TMSS Medical College Journal

Background: Lupus nephritis (LN) is a common and serious complication of systemic lupus erythematosus(SLE) and the strongest predictor of poor outcome. Increased activity on N-acetyl-beta-D-glucosaminadase can be used as an early indicator of damage to the tubular epithelium in LN. Objective: In this study our main goal is to evaluate correlations urinary N-acetyl-beta-D-glucosaminidase with proteinuria, SLEDAI-2K (renal), Anti ds DNA antibody titre and serum C3. Materials and Methods: This cross-sectional prospective observational type of study was done among 60 Diagnosed lupus nephritis patients (active and inactive) at Department of Nephrology, Dhaka Medical College Hospital, Dhaka, from January 2018 to December 2018. Results: There was no significant difference in age between active and inactive lupus nephritis patients. Also, most of the patients in both groups were female and serum C3 were significantly lower in active LN than that of inactive LN. ESR, proteinuria, Anti ds DNA Ab titre and uNAG were significantly higher in active LN than that of inactive LN. Also, uNAG is more sensitive than Anti ds DNA antibody titre. Conclusion: Study concluded that uNAG is a useful biomarker which had positive correlation with SLEDAI-2K (significantly), proteinuria, Anti ds DNA Ab titre. uNAG had negative correlation with serum C,. Further large-scale study should be carried out for reaching optimal goal. There is therefore a need for larger prospective studies in Bangladesh for diabetics to evaluate this as well as its cost effectiveness in resource poor-settings.

Lupus nephritis (LN) is one of the most common and most severe manifestations of SLE, affecting up to 60 % of patients at some point of the disease. The highest frequencies of renal involvement are found in juvenile onset-lupus patients (50-80%) as compared to less than 30 % in late-onset lupus (>50 years). In the SLE cohort at Karolinska University hospital, the prevalence of LN was found to be 42 %." Most patients develop nephritis carly in their disease (within 5 years from diagnosis), especially among children and adolescents in whom renal disease is often a presenting feature of SLE. A recent study on LN patients followed between 1975 and 2005 found that although the overall mortality has decreased, it remained stable over the last decade and the risk for end stage renal disease (ESRD) remained constant over the last 30 years. ? In addition, morbidity and mortality is higher among patients with LN compared to SLE patients overall. Although the treatment of LN has improved, not all patients respond to standard immunosuppressive treatment, 35% have at least one renal relapse and 5-20% develop ESRD after 10 years.* In addition, treatment-related toxicity remains a concern. In this study our main goal is to evaluate correlations urinary N-acetyl- beta-D-glucosaminidase with proteinuria, SLEDAI-2K (renal), Anti ds DNA antibody titre and serum C3.