Role of antiphospholipid antibodies in kidney disease - Risk factors, immunopathogenesis, and diagnosis

Sep 28, 2026

Uploaded by Fans

Antiphospholipid antibodies (aPLs) represent a diverse set of autoantibodies, including anticardiolipin, anti-β2 glycoprotein I, and lupus anticoagulant. Their presence defines antiphospholipid syndrome (APS), an autoimmune disease with multifactorial causes. Kidney involvement is a known complication in both primary and secondary APS, manifesting as renal artery and vein thrombosis, renal allograft loss after transplantation, and microvascular injury termed APS nephropathy (APSN). APSN arises from vaso-occlusive intrarenal vascular disease, while diagnosis and risk stratification remain complex and continually evolving.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Introduction

Antiphospholipid syndrome overview

aPLs and diagnostic criteria

Kidney involvement and APS nephropathy

| W | J | N | World Journal of
Nephrology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Nephrol 2025 December 25; 14(4): 110882 DOI: 10.5527/wjn.v14.i4.110882 ISSN 2220-6124 (online) REVIEW Role of antiphospholipid antibodies in kidney disease: Risk factors, immunopathogenesis, and diagnosis Khawar Abbas, Rubina Naqvi, Wajiha Musharraf, Muhammed Mubarak, Jawahar Lal Specialty type: Immunology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade C Novelty: Grade C Creativity or Innovation: Grade C Scientific Significance: Grade C P-Reviewer: Bo Y, MD, Researcher, China Received: June 18, 2025 Revised: July 8, 2025 Accepted: October 13, 2025 Published online: December 25, 2025 Processing time: 188 Days and 22.2 Hours Khawar Abbas, Wajiha Musharraf, Department of Immunology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan Rubina Naqvi, Department of Nephrology, Sindh Institute of Urology & Transplantation, Karachi 74200, Sindh, Pakistan Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan Jawahar Lal, Department of Internal Medicine, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan Co-corresponding authors: Khawar Abbas and Wajiha Musharraf. Corresponding author: Khawar Abbas, Professor, Department of Immunology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. [drkhawar_imuno@yahoo.com](drkhawar_imuno@yahoo.com) Abstract Antiphospholipid antibodies (aPLs) are a heterogeneous group of autoantibodies that include anticardiolipin antibodies, anti-β2 glycoprotein I antibodies, and lupus anticoagulant. The presence of aPLs is the main characteristic feature of antiphospholipid syndrome (APS), an autoimmune disease with multifactorial etiology. Kidney involvement is a well-recognized complication associated with both primary and secondary APS. Kidney involvement in APS presents with renal artery thrombosis, renal vein thrombosis, allograft loss due to thrombosis after kidney transplantation, and injury to the renal microvasculature, also known as APS nephropathy (APSN) . APSN is the characteristic manifestation of kidney involvement in APS and occurs as a result of vaso-occlusive disease in the intrarenal vasculature. Diagnosis and risk stratification of APS are complex and still evolving. This review synthesizes and updates the available evidence in literature regarding risk factors, pathogenesis, and diagnosis of APS and APSN. Key Words: Antiphospholipid syndrome; Antiphospholipid nephropathy; Antiphospholipid antibodies; Thrombosis; Allograft; Kidney infarction ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. WJN [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 25, 2025 Volume 14 Issue 4 Abbas K et al. Antiphospholipid antibodies in kidney disease Core Tip: Antiphospholipid syndrome (APS) is an autoimmune disorder defined by the presence of antiphospholipid antibodies such as anticardiolipin, anti-β2 glycoprotein I, and lupus anticoagulant. Renal involvement is a significant yet underrecognized complication of both primary and secondary APS. Manifestations include renal artery and vein thrombosis, APS nephropathy (APSN), and renal allograft thrombosis. APSN, a hallmark of renal APS, results from vaso-occlusive injury to the intrarenal microvasculature. Accurate diagnosis and risk assessment remain challenging due to evolving criteria and heterogeneous presentation. This review consolidates current evidence on APS and APSN, emphasizing risk factors, underlying mechanisms, and diagnostic approaches. Citation: Abbas K, Naqvi R, Musharraf W, Mubarak M,

FAQs

What antibodies are included under antiphospholipid antibodies (aPLs) in APS?

aPLs include lupus anticoagulant, anticardiolipin antibodies, and anti-β2 glycoprotein I antibodies directed against phospholipids and phospholipid-binding proteins at cell surfaces.

How does APS affect the kidneys?

Kidney involvement in APS includes renal artery and renal vein thrombosis, renal allograft thrombosis after transplantation, and microvascular injury known as APS nephropathy (APSN).

Why are diagnosis and risk stratification of APS and APSN considered challenging?

Diagnosis and risk stratification are complex because criteria and presentations continue to evolve, and the clinical picture is heterogeneous.

Sep 28, 2026

Uploaded by Fans