Antiphospholipid Syndrome Clinical Trial
Official title:
Retrospective Study of the Prevalence of Antiphospholipid Antibodies in the Population of Hemodialysis Patients at the CHU Brugmann Hospital
In patients with a chronic renal disease at the terminal stage, extrarenal epuration is
essential for the control of clinico-biological complications. Two extrarenal epuration
techniques are currently available: peritoneal dialysis (using the peritoneal membrane of the
patient) and hemodialysis, requiring the use of an external biocompatible membrane known as
'dialysis filter'. This technique requires a vascular access (arteriovenous fistula or
dialysis catheter). The thrombosis of vascular accesses represents a major cause of morbidity
and mortality in hemodialysis patients. Thrombosis are more frequent when using synthetic
prosthetic arteriovenous fistula instead of native arteriovenous fistula.
Antiphospholipid Syndrome (APLS) is a rare autoimmune disease characterized by arterial
thrombosis, venous thrombosis and obstetrical complications such as as defined by the
Sidney's criteria.
In the general population, the presence of antiphospholipid antibodies is associated with an
increased risk of thromboembolic events. In the nephrological population, this prevalence is
higher in hemodialysis patients compared to patients on peritoneal dialysis or non-dialyzed
patients. Up to 37% of hemodialysis patients are positive for antiphospholipid antibodies and
this biology is associated with thrombotic events and vascular access thromboses. However,
some studies do not report this association and there is currently no consensus in terms of
the therapeutic management of these patients.
Some factors influencing the positivity for antiphospholipid antibodies have been reported:
smoking, age, the presence of a non-glomerular nephropathy, hypoalbuminaemia, the use of a
central venous catheter for dialysis or the use of a non-biocompatible dialysis membrane.
Taking into account the conflicting data from the literature, it seems important to study the
respective role(s) of 3 types of antiphospholipid antibodies in the occurrence of thrombo-
embolic events in patients undergoing dialysis within the CHU Brugmann Hospital.
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