303 Urinary vcam 1 as a disease activity indicator in lupus nephritis

Background and aims Currently we do not have a biomarker that can closely reflect the renal disease activity. So the aim of this study is to study the utility of urinary VCAM 1(Vascular cell adhesion molecule 1) in lupus nephritis. Methods It was a diagnostic case control study. The patients presenting to Rheumatology outpatient department were recruited. Patients were divided into 2 groups, SLE without active nephritis and SLE with active nephritis based on the renal SLEDAI. Urinary VCAM1 was tested in all patients using an early morning spot urine sample using ELISA. Renal biopsy was done in patients with active nephritis. VCAM1 levels were compared with the renal SLEDAI, renal biopsy disease activity (ISNRPS) and standard of care markers. The results were analysd using SPSS software version 16.The validity and predictive value statistics was presented with 95 percent confidence interval. Results Urinary VCAM 1 levels had significant correlation (p=0.01) with disease activity based on renal SLEDAI. However, the correlation between the biopsy findings and VCAM levels was not statistically significant. Class 4 and 5 lupus nephritis had higher VCAM level than the lower classes. A positive correlation (r=0.38) was found between VCAM 1 and double stranded DNA. There was a negative correlation between C3 value and VCAM (r=−0.19). The sensitivity and specificity of urinary VCAM 1 is 65.22% and 75% respectively. The cut off value of VCAM is 23.8 pg/mg of creatinine. Conclusions Urinary VCAM 1 may not independently, but combined with other markers may be a promising biomarker for disease activity in lupus nephritis.