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. Plain Language Summary: IgA nephropathy (IgAN) is the most common kidney disease caused by the body’s immune system attacking its own tissues. The disease can lead to kidney failure in some people, but predicting who will experience this outcome has been difficult. In this study, researchers looked at several simple blood test scores that reflect inflammation and nutrition in the body. Among them, the HALP score—which combines levels of hemoglobin, albumin, lymphocytes, and platelets—was found to be the most useful. The study included 204 adults with biopsy-proven IgAN who were followed for an average of about three years. People with lower HALP scores had a much higher chance of developing kidney failure compared to those with higher scores. Other scores, such as SII, NLR, PLR, GPS, and CONUT, did not show the same reliability. This finding suggests that a single routine blood test can provide helpful information about how a patient’s disease may progress. Doctors could use the HALP score to identify patients who need closer monitoring or earlier treatment to protect their kidneys. Keywords: IgA nephropathy, HALP score, nutritional biomarkers, inflammatory indices, prognosis
Benlioğlu et al. (Wed,) studied this question.