- A serum albumin level of >3.7 g/dL at 1 year postbiopsy for lupus nephritis (LN) predicts a favorable renal outcome 3 years later.
- Levels below this cutoff predict negative renal outcomes.
Why this matters
- LN has 40%-60% morbidity or mortality.
- Serum albumin is a new prognostic biomarker that can guide treatment decisions to prevent long-term disease progression.
- Retrospective cohort of 82 patients with LN studied at the time of biopsy and at 12 and 48 months.
- Primary outcome was adverse renal outcome (ARO) at 48 months, defined as doubling of serum creatinine, as creatinine >4 mg/dL if initial >2.5 mg/dL, or end-stage renal disease.
- The receiver operating characteristic (ROC) curves at 48 months were used to predict ARO.
- Funding: None.
- Higher values of serum albumin at 1 year were associated with lower risk for ARO at 48 months (HR, 0.140; 95% CI, 0.071-0.280).
- The ROC curve at 48 months produced a cutoff of 3.7 g/dL for serum albumin at 1 year, with values above predicting non-ARO and values below predicting ARO.
- Serum albumin had a sensitivity of 94%, specificity of 87%, positive predictive value of 64%, and negative predictive value of 98%.
- Retrospective, observational design.
- No control group.