The prognostic role of hemoglobin, albumin, lymphocyte, and platelets score in peritoneal dialysis.

BACKGROUND

The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) index serves as a novel composite biomarker reflecting both systemic inflammation and nutritional status in clinical practice.

METHODS

This observational cohort study enrolled 892 peritoneal dialysis patients categorized by HALP quartiles (Q1-Q4). Through comprehensive survival analyses including Kaplan-Meier curves and multivariable Cox regression, we systematically evaluated the prognostic value of HALP for mortality outcomes. Predictive performance was rigorously assessed using time-dependent receiver operating characteristic analysis and net reclassification improvement metrics.

RESULTS

The analysis revealed clinically significant findings where patients in the highest HALP quartile demonstrated markedly better survival outcomes compared to the lowest quartile, with hazard ratios of 0.43 (95% CI 0.21-0.86) for all-cause mortality and 0.23 (95% CI 0.08-0.69) for cardiovascular mortality. Importantly, incorporating HALP into prediction models yielded meaningful clinical improvements, elevating the 5-year mortality prediction accuracy from an AUC and achieving a statistically significant net reclassification improvement of 15%.

CONCLUSIONS

These findings establish HALP as a practical and robust prognostic indicator in peritoneal dialysis patients that not only independently predicts mortality risk but also provides substantial incremental value beyond conventional risk factors, offering potential clinical utility for risk stratification and patient management decisions.