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Thrombotic Microangiopathy and the Kidney
Vicky Brocklebank1,2, Katrina M Wood3, David Kavanagh1,2
1National Renal Complement Therapeutics Centre, Newcastle upon Tyne, Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK.
Clinical Journal of the American Society of Nephrology : CJASN
|October 19, 2017
Summary
Thrombotic microangiopathy, a condition causing low platelets and red blood cell destruction, can lead to kidney injury. Early diagnosis and treatment improve patient outcomes for thrombotic microangiopathy.
Area of Science:
- Nephrology
- Hematology
- Pathology
Background:
- Thrombotic microangiopathy (TMA) encompasses diverse diseases characterized by thrombocytopenia, microangiopathic hemolytic anemia, and organ damage, notably acute kidney injury (AKI).
- TMAs are associated with considerable morbidity and mortality, necessitating a structured approach to management.
- Despite the severity, timely intervention with supportive and specific treatments can lead to favorable outcomes.
Purpose of the Study:
- To provide a comprehensive review of thrombotic microangiopathies.
- To outline a systematic approach for the diagnosis and management of TMAs.
- To discuss the classification, pathology, epidemiology, characteristics, and pathogenesis of TMAs.
Main Methods:
- Literature review and synthesis of existing data on thrombotic microangiopathies.
- Analysis of classification, pathology, epidemiology, and pathogenesis.
- Development of a pragmatic diagnostic and management strategy.
Main Results:
- TMAs present with a triad of thrombocytopenia, microangiopathic hemolytic anemia, and organ injury, frequently including AKI.
- A systematic diagnostic workup and prompt initiation of management are crucial for improving outcomes.
- Effective specific treatments exist for certain TMAs, underscoring the importance of accurate diagnosis.
Conclusions:
- Thrombotic microangiopathies are serious conditions requiring careful investigation and management.
- A pragmatic, systematic approach to diagnosis and treatment can significantly improve patient prognosis.
- Understanding the diverse classifications, pathologies, and pathogenesis aids in effective clinical decision-making.