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Dekeyser M, Zuily S, Champigneulle J, Eschwège V, Frimat L, Perret-Guillaume C, Wahl D. [Antiphospholipid syndrome in nephrology. Kidney damage and practical aspects of the management]. Nephrol Ther 2013; 10:1-9. [PMID: 24113198 DOI: 10.1016/j.nephro.2013.07.368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 07/19/2013] [Accepted: 07/23/2013] [Indexed: 11/25/2022]
Abstract
The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events, associated with persistent presence of antiphospholipid antibodies. In this syndrome, thromboses may affect all of the vascular tree, renal damage is frequently associated with a specific antiphospholipid syndrome nephropathy. We propose in this review to provide updated recommendations on the management of antiphospholipid syndrome in nephrology. Treatment is based on long-term anticoagulant therapy with or without antiplatelet agents according to clinical events. The use of a conventional nephroprotection must not be forgotten (strict control of blood pressure with drugs blocking the renin-angiotensin-aldosterone system). Catastrophic antiphospholipid syndrome is an extremely severe complication which can threaten the vital prognosis of the patient. This justifies particular surveillance, as well as prevention in high-risk situations. We also illustrate the difficulties of long-term management in these patients, both in dialysis or kidney transplantation.
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Affiliation(s)
- Manon Dekeyser
- Service de néphrologie-hémodialyse-transplantation, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
| | - Stéphane Zuily
- Service de médecine vasculaire, centre de compétence régional des maladies vasculaires rares et systémiques et auto-immunes, institut lorrain du cœur et des vaisseaux Louis-Mathieu, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France; Inserm UMR_S 1116, Nancy University, 54000 Nancy, France
| | | | - Valérie Eschwège
- Laboratoire d'hématologie biologique, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | - Luc Frimat
- Service de néphrologie-hémodialyse-transplantation, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
| | | | - Denis Wahl
- Service de médecine vasculaire, centre de compétence régional des maladies vasculaires rares et systémiques et auto-immunes, institut lorrain du cœur et des vaisseaux Louis-Mathieu, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France; Inserm UMR_S 1116, Nancy University, 54000 Nancy, France
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Hmimech A, Lamchahab M, Benchakroun S. [A confusing renal mass]. Nephrol Ther 2013; 9:171-2. [PMID: 23410949 DOI: 10.1016/j.nephro.2012.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 09/02/2012] [Accepted: 09/03/2012] [Indexed: 11/17/2022]
Affiliation(s)
- Adila Hmimech
- Service Hématologie-Oncologie Pédiatrique, Hôpital 20-Août, Casablanca, Maroc.
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