VCAM1 and kidney disorder: described a close correlation between urinary VCAM-1 and nephritis activity on biopsy.6 In other small studies VCAM-1 levels rose prior to a flare and persistently raised levels following clinical resolution was associated with subsequent relapse.3,16 The current gold standard for monitoring renal disease activity is serial renal biopsy; however, VCAM-1 could provide an alternative non-invasive monitoring tool.