lupus patients compared to controls (p<0.001). In addition, the 3 studied biomarkers were (p<0.001). Levels of uTF, uCP and uNGAL showed significant positive correlations with 24-hour urinary proteins, serum creatinine and significant negative correlations with serum albumin, and estimated Glomerular Filtration Rate. Conclusion: Urinary TF, uCP and uNGAL might serve as non-invasive biomarkers of LN in pediatric and adolescent SLE. Their significant elevation in active cases may reflect a potential predictive value of renal flares and may serve as a valuable affordable tool in the follow-up of LN.