Diagnostic Value of Urinary Ferritin-Creatinine Ratio in Children with Lupus Nephritis

Background and Aim Lupus nephritis (LN) affects 60% of all SLE pediatric patients with 10% progressing to end stage renal disease (ESRD). Urinary ferritin creatinine ratio (UFCR) has been previously proposed as a promising non-invasive biomarker for assessing LN disease activity in adult studies, however, up to our knowledge, there’s not enough data in pediatrics, so, we aimed to assess LN disease activity by UFCR in children with LN. Methods A case control study, where we included SLE patients with LN, and healthy age and gender matched controls. We excluded subjects with active infection at the time of the study. All participants were subjected to detailed medical history, and measurement of level of the urinary Ferritin- Creatinine ratio (UFCR), where we correlated it to the disease activity represented by renal SLEDAI score. Results We included 60 subjects, who were divided equally into SLE with LN, and healthy age and gender matched controls, with mean (±SD) age of 11.71 (±3.37) years. The mean (±SD) duration of SLE and renal disease in lupus nephritis group was 2.58 (±1.99) and 2.3 years (±1.61) years respectively. The measured UFCR was significantly higher in LN group than controls [0.56 (0.35 - 1.53) versus 0.23 (0.14-0.37), p < 0.001], however, UFCR didn’t correlate to disease activity (r = 0.407, p = 0.85). Conclusion the UFCR couldn’t be used as a marker of LN activity in pediatrics, however, longitudinal, and wider scale studies are needed to confirm this relation.