Houston Daily

A researcher at the University of Houston has reported a new method for monitoring lupus nephritis, a severe kidney disease affecting many people with lupus. The research, led by Chandra Mohan, Hugh Roy and Lillie Cranz Cullen Endowed Professor of Biomedical Engineering at the University of Houston, suggests that urine tests could replace invasive kidney biopsies in tracking the progression of the disease.

Lupus is an autoimmune disorder where the body attacks its own tissues. About five million people worldwide have some form of lupus, and half develop kidney problems such as lupus nephritis. Kidney disease is a leading cause of death among these patients, with mortality rates between 5% and 25% within five years of onset.

Currently, renal biopsy is used to assess kidney damage in lupus patients. However, Mohan noted the drawbacks: “Renal biopsy is invasive and inconvenient and associated with potential complications such as bleeding and infection. The reading of a renal biopsy by pathologists is subjective with substantial inter-pathologist discordance,” he said in The Journal of Clinical Investigation.

“Noninvasive biomarkers precisely predicting histological activity and chronicity are urgently needed,” Mohan added.

Mohan’s team used proteomics to analyze 1,317 urine samples from individuals with lupus nephritis collected at the time of biopsy. They identified 57 proteins that were elevated in those with more active kidney damage.

“In this study, we found that 57 different proteins in urine were much higher in subjects whose kidneys showed more signs of active damage,” said Mohan. “Under the microscope we found these higher protein levels were linked to certain changes like swelling of blood vessel cells, areas of tissue death and clusters of damaged cells. Many of these proteins came from immune cells and showed that there was inflammation happening in the kidneys.”

The study also identified proteins linked to long-term scarring in kidneys.

“Overall, the results indicate that by measuring certain proteins in urine, doctors might be able to tell how active or long-lasting someone’s lupus-related kidney disease is, and they could check kidney health without having to do another biopsy,” Mohan said.

The research team from the University of Houston included Ting Zhang, Jessica Castillo, Anto Sam Crosslee Louis Sam Titus, Kamala Vanarsa, Vedant Sharma and Sohan Kureti. Ramesh Saxena from the University of Texas Southwestern Medical Center also contributed.