Lowmolecular heparins in the treatment of APS-nephropathy in primary and secondary antiphospholipid syndrome

Abstract

Aim. To evaluate efficacy of lowmolecular heparin enoxaparin in the treatment of nephropathy in patients with primary and secondary antiphospholipid syndrome (APS). Material and methods. A total of 11 APS-nephropathy patients participated in the study. Of them 8 patients had primary APS and 3 patients had secondary APS. Biopsy of the kidney was made in 5 patients, ultrasonic dopplerography of renal vessels was performed in all 11 patients. Enoxaparin was given as monotherapy to primary APS and combined treatment to secondary APS patients. Results. Enoxaparin decreased proteinuria, arterial pressure, glomerular filtration rate in all the patients. It also promoted normalization of creatinin. Before the anticoagulant treatment a reduction of maximal systolic and diastolic velocities of blood flow have been registered in segmental and interlobar arteries in all APS nephropathy patients compared to healthy subjects. The depletion of renal cortex blood flow beginning with the level of arcuate arteries was also observed in all the patients. Enoxaparin enhanced blood flow in segmental and interlobar arteries. The recovery of blood flow in the arcuate arteries was registered in 6 of 9 patients. Conclusion. Low molecular heparin may be used in the treatment of nephropathy in patients with primary and secondary APS.

Keywords

• antiphospholipid syndrome
• thrombotic microangiopathy
• aps-nephropathy
• low-molecular heparin
• enoxaparin