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Antiphospholipid Antibody Persistent Positivity Is Associated with Worsened Endothelial Dysfunction in Hemodialysis

Maxime Taghavi1,2, Saleh Kaysi1,2, Lila Bekkai1

  • 1Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium.

Journal of Clinical Medicine
|September 13, 2025
PubMed

Insights

Persistent antiphospholipid antibody (aPL) positivity in hemodialysis (HD) patients is linked to more severe endothelial dysfunction. Flow-mediated dilation (FMD) measurements show significantly reduced vascular function in aPL-positive individuals undergoing HD.

Area of Science:

  • Nephrology
  • Vascular Biology
  • Immunology

Background:

  • Endothelial dysfunction is prevalent in end-stage kidney disease patients requiring hemodialysis (HD).
  • Antiphospholipid antibody (aPL) positivity is a persistent condition in some HD patients.
  • The association between aPL positivity and endothelial dysfunction severity in HD patients is not well-established.

Purpose of the Study:

  • To investigate whether persistent antiphospholipid antibody (aPL) positivity is associated with more severe endothelial dysfunction in hemodialysis (HD) patients.
  • To assess endothelial function using flow-mediated dilation (FMD) in aPL-positive HD patients compared to controls.

Main Methods:

  • A cross-sectional study was conducted on hemodialysis (HD) patients.
  • Flow-mediated dilation (FMD) of the brachial artery was measured in 17 aPL-positive patients and 17 matched controls.
  • Matching criteria included age, gender, diabetes mellitus, smoking status, and dialysis adequacy (Kt/V).

Main Results:

  • FMD was significantly lower in the aPL-positive group (6.9%) compared to the control group (11.8%) (p = 0.006).
  • aPL positivity correlated with higher c-reactive protein levels and longer HD vintage.
  • No significant differences were observed in pre-dialysis urea, urinary output, dialysis adequacy (Kt/V), or cardiovascular history between groups.

Conclusions:

  • Persistent antiphospholipid antibody (aPL) positivity in hemodialysis (HD) patients is associated with worse endothelial dysfunction, as indicated by reduced FMD.
  • These findings suggest a link between aPL status and vascular health in HD patients.
  • Larger studies are needed to confirm these results.

Keywords:
antiphospholipid antibodiesendothelial dysfunctionflow-mediated dilationhemodialysisnitric oxide

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