International Journal of Drug Delivery Technology
Volume 16, Issue 1, 2026

The relationship between neutrophil-lymphocyte ratio and early renal affection in patients with lupus nephritis

Abeer Hosny Masoud1, Mohamed Ismail Abdelkareem2, Ahmed Okasha Mohamed3, Asmaa Nafady4, Eman Ragab AbdelRadi5

1Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Qena University, Qena, Egypt
Mobile: 01092614220
Email: abeer.hosney@med.svu.edu.eg

2Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Qena University, Qena, Egypt

3Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Assiut, Egypt

4Department of Radiodiagnosis, Faculty of Medicine, Qena University, Qena, Egypt

5Department of Clinical and Chemical Pathology, Faculty of Medicine, Qena University, Qena, Egypt

Received: 26th Aug, 2025; Revised: 23rd Nov, 2025; Accepted: 20th Dec, 2025; Available Online: 16th Jan, 2026

ABSTRACT

Lupus nephritis (LN) remains one of the most severe manifestations of systemic lupus erythematosus, driven by immune-complex deposition, complement activation, and persistent glomerular inflammation. Renal involvement develops in approximately 30.5% of SLE patients and significantly influences long-term morbidity and mortality. Early detection of renal injury is essential, yet conventional markers such as serum creatinine and proteinuria may not capture early inflammatory changes. The neutrophil-lymphocyte ratio (NLR), a simple and inexpensive marker derived from routine blood counts, reflects the combined effects of neutrophilia and lymphopenia associated with systemic inflammation. NLR correlates with classical inflammatory biomarkers including CRP, ESR, IL-6, and TNF-α, and is influenced by heightened neutrophil activation, impaired lymphocyte regulation, and cytokine-driven immune dysregulation characteristic of LN. The aim of this review is to evaluate the relationship between NLR and early renal affection in lupus nephritis, highlighting its pathophysiologic basis, its association with renal activity and fibrosis, and its potential utility as a predictive marker for early renal involvement.

Keywords: Neutrophil-lymphocyte ratio, Lupus nephritis, Systemic lupus erythematosus, Early renal affection.

How to cite this article: Masoud AH, Abdelkareem MI, Mohamed AO, Nafady A, AbdelRadi ER. The relationship between neutrophil-lymphocyte ratio and early renal affection in patients with lupus nephritis. Int J Drug Deliv Technol. 2026;16(1): 519-522; DOI: 10.25258/ijddt.16.1.57

Source of support: Nil.

Conflict of interest: None