Renal Activity Index for Lupus (RAIL) of Brunner et al

Description

Brunner et al developed the Renal Activity Index for Lupus (RAIL) to evaluate children and young adults with lupus nephritis. This can help to identify patients with high-levels of activity. The authors are from Cincinnati Children's Hospital and multiple institutions in the United States and Canada.

Patient selection: child or young adult with lupus nephritis

Urine protein panel:

(1) neutropil gelatinase-associated lipocalin (NGAL) in ng/mL

(2) monocyte chemotactic protein 1 (MCP-1) in pg/mL

(3) ceruloplasmin in ng/mL

(4) adiponectin in ng/mL

(5) hemopexin in ng/mL

(6) kidney injury molecule 1 (KIM-1) in pg/mL

RAIL score =

= (0.89 * (MCP1)) + (0.18 * (adiponectin)) + (0.62 * (KIM1)) - (0.34 * (NGAL)) - (0.06 * (ceruloplasmin)) - (0.65 * hemopexin)) - 4.29

Interpretation:

• A RAIL score >= 0.39 correctly identifies 90% of high activity status.

Performance:

• The false positive rate was 14%.

• The accuracy for significant tubulointerstitial disease was > 80%.

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Renal Activity Index for Lupus (RAIL) of Brunner et al

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