Objective  To elucidate the relationship between monocyte/high density lipoprotein cholesterol ratio (MHR) and lupus renal damage.

Methods  Clinical data and laboratory test results were retrospectively reviewed for 130 patients with systemic lupus erythematosus hospitalized at Departments of Rheumatology, Nephrology, Dermatology and Endocrinology between March 2014 and March 2021. They were divided into two groups according to SLEDAI score and degree of renal injury. Clinical characteristics of patients were compared between two groups and MHR was calculated respectively. Multivariate logistic regression model was utilized for examining the risk factors of renal injury in LN patients.

Results  There were 7 males and 123 females. MHR was correlated positively with serum creatinine, age, 24 h urine protein and SLEDAI score, but negatively with eGFR, Hb and ALB (P＜0.05). Multivariate logistic regression analysis revealed high MHR (OR=4.522, 95%CI: 0.213-2.805, P＜0.05), low ALB (OR=0.911, 95%CI: −0.174- −0.012, P＜0.05) and positive anti-SSA antibody (OR=4.511, 95%CI: 0.414-2.599, P＜0.05) were independent risk factors for renal damage in SLE patients.

Conclusions  MHR is correlated closely with renal damage in patients. It may be employed as a readily available inflammatory marker for assessing lupus renal damage.