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Antiphospholipid syndrome and the kidneys
Imad Uthman1, Munther Khamashta
1Division of Rheumatology, Faculty of Medicine, American University of Beirut, Medical Center, Beirut, Lebanon. iuthman@aub.edu.lb
Insights
Antiphospholipid antibodies are linked to various kidney diseases, including thrombotic events and glomerulonephritis. Early detection of kidney involvement in antiphospholipid syndrome (APS) can improve patient outcomes.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a prothrombotic state.
- Renal involvement is a significant complication of APS, impacting both primary and secondary forms.
- Understanding the spectrum of kidney diseases associated with antiphospholipid antibodies is crucial for patient management.
Purpose of the Study:
- To investigate the relationship between antiphospholipid antibodies and various kidney diseases.
- To consolidate knowledge on renal manifestations of APS.
- To highlight the importance of early diagnosis of renal complications.
Main Methods:
- Comprehensive literature review of medical studies from 1968 to 2005.
- Utilized MEDLINE database for relevant research.
- Keywords included antiphospholipid syndrome, anticardiolipin antibodies, lupus anticoagulant, and various renal pathologies.
Main Results:
- Renal manifestations stem from thrombosis in arteries, arterioles, glomerular capillaries, and veins.
- Observed conditions include renal artery stenosis, malignant hypertension, infarction, venous thrombosis, and thrombotic microangiopathy.
- Glomerulonephritis, a nonthrombotic condition, is also increasingly reported in APS patients.
Conclusions:
- The kidney is a primary target organ in antiphospholipid syndrome.
- Early identification of renal involvement is key to improving prognosis.
- Further research into nonthrombotic renal manifestations is warranted.
Objectives:
To study the relationship between antiphospholipid antibodies and kidney diseases.
Methods:
We reviewed the medical literature from 1968 to 2005 using MEDLINE and the keywords antiphospholipid syndrome, anticardiolipin antibodies, lupus anticoagulant, hypertension, renal artery stenosis, renal vascular thrombosis, thrombotic microangiopathy, and glomerulonephritis.
Results:
The renal manifestations of the antiphospholipid syndrome may result from thrombosis occurring at any location within the renal vasculature, that is, in the renal artery trunk or branches, intraparenchymal arteries and arterioles, glomerular capillaries, and the renal veins. The spectrum of these manifestations includes renal artery stenosis and/or malignant hypertension, renal infarction, renal vein thrombosis, thrombotic microangiopathy, increased allograft vascular thrombosis, and reduced survival of renal allografts. More recently nonthrombotic conditions like glomerulonephritis have also been reported.
Conclusion:
The kidney appears to be a major target organ in both primary and secondary APS. Early detection of renal involvement may improve the prognosis of these patients.
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