Kidney disease in primary anti-phospholipid antibody syndrome

Rheumatology (Oxford). 2017 Jul 1;56(7):1069-1080. doi: 10.1093/rheumatology/kew307.

Abstract

APS is an autoimmune disease defined by the presence of arterial or venous thrombotic events and/or pregnancy morbidity in patients who test positive for aPL. APS can be isolated (primary APS) or associated with other autoimmune diseases. The kidney is a major target organ in APS, and renal thrombosis can occur at any level within the vasculature of the kidney (renal arteries, intrarenal vasculature and renal veins). Histological findings vary widely, including ischaemic glomeruli and thrombotic lesions without glomerular or arterial immune deposits on immunofluorescence. Renal involvement in patients with definite APS is treated with long-term anticoagulants as warfarin, but new treatments are being tried. The aim of this article is to review the links between primary APS and kidney disease.

Keywords: anti-phospholipid antibodies; anti-phospholipid–associated nephropathy; kidney disease; primary anti-phospholipid syndrome; thrombosis; treatment.

Publication types

  • Review

MeSH terms

  • Antibodies, Antiphospholipid / immunology
  • Anticoagulants / administration & dosage*
  • Antiphospholipid Syndrome / complications*
  • Antiphospholipid Syndrome / immunology
  • Antiphospholipid Syndrome / pathology
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / pathology
  • Biopsy, Needle
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Kidney Diseases / drug therapy*
  • Kidney Diseases / etiology*
  • Kidney Diseases / pathology
  • Kidney Function Tests
  • Male
  • Renal Artery Obstruction / drug therapy
  • Renal Artery Obstruction / etiology*
  • Renal Artery Obstruction / pathology
  • Renal Veins
  • Risk Assessment
  • Severity of Illness Index
  • Thrombosis / drug therapy*
  • Thrombosis / etiology
  • Thrombosis / pathology

Substances

  • Antibodies, Antiphospholipid
  • Anticoagulants