Lupus & antiphospholipid syndrome
Primary antiphospholipid syndrome and the kidney: biopsy-proven insights from two referral Italian centres
Authors' conclusion
Intra-renal involvement in PAPS is rare but heterogeneous, encompassing both vascular and glomerular pathologies.
Study context
- Population
- Patients with primary APS (PAPS) followed 1984–2023 at two Italian referral centres
- Participants
- 258 patients
- Comparison
- PAPS with biopsy-proven intra-renal involvement vs PAPS without renal manifestations
- Intra-renal involvementn = 17
- Outcome
- Prevalence, clinical features, histological spectrum and outcomes of intra-renal involvement in PAPS
Methodological detailsmulticentric, two Italian referral centres
- Multicentric
- Two Italian referral centres
Main finding
As reported in the abstract
Biopsy-proven intra-renal involvement (prevalence)
Underwent renal biopsy
17 of 258
7%
APL nephropathy (aPL-N)
6
2.3%
Alternative glomerular lesions (non-aPL-N)
11
4.2%
Observational data: associations, not effects.
Further findings
CAPS
P = 0.001
Thrombocytopenia
P = 0.006
Epilepsy
P = 0.018
LA positivity
P = 0.002
Presentation of intra-renal involvement
- Acute kidney injury
- 2/17 (12%)
- Nephrotic syndrome
- 5/17 (29%)
- Isolated urinary abnormalities
- 5/17 (29%)
- Different combination of signs/symptoms
- 5
Renal response · 12 months
- Partial renal response in most cases; worse prognosis in aPL-N despite anti-thrombotic treatment
aPL-related events in non-aPL-N
- Non-aPL-N renal disease preceded these events
- 45%
- All non-aPL-N patients had aPL-related events (thrombotic, obstetric, non-thrombotic)
Original publication
Primary antiphospholipid syndrome and the kidney: biopsy-proven insights from two referral Italian centres. Rheumatology (Oxford). Published 13 November 2025. doi:10.
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