Abstract: Objective To investigate the levels of serum interleukin(IL)-22, and inflammatory factors including systemic immune inflammatory index(SII), platelet to lymphocyte ratio(PLR) and monocyte to lymphocyte ratio(NLR) in patients with primary IgA nephropathy, and to explore their relationship with the risk factors of clinical progression.Methods A total of 60 patients with primary IgA nephropathy who were admitted in the Affiliated Hospital of Xuzhou Medical University and diagnosed by kidney biopsy were enrolled and their clinical data were collected. Meanwhile, 40 healthy subjects were selected. Their levels of serum IL-22 were detected by ELISA. Furthermore, independent sample t-test, Spearman correlation analysis, ROC curve and binary logistic regression analysis were performed to investigate the role of IL-22 level, and SII, PLR and NLR in evaluating the progression of IgA nephropathy.Results Compared with healthy controls, patients with IgA nephropathy showed remarkable increases in the levels of serum IL-22, SII, PLR and NLR. According to Spearman correlation analysis, IL-22 level was positively related to SII(r=0.342,P=0.001), WBC(r=0.226,P=0.025) and NLR(r=0.371,P=0.000), and negatively related to eGFR(r=-0.296,P=0.003). Furthermore, ROC curve analysis showed that the area under the curve of IL-22 was the largest(0.882), followed by SII(0.766), NLR(0.727) and PLR(0.693). Binary logistic regression analysis indicated that serum IL-22 level was an independent risk factor for IgA nephropathy.Conclusions IL-22 is an independent factor for patients with IgA nephropathy, and the progress of IgA nephropathy can be evaluated by detecting the level of IL-22 in the early stage.