Chapters Transcript Video Persistence of Urinary Biomarkers of Intrarenal Inflammation Precedes Loss of Kidney Function in Lupus Nephritis Rheumatologist Andrea Fava discusses an exciting new abstract being presented at The American College of Rheumatology Annual Meeting. Hi, I'm Andrea Fava and I'm an assistant professor and director of the Lupus uh translational research program at Johns Hopkins University. Today, I wanna tell you about very exciting research that we are going to present as an abstract at the American College of Rheumatology Convergence Meeting. Uh My research is on Lupus nephritis, which is when there is inflammation in the kidney in patients with uh lupus. Unfortunately, most of the times this uh this comes without symptoms. And therefore, we have to rely on screening the urine of patients for protein. When patients have too much protein in the urine, we react with the kidney biopsy to diagnose the disease and then we treat with immunosuppression, sometimes having to muster side effects and we monitor the response to treatment based on the reduction of this amount of protein. However, this has limitations, uh the amount of the amount of protein in the urine, it's not a very reliable biomarkers. We do know that patients may have protein in the urine and not having inflammation. Other patients have uh uh a lot of inflammation in the kidney and do not have protein in the urine. And therefore, when we treat patients and we just monitor the decrease of proteinuria, which is the name for urine protein. Uh We may treat these patients uh in the dark. And so, um in the last few years, we've been studying along with the accelerating medicines partnership, uh biomarkers in the urine. That can tell us if there is inflammation in the kidney. We found several that outperform proteinuria in telling us if there is true inflammation in the kidney. Now, what we have looked at is whether the decrease of these biomarkers in the urine is a useful biomarker to predict long term outcomes at the end of the day. That's what we care about. We care about saving kidneys in patients with lupus. Well, we we hypothesized that if we with treatment are able to reduce this biomarkers to a normal level, that that means there will be no inflammation in the kidney and therefore there will be no accrual of damage over time. Conversely, patients have uh persistently elevated uh evidence of inflammation in the kidney. These are the patient who will lose kidney function over time. What we have found is that uh patients that after six or 12 months of treatment, if they had a persistence in the urine of these biomarkers of inflammation, this patient had a much higher risk of uh losing kidney function permanently or uh to the point that require dialysis or kidney transplant. And this was better than just using proteinuria, which is what's used in the clinic right now. So this study is very exciting, has implications both for clinical practice, but importantly, for clinical trial design, because it's very hard to get a, a positive trial in Lupus. And sometimes that's because the outcomes that we choose, it's not a precise one and these biomarkers may prove better than the current targets. And so it can lead to a better clinical trial trial design and therefore better treatments for patients. If you want to learn more about this, please join us. Uh There's a couple of sessions in which we'll be talking about these biomarkers and you can find also this information on the abstract on the AC R website. Thank you. Created by Related Presenters Andrea Fava, MD Assistant Professor of Medicine, Division of Rheumatology View full profile
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