title: [Antiphospholipids antibodies and hemodialysis: a frequent association linked to arteriovenous fistula thrombosis].
abstract: Antiphospholipid antibodies (APL) are a heterogeneous family of auto-antibodies that recognize phospholipoproteins bound antigenic epitopes. APL prevalence in patients on chronic hemodialysis ranges from 11 to 37% in the literature. The association of APL with hemodialysis vascular access (VA) thrombosis has already been reported in small studies. In this single center and retrospective study, we defined the APL prevalence and APL risk factors in a large cohort of 192 hemodialysis patients. The association between history of VA thrombosis and APL presence was also analyzed. At least one type of APL was found in 38 patients (19.8%) of which 74% (n=28) had only lupus anticoagulant. Median age of APL positive patients was 68.1years vs. 71.3years in APL negative patients (P=0.02). Smoking history was associated with APL presence: 35.5% of APL positive patients had a smoking history vs only 18.3% of APL negative patients (P=0.04). The multivariate analysis showed an association between the history of VA thrombosis and patient age (HR [IC 95%]=1.04 [1.02-1.06]; P=0.001) or APL presence (HR [IC 95%]=3.03 [1.69-4.42]; P<10(-3)). In conclusion, the prevalence of APL in hemodialysis patients remains high despite hemodialysis techniques improvement: hemodiafiltration, biocompatibility improvements, ultrapure dialysis water. We report that a younger age and past history of smoking are associated with an increased risk of APL presence. The presence of APL, especially lupus anticoagulant, is associated to VA thrombosis in hemodialysis patients.
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France; Institut Phocéen de néphrologie, clinique Bouchard, 13006 Marseille, France. Electronic address: stanislas.bataille@ap-hm.fr.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Bataille
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France; UMRS_1076, VRCM, faculté de pharmacie, Aix-Marseille université, 13385 Marseille cedex 05, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Burtey
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Decourt
authors.affiliation: Laboratoire d'hématologie, hôpital de la Timone, université Aix-Marseille, 13385 Marseille cedex 05, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Frère
authors.affiliation: Laboratoire d'hématologie, hôpital de la Timone, université Aix-Marseille, 13385 Marseille cedex 05, France.
authors.forename: Agathe
authors.initials: A
authors.lastname: Henneuse
authors.affiliation: Laboratoire d'hématologie, hôpital de la Timone, université Aix-Marseille, 13385 Marseille cedex 05, France.
authors.forename: Marie-Françoise
authors.initials: MF
authors.lastname: Aillaud
authors.affiliation: Laboratoire d'hématologie, hôpital de la Timone, université Aix-Marseille, 13385 Marseille cedex 05, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Morange
authors.affiliation: UMRS_1076, VRCM, faculté de pharmacie, Aix-Marseille université, 13385 Marseille cedex 05, France; Medistats, 10, rue de la Conception, 13004 Marseille, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bardin
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Duval
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Sallée
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Noémie
authors.initials: N
authors.lastname: Jourde-Chiche
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Gondouin
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Samson
authors.affiliation: Biostatistiques, institut Phocéen de néphrologie, clinique Bouchard, Marseille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Yvon
authors.initials: Y
authors.lastname: Berland
authors.affiliation: Centre de néphrologie et transplantation rénale, hôpital de la Conception, université Aix-Marseille, 147, boulevard Baille, 13385 Marseille cedex 05, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunet
mesh_terms: D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology*
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Anticoagulant circulant; Anticorps antiphospholipide; Antiphospholipid antibody; Arteriovenous fistula; Fistule artério-veineuse; Hemodialysis; Hémodialyse; Lupus anticoagulant; Thrombose; Thrombosis