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Proteinuria doesn’t correlate with internal activity in lupus nephritis , we really need better biomarkers.
@andreafava
#RNL2024
@RheumNow https://t.co/bFuxVnUCEB
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
This is a crucial nuance. Men and women experience pain differently. The tendency to use that to then dismiss pain in women is entirely incorrect. @lihi_eder @RheumNow #RNL2024 https://t.co/X5QQsaIuNP
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Richard Conway RichardPAConway ( View Tweet)
Dr. Gabalawy: "How do you know what disease patients will develop in this preclinical autoimmunity state?"
@drdavidkarp "it's like when weeds pop up in a garden, it's random ...if ACPA Ab pops up, you might have RA, if it's dsDNA, maybe lupus." #RNL2024 @RheumNow https://t.co/JmDtaTt3sU
TheDaoIndex KDAO2011 ( View Tweet)
Great talk -this is a summary slide on lupus nephritis and biomarkers to predict renal survival. When you get a chance, you have to watch @andreafava on #RNL2024 https://t.co/3PgFWCU9n6 @RheumNow https://t.co/AZNq9XrTMx
TheDaoIndex KDAO2011 ( View Tweet)
Combining results of urinary IL16, PR3, CD163 at 12 months best predicts kidney function protection at 3 years - @andreafava #RNL2024 @rheumnow https://t.co/0XV0MrhL1F
TheDaoIndex KDAO2011 ( View Tweet)
Low urine IL-16 at 12 months predicted kidney survival much better than proteinuria. Check out AUCs in the this first slide. Dr. @andreafava reviews this potential biomarker. Question if this could also be a possible target for treatment as well?
#RNL2024 @RheumNow https://t.co/cCLRERVXmq
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Dr. Rachel Tate uptoTate ( View Tweet)
Low urinary IL16 levels at 12 months predicts kidney suvial at 3 years better than proteinuria - @Andreafava @rheumnow #RNL2024 https://t.co/AEaL8n2nv8
TheDaoIndex KDAO2011 ( View Tweet)
@andreafava @jhrheumatology
Urinary biomarkers (CD163, IL-16) at 3 months predict the 1 year response better than UPCR
- At 6 & 12 mos predicts renal survival at 3 yrs
- At 12 mos: IL-16 92% accurate, sens 97%, Spec 80% vs UPCR 72% accurate, 75% sens, spec 67%
#ACR2024 @RheumNow https://t.co/YtbCrwrch0
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Eric Dein ericdeinmd ( View Tweet)
Scary! A third of patient with lupus nephritis who are considered complete respondues continue to aaccrue progressive renal damage - @Andreafava @rheumnow #RNL2024 https://t.co/mhu3YoY3YV
TheDaoIndex KDAO2011 ( View Tweet)
1/3 of lupus nephritis patient classified as "complete responders" continued to accrue progressive renal damage despite resolution of proteinuria over 1 year.
Dr. @andreafava reviews GFR trajectories after renal bx at #RNL2024 @RheumNow https://t.co/nYJZWw9jUL
Dr. Rachel Tate uptoTate ( View Tweet)
Myeloid and neutrophil degranulation is involved in disease activation of lupus nephritis. IL16 and CD163 are urinary biomarkers correlating with histologic disease activity “- Dr. @andreafava #RNL2024 @rheumnow https://t.co/YffIRy8B9u
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TheDaoIndex KDAO2011 ( View Tweet)
Urine proteomics in lupus nephritis
IL-16 and CD163 are urinary biomarkers most correlated w/ histologic activity
Myeloid & degranulation sign ass w histo activity -> PR3+cells abundant in LN
@andreafava #RNL2024 @RheumNow https://t.co/AVkZxPXkw3
Eric Dein ericdeinmd ( View Tweet)
@andreafava reviews options other than renal biopsy in the future of Lupus renal disease.
Urine proteomics can detect LN active pathways
IL-16, proinflammatory chemokine, linked to LN activity as potential new biomarker?
#RNL2024 @RheumNow https://t.co/GoEwu09npd
Dr. Rachel Tate uptoTate ( View Tweet)
Proteinuria does NOT correlate with intrarenal activity. Additionally, initial bx was not predictive of ESKD. Dr. Andrea Fava discusses need for second bx but difficulty doing so ie: it's invasive, it has risk, etc. #RNL2024 @RheumNow @andreafava https://t.co/1E5uuBGsO9
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Dr. Rachel Tate uptoTate ( View Tweet)
“90% of repeat biopsy will lead to change in treatment. Get the 2nd biopsy” – Dr. A Fava #RNL2024 @rheumnow https://t.co/wLaZelSeFo
TheDaoIndex KDAO2011 ( View Tweet)
@andreafava: 57% of pts w/ lupus nephritis are asymptomatic
Screen w/ proteinuria- but does NOT correlate w/ intrarenal disease
- Cannot differentiate classes, lagging indicator, does not distinguish inflammation from damage
87% repeat Bx lead to change in Rx
#RNL2024 @RheumNow https://t.co/de66VSKUG1
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Eric Dein ericdeinmd ( View Tweet)
“50% of pts with lupus nephritis are asymptomatic . You have to have a degree of kidney damage before you have proteinuria. Proteinuria does not correlate with intrarenal activity.” – Dr. A Fava #RNL2024 @rheumnow https://t.co/9aHmLG6VjA
TheDaoIndex KDAO2011 ( View Tweet)
ICYMI @eular_org 2023 SLE Treatment guidelines https://t.co/BkGhwQtSor @rheumnow #RNL2024 https://t.co/troJ9D6AGm
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TheDaoIndex KDAO2011 ( View Tweet)
Dr. Kahlenberg reviews the cycle of lupus. #RNL2024 @RheumNow @Kahlenberglab
Genetic > environmental > immune system activation > immunocomplexes > clinical disease https://t.co/Q7T9QpbFlm
Dr. Rachel Tate uptoTate ( View Tweet)
Don’t forget: complement activation by Abs form immune complexes resulting tissue destruction in different organs. - Dr. M Kahlenberg may use AVISE CTD to help determine if pts are in a flare @rheumnow #RNL2024 https://t.co/wdwtq1G3Sn
TheDaoIndex KDAO2011 ( View Tweet)