Renal manifestations of the antiphospholipid syndrome

The antiphospholipid syndrome is characterized by recurrent arterial and venous thromboses and pregnancy morbidity in association with antiphospholipid antibodies. Recurrent thrombotic events are associated with significant morbidity and mortality. Renal involvement encompasses the whole renal vasculature and may lead to proteinuria, renal impairment, hypertension, and end-stage renal failure. Renal involvement is especially difficult to distinguish from glomerulonephritis when the antiphospholipid syndrome develops in patients with systemic lupus erythematosus. This article reviews the diagnosis and treatment of the major features of this syndrome, with particular reference to the kidney.