OP0299 ASSESSMENT OF ROLE OF URINARY HEPARANASE IN LUPUS NEPHRITIS PATIENTS AND ITS CORRELATION WITH DISEASE ACTIVITY

Abstract

Background Lupus nephritis (LN) is one of the most common and serious complication of Systemic Lupus Erythrematosus (SLE) and assessment of its activity is crucial. Heparanase has been proposed to be important in the pathogenesis of proteinuria in various forms of glomerulonephritis. Objectives To assess the ability of urinary heparanase to identify SLE with nephritis and the relation of this marker to lupus activity. Methods This cross sectional study was carried out on 90 subjects; 70 patients with SLE and 20 healthy volunteers as a control. All patients and controls were subjected to full history taking and complete clinical examination, routine investigations. Immunological assay and assessment of disease activity by systemic lupus erythematosus disease activity index (SLEDAI) score, renal SLEDAI (r-SLEDAI) were done for lupus nephritis group. The lupus patients were divided according to SLEDAI score into 4 groups; 20 with active lupus nephritis, 17 with non-active LN, 18 with active lupus without renal involvement, 15 with non-active lupus without renal involvement. Urinary Heparanase levels were measured by using ELISA for all groups. Results The level of urinary heparanase was significantly higher in LN groups than non-LN groups and control. It was also significantly higher in active LN than non-active LN patients. There was a significant positive correlation between urinary heparanase and 24 hours urinary proteins, total SLEDAI, and r-SLEDAI, and significant negative correlation between urinary heparanase and C3 & C4. ROC curve analysis revealed that urinary heparanase predicted presence of lupus nephritis activity with a sensitivity of 80%, and a specificity of 91.43%. Conclusion Urinary heparanase levels are increased in patients with active LN and correlate with disease activity markers, indicating that it can serve as a new useful biomarker for lupus nephritis activity.