Predicting Study by some New Serum and Urinary Biomarkers for The Diagnosis of Lupus Nephritis in SLE Patients in Kerbela Province

Abstract

Background: As a common side effect of SLE, lupus nephritis is an immunological complex glomerular nephritis (GN). Its pathogenesis involves a number of pathogenic pathways. The increased incidence of ESRD emphasizes the significance of early diagnosis in this challenging to control disease with unpredictable course that is caused by multiple combinations of genetic variants that compromise those mechanisms normally assuring immune tolerance to nuclear auto antigens. Aim of study: This study aimed to Measuring Level Urinary Epidermal Growth Factor (UEGF) in urine, Neutrophil gelatinase-associated Lipocaline (NG- AL) and measuring the level of complement (C1q, C3, C4) in serum for Lupus Nephritis patients by using ELISA method, this research included eighty female patients with SLE. Methodology: A cross section study of patients with Systemic lupus erythematosus was conducted. Imam AL Hasan Al Mujtaba Hospital in Karbala city during period from November 2022 to March 2023. Results: The findings of the present investigation have demonstrated a considerable reduction of UEGF concentration in Sever Lupus nephritis group, compeer with Moderate Lupus nephritis and other organ SLE group, the mean of UEGF was (145.97±45.55 ng/L) (195.78±60.38 ng/L) (339.15±85.59ng/L) respectively. The findings of this study have demonstrated a considerable rise in NGAL concentration in Sever Lupus nephritis group, compeer with Moderate Lupus nephritis and other organ SLE group, the mean of NGAL was (1027.53± 259.01 ng/ml) (768.82± 228.8) (715.89± 173.9 ng/ml) respectively. The findings of the current investigation showed a negligible decline in C1q in Sever Lupus nephritis group, compeer with Moderate Lupus nephritis and other organ SLE group, the mean of C1q was (8.04± 8.93 μg/ml) (8.44± 1.46 μg/ml) (9.43± 2.52 μg/ml) respectively. The result of C3 show un-Significant reduction in the concentration in the Sever Lupus Nephritis Patients compeer with Moderate Lupus nephritis and other organ SLE, The Mean concentration of C3 (0.79± 0.36 g/l) (0.85± 0.47g/l) (1.04± 0.35g/l) respectively. And the mean concentration of C4 as show un-Significant reduction in the concentration in the Sever Lupus Nephritis Patients compeer with Moderate Lupus nephritis and other organ SLE, The Mean concentration of C4 (0.14± 0.1g/l) (0.31± 0.17g/l) (0.38± 0.2g/l) respectively. Conclusions: Decrease both the level of UEGF expression and urinary excretion after kidney injury and the level of the complement system is a major factor in lupus nephritis-related kidney damage and Increase Neutrophil gelatinase-associated Lipocaline (NGAL) can serve as an early indicator for the diagnosis of acute renal damage.