AngelWings, as far as I know "presumptive positive bilibrubin" (in a urine test?) is not a big indicator of lupus with kidney involvement. The statement, "Consider confirmation by serum bilirubin if clinically indicated" is a suggestion for a blood test if other symptoms indicate it. High levels of bilirubin in the blood can indicate a gastrointestinal issue much more than kidney involvement.

But presumptive positive bilirubin in the urine may turn out to be completely negative when a more thorough blood test is given. So it's too early to panic or give yourself a diagnosis.

The sed rate is not specific for any particular disorder. It measures markers for inflammation, which can come from many different things in any part of the body. But the test can't tell what's causing the elevated sed rate.

Most North Americans and Europeans have lower than optimum blood Vitamin D levels. The darker a person's natural skin pigment and the less time skin is exposed to the unblocked sun, the more likely people are to have low Vitamin D levels. Natural Vitamin D is absorbed into the body through natural skin oils that must sit on the skin for 24-48 hours and it's theorized that one of the reasons modern people suffer so much from low Vitamin D levels is because we bathe frequently and not as many people work in the sun.

If you have any worries or concerns about these tests, it's important for you to talk to the doctor who ordered them. The negative ANA test is something to take comfort in. It's way too early to jump to any conclusions about the other tests. But they don't necessarily point to lupus, much less lupus with kidney involvement. But I'm not a doctor and you do need to have your tests interpreted by the doctor who ordered them. Hope you talk to your doctor soon and then come back and tell us the official news on your results. I wish you the best.