Serum Albumin as an Early Predictor of Proteinuria Recovery in Lupus Nephritis
Bibliographic record
Abstract
Background/Purpose: Proteinuria, a slowly changing marker, is considered the best predictor of long-term renal outcomes in lupus nephritis (LN). In this study, we aimed to determine if serum albumin can serve as an early predictor of combined proteinuria recovery in LN. Methods: We studied patients diagnosed with LN with baseline and follow-up visits at 6-9 and 18-21 months. Receiver operating characteristic (ROC) curves were generated and the area under the curve (AUC) was analysed at different time points to test if serum albumin was a predictor of combined proteinuria recovery response (complete and partial proteinuria recovery, CPR+PPR) and primary efficacy proteinuria recovery (PEPR) at 6-9 and 18-21 months. Results: ROC curves for serum albumin level at baseline did not predict combined proteinuria recovery or PEPR at 6-9 or 18-21 months. However, serum albumin level at 6-9 months predicted combined proteinuria recovery at 6-9 months (AUC 0.77) and PEPR at 6-9 (AUC 0.83) and 18-21 months (AUC 0.83). Serum albumin absolute change (AUC=0.82) and percent change (AUC=0.81) from baseline to 6-9 months predicted the 6-9-month combined proteinuria recovery. Similarly, serum albumin absolute change (AUC=0.84) and percent change (AUC=0.82) from baseline to 18-21 months predicted the 18-21-month combined proteinuria recovery. A less pronounced, but similar signal was observed when PEPR was used as the endpoint at 6-9 (AUC 0.70 and 0.68, respectively) and 18-21 months (AUC 0.73 and 0.71, respectively). Conclusion: Serum albumin may serve as an accessible adjunct to proteinuria in assessing the clinical course and treatment response in LN. Cite this article as: Kharouf F, Tofighi T, Reich HN, Li Q, Su J, Gladman DD, Touma Z. Serum Albumin as an Early Predictor of Proteinuria Recovery in Lupus Nephritis. Mediterr J Rheumatol 2025;36(2):242-250. Article Submitted: 4 Sep 2024; Revised Form: 13 Oct 2024; Article Accepted: 4 Nov 2024; Available Online: 14 May 2025 This work is licensed under a Creative Commons Attribution 4.0 International License. ©2025 The Author(s). https://doi.org/10.31138/mjr.040924.sai
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".