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Prognostic Value of the HALP Score Compared with Other Inflammatory and Nutritional Indices in IgA Nephropathy
Beyza Nur Benlioglu1, Gizem Korkut2, Ege Girtine1
1Department of Internal Medicine, Ege University Faculty of Medicine, Izmir, Türkiye.
Insights
The Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score shows strong prognostic value in IgA nephropathy (IgAN), predicting kidney disease progression. This index offers better accuracy than traditional factors for managing IgAN patients.
Area of Science:
- Nephrology
- Immunology
- Clinical Biomarkers
Background:
- IgA nephropathy (IgAN) is the most prevalent primary glomerulonephritis with unpredictable renal outcomes.
- Conventional prognostic factors like proteinuria, hypertension, eGFR, and MEST-C classification have limited predictive accuracy.
Purpose of the Study:
- To evaluate the prognostic significance of inflammatory and nutritional indices, specifically the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, in IgAN patients.
- To compare the predictive accuracy of the HALP score against other established indices.
Main Methods:
- Retrospective cohort study of 204 patients with biopsy-proven IgAN.
- Collected baseline demographic, clinical, laboratory, and histopathological data.
- Calculated various inflammatory and nutritional indices (HALP, SII, NLR, PLR, GPS/mGPS, CONUT) and analyzed their association with renal outcomes (progression to end-stage kidney disease - ESKD) using Cox regression, Kaplan-Meier, and ROC analyses.
Main Results:
- During a median follow-up of 39.5 months, 17.1% of patients progressed to ESKD.
- Higher HALP scores were significantly associated with better renal survival.
- HALP independently predicted renal outcomes (HR=0.13, p<0.001) with good prognostic performance (AUC=0.65, p<0.001).
Conclusions:
- The HALP score is a robust and independent prognostic biomarker for IgAN.
- HALP demonstrates superior predictive value compared to other inflammatory and nutritional indices.
- Integrating the HALP score into risk-stratification models may improve prognostic assessment and clinical management of IgAN.
Purpose:
IgA nephropathy (IgAN) is the most common primary glomerulonephritis and is characterized by highly variable renal outcomes. Conventional prognostic factors, including proteinuria, hypertension, estimated glomerular filtration rate (eGFR), and the MEST-C classification, provide limited predictive accuracy. This study aimed to evaluate the prognostic value of inflammatory and nutritional indices, particularly the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, in patients with IgAN.
Patients And Methods:
This retrospective cohort included 204 patients with biopsy-proven IgAN. Baseline demographic, clinical, laboratory, and histopathological data were collected. Inflammatory and nutritional indices (HALP, Systemic Immune-Inflammation Index [SII], Neutrophil-to-Lymphocyte Ratio [NLR], Platelet-to-Lymphocyte Ratio [PLR], Glasgow Prognostic Score [GPS/mGPS], and Controlling Nutritional Status [CONUT]) were calculated from routine laboratory parameters. Associations with renal outcomes, particularly progression to end-stage kidney disease (ESKD), were analyzed using Cox regression, Kaplan-Meier survival, and receiver operating characteristic (ROC) analyses.
Results:
During a median follow-up of 39.5 months, 17.1% of patients progressed to ESKD. Higher HALP scores were significantly associated with better renal survival, whereas other indices showed no consistent prognostic value. In multivariate analysis, HALP remained an independent predictor of renal outcome (hazard ratio = 0.13; p < 0.001). ROC analysis confirmed its prognostic performance (AUC = 0.65; 95% CI: 0.56-0.74; p < 0.001) with an optimal cut-off value of 42.4 (sensitivity: 72.7%; specificity: 55.0%).
Conclusion:
The HALP score is a strong and independent prognostic biomarker in IgAN, outperforming other inflammatory and nutritional indices. Incorporating HALP into current risk-stratification models may enhance prognostic assessment and guide clinical management.
