BACKGROUND: Immunoglobulin A nephropathy (IgAN), a common primary glomerulonephritis worldwide, has been investigated, and complex factors are involved in disease progression. A group of evidence emerged that nutrition status plays a nonsubstitutable role in the management of chronic kidney disease. Meanwhile, a novel marker of nutrition and inflammation, the prognostic nutritional index (PNI), has been studied in various diseases. Whether PNI can predict the renal outcome of patients with IgAN remains unclear. Thus, we aimed to evaluate the relationships between PNI and clinicopathologic features, renal progression and renal prognosis in patients with IgAN. METHODS: A total of 1,377 patients with biopsy-proven IgAN were recruited for this retrospective study. All patients were divided into two groups based on the cutoff value of PNI: the high group (PNI ≥ 47.1, RESULTS: The correlation test revealed that PNI was positively associated with eGFR ( CONCLUSION: PNI is associated with renal function and pathologic lesions in IgAN patients and could be a novel marker for the evaluation of renal progression and prognosis.