Antiphospholipid Antibodies Significance in Hemodialysis Patients: A Single-Center Cohort Study

Background :Antiphospholipid syndrome (APS) is an autoimmune disease caracterized by arterio-venous thrombotic manifestations and persistently positive antiphospholipid antibodies (APAb) as reported in the revised Sapporo classification criteria. The prevalence of APAb in haemodialysed patients is higher compared to the general population. Their role in the occurrence of vascular access thrombosis remains controversial.This study aims to determine the prevalence of APAb and APS and to evaluate their association with vascular access thrombosis and quality of extrarenal purification in haemodialysis patients.Methods :This is a singler-centre crosse sectional study including 145 haemodialysis patients with available demographic, clinical, biological and immunological parameters (APAb) as well as haemodialysis characteristics.Antiphospholipid biology was defined as persistently positive antibodies (at least 12 weeks apart) without history of clinical manifestation.Results :The prevalence of antiphospholipid biology (APB) and APS were respectively 17.7% (12/ 117) and 10.3% (6/117). Those patients were younger. Antiphospholipid biology is significantly associated with arterial hypertension and diabetes while the antiphospholipid syndrome with dyslipidaemia. Antiphospholipid biology is a significant risk factor for lower Kt/V independently of type of membrane or haemodialysis modality (conventional haemodialysis versus hemodiafiltration). The APS is associated with vascular access thrombosis. Interestingly, patients with one positive APAb at the screening that were controlled negative during the follow-up were still expose to an increased risk of arterial thrombosis (however this did not reach statistical significance, p = 0,054). These patients were not at risk for vascular access thrombosis.Conclusion :Despite a small sample size, we report that antiphospholipid syndrome increases the risk of vascular access thrombosis and is an independent risk factor of a lower Kt/V. O
info:eu-repo/semantics/nonPublished