Background: Currently, the relationship between serum homocysteine levels and microalbuminuria (MAU) in patients with systemic lupus erythematosus (SLE) remains uncertain. Therefore, our objectives were to assess albuminuria as a potential early indicator of renal involvement in systemic lupus erythematosus, determine the level of blood homocysteine in adults with SLE, and examine the relationship between serum homocysteine and microalbuminuria in SLE patients.

Methods: This cross-sectional study included 48 adult patients with SLE divided equally between 3 groups according to albuminuria, recruited from Internal Medicine Department, Zagazig University Hospitals and compared to 16 healthy individuals as a control group. Serum Homocysteine was measured in all subjects.

Results: Homocysteine displayed statistically significant higher levels among patients with macroalbuminuria followed by patients with microalbuminuria then patients with normoalbuminuria with no statistically significant difference between patients with normoalbuminuria and the control group. It also exhibited significantly higher levels among patients with renal manifestations compared to patients with no renal manifestations. The sensitivity and specificity of serum homocysteine were 94.5% and 94.4%, respectively at a cutoff point 13.1 nmol/mL to detect renal impairment in SLE patients.

Conclusion: The frequency of albuminuria in SLE patients is clearly correlated with higher serum homocysteine levels. Serum homocysteine is a good predictor to renal impairment in SLE patients.