Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol
Introduction Lupus nephritis (LN) is a frequent complication of SLE, occurring in up to 60% of adult patients and ultimately progressing from acute inflammation to chronicity with fibrosis and end-stage kidney failure in 10%–30% of patients. Racial/ethnic minority patients with lupus have worse long...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-11-01
|
| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/11/2/e001390.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846148688208986112 |
|---|---|
| author | Jill P Buyon Peter M Izmirly Mala Masson Heather T Gold Omar El Shahawy Brooke Cohen |
| author_facet | Jill P Buyon Peter M Izmirly Mala Masson Heather T Gold Omar El Shahawy Brooke Cohen |
| author_sort | Jill P Buyon |
| collection | DOAJ |
| description | Introduction Lupus nephritis (LN) is a frequent complication of SLE, occurring in up to 60% of adult patients and ultimately progressing from acute inflammation to chronicity with fibrosis and end-stage kidney failure in 10%–30% of patients. Racial/ethnic minority patients with lupus have worse long-term outcomes, including progression to end-stage renal disease and overall mortality. A major challenge in the management of patients with SLE is delayed identification of early kidney disease, which ultimately leads to a greater burden on both patients and the health system.Methods and analysis Using a mixed methods approach, this study will develop, adapt and evaluate a home urine sampling protocol with a text-messaging reminder and data capture system for patients at elevated risk of de novo LN or relapse. First, a feasibility pilot using a single-group trial design (n=18) will be implemented, with a feasibility assessment and qualitative, debriefing interviews with patients to further refine the intervention. The second phase is a comparative effectiveness trial of the intervention (n=160) with the primary outcome of biopsy eligibility, that is, the participant has a clinical indication for a kidney biopsy (urine protein–creatinine ratio≥0.5), whether or not the patient actually undergoes the biopsy procedure. The randomised trial includes an economic evaluation of the adapted home urinalysis protocol.Discussion and dissemination It is unknown whether weekly home-based urine sampling can identify proteinuria sooner than standard care; if found sooner, kidney problems could be diagnosed earlier, hopefully leading to earlier care for less-involved disease and subsequent reduced morbidity. The data collected in this trial will inform future feasibility and effectiveness of text-messaging-based home urine sampling interventions.Trial registration number The randomised trial will be registered with ClincialTrials.gov prior to enrolment start. |
| format | Article |
| id | doaj-art-9d4b28b7db40492f9ad4a446d8a18fb1 |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-9d4b28b7db40492f9ad4a446d8a18fb12024-11-30T12:00:12ZengBMJ Publishing GroupLupus Science and Medicine2053-87902024-11-0111210.1136/lupus-2024-001390Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocolJill P Buyon0Peter M Izmirly1Mala Masson2Heather T Gold3Omar El Shahawy4Brooke Cohen5Department of Medicine, NYU Grossman School of Medicine, New York City, New York, USADepartment of Medicine, NYU Grossman School of Medicine, New York City, New York, USADepartment of Medicine, NYU Grossman School of Medicine, New York City, New York, USADepartment of Population Health, NYU Grossman School of Medicine, New York City, New York, USADepartment of Population Health, NYU Grossman School of Medicine, New York City, New York, USADepartment of Medicine, NYU Grossman School of Medicine, New York City, New York, USAIntroduction Lupus nephritis (LN) is a frequent complication of SLE, occurring in up to 60% of adult patients and ultimately progressing from acute inflammation to chronicity with fibrosis and end-stage kidney failure in 10%–30% of patients. Racial/ethnic minority patients with lupus have worse long-term outcomes, including progression to end-stage renal disease and overall mortality. A major challenge in the management of patients with SLE is delayed identification of early kidney disease, which ultimately leads to a greater burden on both patients and the health system.Methods and analysis Using a mixed methods approach, this study will develop, adapt and evaluate a home urine sampling protocol with a text-messaging reminder and data capture system for patients at elevated risk of de novo LN or relapse. First, a feasibility pilot using a single-group trial design (n=18) will be implemented, with a feasibility assessment and qualitative, debriefing interviews with patients to further refine the intervention. The second phase is a comparative effectiveness trial of the intervention (n=160) with the primary outcome of biopsy eligibility, that is, the participant has a clinical indication for a kidney biopsy (urine protein–creatinine ratio≥0.5), whether or not the patient actually undergoes the biopsy procedure. The randomised trial includes an economic evaluation of the adapted home urinalysis protocol.Discussion and dissemination It is unknown whether weekly home-based urine sampling can identify proteinuria sooner than standard care; if found sooner, kidney problems could be diagnosed earlier, hopefully leading to earlier care for less-involved disease and subsequent reduced morbidity. The data collected in this trial will inform future feasibility and effectiveness of text-messaging-based home urine sampling interventions.Trial registration number The randomised trial will be registered with ClincialTrials.gov prior to enrolment start.https://lupus.bmj.com/content/11/2/e001390.full |
| spellingShingle | Jill P Buyon Peter M Izmirly Mala Masson Heather T Gold Omar El Shahawy Brooke Cohen Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol Lupus Science and Medicine |
| title | Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol |
| title_full | Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol |
| title_fullStr | Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol |
| title_full_unstemmed | Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol |
| title_short | Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol |
| title_sort | evaluation and randomised controlled trial of home urinalysis testing in patients with sle at elevated risk for developing lupus nephritis a study protocol |
| url | https://lupus.bmj.com/content/11/2/e001390.full |
| work_keys_str_mv | AT jillpbuyon evaluationandrandomisedcontrolledtrialofhomeurinalysistestinginpatientswithsleatelevatedriskfordevelopinglupusnephritisastudyprotocol AT petermizmirly evaluationandrandomisedcontrolledtrialofhomeurinalysistestinginpatientswithsleatelevatedriskfordevelopinglupusnephritisastudyprotocol AT malamasson evaluationandrandomisedcontrolledtrialofhomeurinalysistestinginpatientswithsleatelevatedriskfordevelopinglupusnephritisastudyprotocol AT heathertgold evaluationandrandomisedcontrolledtrialofhomeurinalysistestinginpatientswithsleatelevatedriskfordevelopinglupusnephritisastudyprotocol AT omarelshahawy evaluationandrandomisedcontrolledtrialofhomeurinalysistestinginpatientswithsleatelevatedriskfordevelopinglupusnephritisastudyprotocol AT brookecohen evaluationandrandomisedcontrolledtrialofhomeurinalysistestinginpatientswithsleatelevatedriskfordevelopinglupusnephritisastudyprotocol |