This study investigates the relationship between serum uric acid (SUA) levels and lupus nephritis (LN) in systemic lupus erythematosus (SLE) patients with normal renal function. Elevated SUA levels were found to be associated with both the presence of LN and an increased risk of developing LN over time.
Background
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with significant morbidity, particularly due to lupus nephritis (LN). Early detection and monitoring of LN are crucial for improving patient outcomes, yet current noninvasive methods are limited. Identifying reliable biomarkers, such as serum uric acid (SUA), could enhance risk assessment and management strategies in SLE patients.
Data Highlights
Group
SUA Levels (µmol/L)
p-value
LN Patients
489.2 ± 80.8
< 0.001
NLN Patients
339.8 ± 104.2
Key Findings
Initial SUA levels were significantly higher in LN patients compared to NLN patients (489.2 vs. 339.8 µmol/L, p < 0.001).
Elevated SUA was linked to baseline LN with an adjusted odds ratio of 4.20 for each 1-SD increase (95% CI 2.00–8.83, p < 0.001).
Incorporating SUA into clinical models improved discrimination for LN risk (AUC increased from 0.863 to 0.929, p = 0.001).
Over 3 years, 28.2% of NLN patients developed incident LN; higher SUA was associated with increased risk (adjusted HR 1.83, 95% CI 1.09–3.07, p = 0.022).
The association of SUA with LN may reflect broader disease activity and systemic inflammation.
Clinical Implications
Clinicians should consider monitoring SUA levels in SLE patients with preserved renal function as part of their risk assessment for lupus nephritis. Elevated SUA may indicate not only renal involvement but also systemic disease activity, warranting closer observation and potential intervention.
Conclusion
SUA levels may serve as a valuable biomarker for assessing the risk of lupus nephritis in SLE patients with normal renal function, highlighting the need for further exploration of SUA's role in disease management.
