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Nephrol Dial Transplant (1992) 7: 1194-1198
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Are antiphospholipid antibodies clinically relevant in dialysis patients?

S. L. Chew1,, R. L. Lins1, R. Daelemans1, P. Zachee1,2, L. S. De Clerck3 and J. Vermylen4

1Department of Nephrology-Hypertension, Stuivenberg General Hospital Antwerp, Belgium 2Department of Haematology,Catholic University of Leuven Belgium 3Department of Immunology, Allergy and Rheumatology, University Hospital Antwerp Edegem, Belgium 4Centre for Thrombosis and Vascular Research, Catholic University of Leuven Leuven, Belgium

Correspondence and offprint requests to: Dr S.L. Chew, Department of Endocrinology, St. Bartholomew's Hospital, London, EC1A 7BE, UK

A cohort of 60 stable dialysis patients (56 haemodialysis, 4 continuous ambulatory peritoneal dialysis) was followed for 1 year to determine the relationship between anticardiolipin (aCL) antibodies and lupus anticoagulant (LA), and clinical events. The outcome measures were death, arterial, venous, and fistula thromboses, and fistula repairs. At baseline 15% had antibodies (5/60 IgG aCL, 3/60 LA, and 1/60 had both); 15 patients had a history of arterial thrombosis (1 patient was aCL positive), seven venous thrombosis (1 patient LA positive), 10 fistulathromboses (1 aCL positive); and 21 had a history of fistula repairs (4 aCL positive). Renal diagnosis, age (66.78 versus 59.67 years) and duration of dialysis (38.11 versus 45.25 months) were similar in patients with and without aCL antibodies or LA. Only the sex ratio showed a female predominance in the aCL- or LA-positive patients compared to the negative patients (3M:6F versus 36M:15F), but this was not significant (p=0.07). After 1 year there were 10 deaths (1 LA positive), 12 thrombotic events in eight patients (none aCL or LA positive), and nine fistula repairs in seven patients (1 aCL-positive patient). We are unable to show higher rates of death, thrombotic event, or fistula repair in dialysis patients with aCL antibodies or LA followed up for 1 year in one centre. The clinical importance of antiphospholipid antibodies in dialysis patients is uncertain

Keywords: anticardiolipin antibodies; antiphospholipid antibodies; continuous ambulatory peritoneal dialysis; end-stage renal disease; haemodialysis; lupus anticoagulant


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