HALP Score for Predicting Renal Relapse in Lupus Nephritis: A Nested Case-Control Study

Area of Science:

• Nephrology
• Rheumatology
• Clinical Biomarkers

Background:

• Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus.
• Predicting renal relapse (RR) in LN patients is crucial for timely intervention.
• The HALP (hemoglobin-albumin-lymphocyte-platelet) score is a novel composite biomarker.

Purpose of the Study:

• To evaluate the predictive value of the HALP score at diagnosis for renal relapse in LN patients.
• To establish an optimal cutoff for the HALP score in predicting RR.
• To assess the association between HALP score and clinical outcomes in LN.

Main Methods:

• Nested case-control study involving adult LN patients diagnosed between 2010-2022.
• Patients divided into training and validation sets, each with renal relapse (RR) and non-RR groups.
• Cox regression analysis used to determine the association between HALP score and RR.

Main Results:

• An optimal HALP score cutoff of 23.5 was identified in the validation set (AUC 0.896, sensitivity 91.9%, specificity 97.3%).
• A HALP score ≤23.5 was significantly associated with higher baseline SLEDAI-2K, increased long-term damage index, and higher renal biopsy chronicity.
• Patients with HALP score ≤23.5 experienced significantly shorter time to renal relapse (4.2 vs. 12.9 years).

Conclusions:

• A HALP score ≤23.5 at lupus nephritis diagnosis is an independent risk factor for renal relapse.
• The HALP score serves as a valuable tool for early identification of high-risk LN patients.
• This biomarker can guide intensified monitoring and treatment strategies for lupus nephritis.