A Systematic Review on Exploring the Role of Uric Acid in Predicting New-Onset Renal Damage in Lupus Nephritis

Background: Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE) that can lead to significant renal damage if not detected and managed early. Hyperuricemia has been proposed as a potential predictive biomarker for renal outcomes in LN. However, gender-specific cut-off values for uric acid and the optimal timing of uric acid testing following LN diagnosis remain unclear.

Methodology: A systematic review was conducted to investigate the utility of hyperuricemia in predicting new-onset renal damage in LN. We searched five prominent databases (PubMed, Medline, Direct Science, Google Scholar, and BMC) for articles published in English within the past decade. Only studies involving participants over 18 years of age with biopsy-proven LN were included in this review.

Results: Ten research papers, encompassing a total of 1,674 patients diagnosed with biopsy-proven LN, were identified. The majority of these papers reported a positive correlation between hyperuricemia and LN, predominantly in female patients. An average follow-up duration of two years was found to have the highest specificity for uric acid as a predictor, with cut-off ranges varying from >4.9 mg/dl to >9.39 mg/dl

Conclusion: This systematic review highlights the potential significance of hyperuricemia as a predictive biomarker for new-onset renal damage in LN. Gender-specific cut-off values for uric acid could enhance the accuracy of prognostic assessment. Uric acid testing, which is affordable and widely accessible across various healthcare settings, may aid in achieving early identification of patients at risk of renal deterioration after LN diagnosis. Further prospective studies are warranted to validate these findings and establish standardized guidelines for incorporating uric acid testing into the clinical management of LN patients.