Introduction :

Young women are primarily affected by lupus nephritis, which is linked to systemic lupus erythematosus and can seriously harm the kidneys if left untreated. Urine neutrophil gelatinase-associated lipocalin (NGAL) has become a viable non-invasive biomarker due to the invasiveness of renal biopsy. NGAL levels provide crucial information about kidney damage and the efficacy of therapy by indicating the severity of the disease and the response to treatment.

Materials & Methods :

A prospective observational study was conducted at BSMMU, Dhaka, between March 2023 and August 2024. Fifty-two adults with biopsy-proven lupus nephritis were enrolled. Clinical characteristics, urinary NGAL levels, biochemical parameters, and renal histopathology were recorded at baseline and reassessed after six months of therapy.

Results :

The study predominantly involved young females (92.3%), with 69.2% under the age of 30 and 67.3% having a normal weight. A majority were married (80.8%) and resided in urban areas (57.7%). Histologically, 57.7% of participants had class IV lupus nephritis.

All patients were treated with Hydroxychloroquine, while 61.5% also received Cyclophosphamide plus Corticosteroids, 23.1% received MMF plus Corticosteroids, and 15.4% were treated with only Corticosteroids.

A complete response was achieved by 67.3% of the patients. Urinary NGAL levels, a marker of renal inflammation, were highest in patients with class IV lupus nephritis, both at baseline (2.14 ? 1.01 ng/mL) and at 6 months (1.20 ? 0.59 ng/mL), with a significant correlation to disease severity (p < 0.05).

Patients with proliferative lupus nephritis had higher urinary NGAL, elevated serum creatinine, and lower serum albumin levels compared to those with non-proliferative lupus nephritis. Those who experienced a complete response exhibited lower NGAL levels at both baseline (1.39 ? 0.48 ng/mL) and 6 months (0.80 ? 0.25 ng/mL).

Conclusion :

The study highlights the potential of urine NGAL as a valuable biomarker for evaluating disease severity and treatment outcomes in lupus nephritis, suggesting that it could enhance clinical management and inform therapeutic decisions. However, further large-scale, multi-center studies are required to validate its use in routine clinical practice.