ALCAM and lupus nephritis: Urine ALCAM normalized by creatinine, the current gold standard, showed a fold change of 4.06 (Mann Whitney U-Test P = 0.0040) between active and inactive lupus nephritis patients, while normalization of urine ALCAM with urine HVEM showed a similar fold change of 4.41 (Mann Whitney U-Test P = 0.0369) between active and inactive lupus nephritis, as shown in Figures 6A, B).