Perspective in Renal Involvement in Antiphospholipid Syndrome: Implications For Diagnosis, Pathogenesis and Treatment

• DOI: 10.20944/preprints202503.1706.v1
• Publication Date: 2025-03-26T05:23:44Z
• Authors: Ariela Hoxha; Dorella Del Prete; Irene Condonato; Francesca K. Martino; Marco Lovisotto; Federico Nalesso; Paolo Simioni
• Keywords: Pathogenesis

Antiphospholipid syndrome (APS) can affect the kidneys, leading to renal artery and vein thrombosis, allograft loss following transplantation, microvascular damage referred as aPL-nephropathy (aPL-N). APL-N is a complex frequently underdiagnosed condition characterized by an incomplete understanding of its etiopathogenesis associated with unfavorable outcomes. The 2023 ACR/EULAR classification criteria for APS included aPL-N within domain. gold standard biopsy, revealing lesions acute thrombotic microangiopathy chronic vascular changes. Nevertheless, reluctance biopsies due anticoagulation thrombocytopenia underscores need noninvasive diagnostics. SCommon clinical features include hypertension, microscopic hematuria, proteinuria, insufficiency. antibodies seem crucial kidney through inflammatory processes. Studies experimental models suggest involvement complement cascade, tissue factor, mammalian target rapamycin activation pathway. Currently, management based mainly on expert opinion, limited evidence supporting use anticoagulants, controversy in their application. Treatment may heparin, intravenous immunoglobulin, plasma exchange, targeted therapies tailored mechanisms. Future multicenter studies are essential clarify roles.