Taghavi Maxime, Kaysi Saleh, Bekkai Lila, Debbarh Ghita, Jacobs Lucas, Cubilier Edouard, Demulder Anne, Collart Frédéric, Antoine Marie-Hélène, Nortier Joëlle
Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium.
Laboratory of Experimental Nephrology, Department of Biochemistry, Faculty of Medicine, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium.
J Clin Med. 2025 Aug 29;14(17):6115. doi: 10.3390/jcm14176115.
: Endothelial dysfunction is a common feature of end-stage kidney disease, requiring hemodialysis (HD) and antiphospholipid antibody (aPL) persistent positivity. Endothelial dysfunction can be assessed with noninvasive tests such as flow-mediated dilation (FMD). In the HD population, it is not known whether aPL persistent positivity is associated with a more severe endothelial dysfunction. : We performed a cross-sectional study in our HD patients. The FMD of the brachial artery was measured in 17 aPL-positive patients who fulfilled the inclusion criteria and were matched to 17 controls according to age, gender, diabetes mellitus, smoking status and markers of dialysis adequacy (Kt/V). : FMD was significantly lower in the aPL group with a mean of 6.9% and 11.8% in the aPL-positive and the control groups, respectively (mean difference (IC 95%): -4.9 (-8.3; -1.6), = 0.006). aPL was associated with a higher c-reactive protein level, and longer HD vintage. There was no statistical difference between groups in terms of pre-dialysis urea and urinary output, dialysis adequacy (Kt/V), and history of cardiovascular disease or treatments. : aPL persistent positivity in HD patients was associated with worse endothelial dysfunction, reflected by FMD measurements. These findings have to be confirmed in larger studies.
内皮功能障碍是终末期肾病的常见特征,需要进行血液透析(HD)且抗磷脂抗体(aPL)持续呈阳性。内皮功能障碍可以通过诸如血流介导的血管舒张(FMD)等非侵入性测试来评估。在血液透析人群中,尚不清楚aPL持续阳性是否与更严重的内皮功能障碍相关。
我们对血液透析患者进行了一项横断面研究。对17名符合纳入标准且根据年龄、性别、糖尿病、吸烟状况和透析充分性指标(Kt/V)与17名对照匹配的aPL阳性患者测量了肱动脉的FMD。
aPL组的FMD显著更低,aPL阳性组和对照组的平均值分别为6.9%和11.8%(平均差异(95%置信区间):-4.9(-8.3;-1.6),P = 0.006)。aPL与更高的C反应蛋白水平以及更长的血液透析病程相关。两组在透析前尿素和尿量、透析充分性(Kt/V)以及心血管疾病史或治疗方面无统计学差异。
血液透析患者中aPL持续阳性与内皮功能障碍恶化相关,这通过FMD测量得以体现。这些发现必须在更大规模的研究中得到证实。