Low serum uromodulin levels and their association with lupus flares

• Published in: PloS one Vol. 17; no. 10; p. e0276481
• Main Authors: David, Bonilla-Lara, Ivan, Gamez-Nava Jorge, Emilio, Perez-Guerrero Edsaul, Daniela, Murillo-Saich Jessica, Betsabe, Contreras-Haro, Luisa, Vazquez-Villegas Maria, Selene, Fajardo-Robledo Nicte, Guadalupe, Aguilar-Chavez Erika Anita, Miriam, Saldaña-Cruz Ana, Alfredo, Celis, Arturo, Nava-Valdivia Cesar, Mercedes, Hernandez-Corona Diana, German, Cardona-Muñoz Ernesto, Gonzalez-Lopez, Laura
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 27.10.2022; Public Library of Science (PLoS)
• Subjects: Antibodies; Autoimmune diseases; Biological markers; Biology and Life Sciences; Biomarkers; Blood & organ donations; Chronic conditions; Creatinine; Diabetes; Diagnosis; Diagnostic systems; Epidermal growth factor receptors; Flares; Glomerular filtration rate; Glycoproteins; Health aspects; Hematuria; Infections; Kidney diseases; Lupus; Lupus nephritis; Markers; Medical research; Medicine and Health Sciences; Nephritis; Proteins; Proteinuria; Regression analysis; Regression models; Remission (Medicine); Research and Analysis Methods; Rheumatic diseases; Rheumatology; Risk factors; Systemic lupus erythematosus; Urinalysis; Urine; Mexico
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0276481

Only two previous studies in systemic lupus erythematosus (SLE) patients have identified that the blood concentrations of uromodulin are lower in nephritis. However, none of them had evaluated whether a low serum uromodulin adjusted by the glomerular filtration rate (sUromod/eGFR index) contributed to identify patients in risk of lupus nephritis (LN) using multivariable models. Therefore, this study aimed two objectives to evaluate the association between low serum uromodulin levels and low sUromod adjusted by eGFR with renal flares in SLE excluding effects of potential confounders in multivariable analyses; and to identify the value of low sUmod and low sUmod/eGFR index as a potential diagnostic marker of LN. Low serum uromodulin and low sUromod/eGFR index correlated to high scores of renal-SLEDAI, SLICC-renal and proteinuria. SLE patients with a renal flare had lower uromodulin levels compared to SLE patients without renal flare (p = 0.004). After adjusting by potential confounders, the low sUromod/eGFR index (<0.80 ng/mL) increased the risk of a renal flare (OR, 2.91; 95%CI, 1.21 to 6.98; p = 0.02). We propose the low sUromod/eGFR index as a potential new marker of renal disease activity in SLE.