PloS one
Association between the hemoglobin albumin lymphocyte and platelet score and chronic kidney disease: Insights from patient data and animal models
By Zhang W, Wang Y, Ye W and 5 others.
Abstract
Objectives
The hemoglobin, albumin, lymphocytes and platelets (HALP) score, a novel nutritional and inflammatory biomarker, has been used in various chronic disease studies. However, the relationship between the HALP score and chronic kidney disease (CKD) remains poorly elucidated. This study aimed to explore the association between the HALP score and CKD.
Methods
Our analysis encompassed 25,181 adult participants drawn from NHANES cycles spanning 2009-2018. Weighted multivariable logistic regression and generalized additive models (GAMs) were employed to evaluate the independent associations between the HALP score and three outcomes: CKD, albuminuria, and low-estimated glomerular filtration rate (eGFR). CKD was defined as albuminuria (urinary albumin-to-creatinine ratio ≥ 30 mg/g) or low-eGFR (eGFR < 60 mL/min/1.73m2). Threshold effects were examined using two-piecewise linear regression. Subgroup and sensitivity analyses were performed to assess robustness. Receiver operating characteristic (ROC) curve analyses were applied to compare the discriminative capacity of the HALP score with the prognostic nutritional index (PNI), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). A 5/6 nephrectomy rat model of CKD was established to evaluate the HALP values and their components.