Le syndrome des antiphospholipides en néphrologie. Atteinte rénale et aspects pratiques de la prise en charge

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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Submitted on : Monday, May 14, 2018 - 3:15:10 PM
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Manon Dekeyser, Stéphane Zuily, Jacqueline Champigneulle, Valérie Eschwège, Luc Frimat, et al.. Le syndrome des antiphospholipides en néphrologie. Atteinte rénale et aspects pratiques de la prise en charge. Néphrologie et Thérapeutique, Elsevier Masson, 2014, 10 (1), pp.1 - 9. ⟨10.1016/j.nephro.2013.07.368⟩. ⟨hal-01791299⟩

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