Abstract: Objective To investigate the predictive value of serum chemokine(C-C motif)ligand 5(CCL5)and chemokine(C-C motif)ligand 13(CCL13)for early renal injury in children with IgA vasculitis(IgAV). Methods A total of 267 children with IgAV treated at the 940th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2023 to March 2025 were enrolled.According to the presence or absence of renal injury,they were divided into an IgA vasculitis with nephritis(IgAVN)group(n=94)and an IgAV-without-nephritis group(n=173).Clinical data were collected.Serum CCL5 and CCL13 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation was used to evaluate the relationship between CCL5 and CCL13 in IgAVN patients.Differences in CCL5 and CCL13 among IgAVN clinical subtypes were compared.Multivariate logistic regression was performed to identify independent risk factors for early renal injury in children with IgAV,and a nomogram was constructed.ROC curves,calibration curves,and decision-curve analysis were used to assess the model’s predictive performance.ROC curve analysis was also used to evaluate the diagnostic value of serum CCL5 and CCL13 for early renal injury. Results The IgAVN group showed significantly older age and higher neutrophil-to-lymphocyte ratio(NLR)than the IgAV group(both P<0.05).Serum CCL5 and CCL13 levels were also markedly elevated in the IgAVN group(both P<0.05).Spearman analysis revealed a significant positive correlation between serum CCL5 and CCL13 in IgAVN patients(r=0.339,P<0.001).CCL5 and CCL13 levels differed among IgAVN clinical subtypes and increased with disease severity(P<0.05).Multivariate logistic regression indicated that increased age,elevated NLR,and higher serum CCL5 and CCL13 levels were independent risk factors for early renal injury in children with IgAV.The nomogram based on these factors demonstrated good predictive performance and clinical utility.ROC curve analysis showed that serum CCL5 and CCL13 were effective biomarkers for diagnosing early renal injury in children with IgAV. Conclusion Elevated serum CCL5 and CCL13 levels are closely associated with early renal injury in pediatric IgAV patients.Combined detection of these markers holds significant value for assessing the occurrence of early renal injury.

Key words: immunoglobulin A vasculitis, immunoglobulin A vasculitis with nephritis, chemokine(C-C motif)ligand 5, chemokine(C-C motif)ligand 13, renal injury, predictive value