Among African-American patients, the best biomarkers that distinguished active LN from inactive disease, with statistical significance, were urine PF-4 (AUC = 0.88), VCAM-1 (AUC = 0.87), properdin (AUC = 0.85), ALCAM (AUC = 0.84), and FcgRIIBC (AUC = 0.82), followed by MCP-1, hemopexin, calpastatin and TFPI, all exceeding the performance of C3/C4 and anti-DNA (Supplementary Table 3 and Fig. 2). Here, ALCAM is linked to lobular neoplasia.