The hemoglobin, albumin, lymphocyte, and platelet (HALP) score serves as a predictive indicator for the autogenous arteriovenous fistula maturation failure

The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score is an emerging composite indicator that integrates markers of systemic inflammation and nutritional status. This research aims to evaluate the association between the HALP score and the failure of autogenous arteriovenous fistula (AVF) maturation in patients diagnosed with end-stage renal disease (ESRD), as well as to assess its potential predictive utility. A retrospective cohort of 509 ESRD patients who received their first autogenous AVF creation at our institution was enrolled, and their baseline clinical characteristics were compiled. Participants were stratified into two cohorts based on established AVF maturation criteria: a maturation group and a maturation failure group. The HALP score was computed for each patient using the formula: Hemoglobin (g/L) × Albumin (g/L) × Lymphocyte count (/L) / Platelet count (/L). Subsequently, the patient population was divided into four quartiles based on their HALP scores. The relationship between the HALP score and AVF maturation failure was interrogated using both trend analysis and multi-variable adjusted logistic regression models. The analysis revealed that the median HALP score was significantly lower in the maturation failure group compared to the successful maturation group (P < 0.01). When categorized into quartiles (Q1: ≤20.98, Q2: 20.98-32, Q3: 32-49.29, Q4: >49.29), a clear inverse relationship was observed. Using the highest quartile (Q4) as the reference category, patients in the lowest quartile (Q1, HALP ≤ 20.98) demonstrated a substantially elevated risk for AVF maturation failure (Odds Ratio [OR] = 7.34, 95% Confidence Interval [CI] = 3.19-16.89, P < 0.001). In conclusion, among ESRD patients, the HALP score exhibits a significant and independent inverse association with autogenous AVF maturation failure. These findings suggest that the HALP score holds promise as a valuable diagnostic and prognostic tool for estimating the probability of AVF maturation failure.