Table 1_The lactate dehydrogenase-to-albumin ratio is independently associated with moderate-to-severe tubulointerstitial fibrosis in patients with IgA nephropathy.docx

Following adjustment for confounders, LAR remained independently associated with fibrosis (OR = 1.425, 95% CI: 1.122–1.809, P = 0.004). The AUC was 0.717, with an optimal cut-off of 4.91 (sensitivity 56.8%, specificity 78.0%). RCS analysis indicated a linear relationship (P for non-linearity = 0.2350).

Subgroup analyses showed consistent positive associations (OR > 1.2), reaching statistical significance in males, patients aged ≥40 years, and those with eGFR ≥60 mL/min/1.73 m². Sensitivity analyses confirmed robustness. Patients with LAR > 4.91 demonstrated worse renal function, heavier proteinuria, and higher fibrosis incidence (54.2% vs. 20.2%, P < 0.001).</p>Conclusion<p>LAR is independently associated with moderate-to-severe tubulointerstitial fibrosis and demonstrates moderate diagnostic efficacy.

As a cost-effective indicator, LAR may serve as a non-invasive auxiliary tool for clinical screening and risk stratification in IgAN, but it cannot replace renal biopsy as the diagnostic gold standard.</p>