New urinary biomarkers such as soluble vascular cell adhesion molecule(sVCAM), angiostatin, ceruloplasmin, and osteopontin N-half (OPN N-half)were recently associated with LN activity.(37) When compared to the use of one single marker, combinationsof some of these urinary biomarkers proved better in determining LNactivity.(42-44) However, these biomarkers must bevalidated in longitudinal studies with greater numbers of patients,including children and adolescents. This evidence concerns the gene SPP1 and lobular neoplasia.