Urinary VCAM-1 as a biomarker of lupus nephritis disease activity

Up to 80% of children with Juvenile Systemic Lupus Erythematosus (JSLE) develop lupus nephritis (LN) (1), with the 5-year renal survival rate varying between 44-94% (2-4). Conventional markers of JSLE disease activity fail to adequately predict impending LN flares (5), with significant renal involvement (class III, IV or V LN) known to occur with low level proteinuria (6). Cross-sectional adult SLE studies have shown urinary vascular cell adhesion molecule-1 (VCAM-1) to be significantly higher in active LN than inactive LN or healthy controls, correlating with traditional markers of LN disease activity (7, 8).