#1249 Impact of HALP score on renal prognosis in IgA nephropathy

Abstract Background and Aims IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis, and 15%–40% of patients develop end-stage renal disease (ESRD) within 10–20 years. New biomarkers are needed to predict the prognosis of IgAN. This study aimed to evaluate the effect of the HALP score (hemoglobin, albumin, lymphocyte, and platelet) on disease prognosis and renal survival in patients with IgAN. Method A total of 204 patients diagnosed with IgAN through kidney biopsy between 2012 and 2023, registered in the nephrology database of Ege University Hospital, were retrospectively analyzed. Patients were categorized into three groups based on their HALP scores: Group 1: HALP <36.6 Group 2: HALP 36.6–51.4 Group 3: HALP >51.4 Numerical variables were presented as median with interquartile range (IQR), and a p-value <0.05 was considered statistically significant. Results Among 204 patients, 67.2% were male, and the median age at diagnosis was 42 years. Patients with a high HALP score had significantly longer mean renal survival compared to those with a low HALP score (P < 0.01) (Fig. 1). ROC analysis was performed to determine the predictive value of HALP, showing that the cutoff value for IgAN patients was 42.4 with 72.7% sensitivity and 55% specificity (Fig. 2). After adjusting for age, gender, hypertension (HT), diabetes mellitus (DM), number of red blood cells in urine, 24-hour proteinuria, use of renin-angiotensin system (RAS) blockers, and number of globally sclerotic glomeruli in biopsy, Cox regression analysis showed that patients with high HALP scores had an 87% lower risk of developing ESRD compared to those with low HALP scores (P < 0.001, HR: 0.13). Conclusion The HALP score is considered a strong predictor of renal prognosis in patients with IgAN. Patients with high HALP scores exhibited better renal survival and a lower risk of ESRD. The HALP score can be used as a prognostic tool in the management of IgAN and may play a significant role in guiding treatment strategies. The results of this study should be validated with larger patient populations.