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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".