%0 Journal Article
%T Evaluating Tubuloglomerular Outcome by Measuring Proteinuria and Neutrophil Gelatinase Associated Lipocalin after Induction of Low-Dose Cyclophosphamide among Patients with Class III/IV Lupus Nephritis
%A Md. Shahadut Hossain
%A Masud Iqbal
%A Md. Kazi Shahnoor Alam
%A Md. Masudul Karim
%A A. K. M. Shahidur Rahman
%A Mahmudul Hasan Sabuz
%A Sujon Sarker
%A Mst Hure Jannat
%A Muhammad Saiful Islam
%A Md. Jiaur Rahman
%A Shahida Islam
%A Nowshin Taslima Hossain
%J Journal of Biosciences and Medicines
%P 75-89
%@ 2327-509X
%D 2025
%I Scientific Research Publishing
%R 10.4236/jbm.2025.137006
%X <b>Background: </b>In lupus nephritis (LN), glomerular dysfunction is evident by proteinuria. Urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) has emerged as a promising biomarker to detect tubular dysfunction. <b>Objective:</b> To evaluate the tubulo-glomerular outcome after induction of Euro-Lupus regimen by measuring proteinuria and NGAL. <b>Methods: </b>This was a quasi-experimental study. Patients were included based on American College of Rheumatology (ACR) criteria. A total of 19 diagnosed lupus nephritis (class III & IV with or without class V) cases were evaluated. Their renal biopsy report was labelled according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS). All patients were treated with low-dose cyclophosphamide (Euro-Lupus regimen) for three months. Patients were assessed at baseline and then monthly up to 3 months of induction. The observed major variables were complete blood count (CBC), lupus serology (ANA, anti-dsDNA, C3, C4, anti-phospholipid), 24-hour urinary total protein (UTP), spot urinary protein creatinine ratio (PCR), spot urinary NGAL, urinary NGAL creatinine ratio, serum creatinine, serum albumin and estimated glomerular filtration rate (e-GFR). The activity index (AI), chronicity index (CI) and disease activity over time (SLEDAI) were assessed accordingly. <b>Results:</b> Mean age of the study population was 29 &#177; 10 years, where 95.5% were female. After 3 months of induction with low-dose cyclophosphamide (Euro-Lupus regimen), hemoglobin, eGFR, and serum albumin level had significantly increased from baseline (p &lt; 0.05), while serum creatinine, UTP, PCR, urinary NGAL and disease activity score were significantly decreased (p &lt; 0.05). Complete response was seen in 26.3% study patients and partial response in 36.8% patients after 3 months of induction. Response did not differ significantly in this short period of treatment among different histological types of LN. <b>Conclusion: </b>Induction in lupus nephritis by low-dose cyclophosphamide (Euro-Lupus regimen) reduces proteinuria and urinary NGAL significantly after three months of therapy. This regimen is effective in improving glomerular and tubular dysfunctions of LN.
%K Euro-Lupus Regimen
%K Lupus Nephritis (LN)
%K Neutrophil Gelatinase Associated Lipocalin (NGAL)
%K Proteinuria
%K Tubulo-Glomerular Outcome
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=143946