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


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.


  1. Nochy D., Daugas E., Droz D. et al. The intrarenal vascular lesions associated with primary antiphospholipid syndrome. J.Am. Soc. Nephrol. 1999; 10: 507-518.
  2. Nochy D., Daugas E., Thi Huong et al. Kidney involvement in the antiphospholipid syndrome. J. Autoimmun. 2000; 15: 127-132.
  3. Решетняк Т. М., Алекберова 3. С. Антифосфолипидный синдром: серологические маркеры, клинические проявления, классификация, прогноз. Тер. арх. 1998; 12: 74-78.
  4. Bridox F., Vrtovsnik F., Noel C. et al. Renal thrombotic microangiopathy in systemic lupus erythematosus: clinical correlations and long-term renal survival. Nephrol. Dial. Transplant. 1998; 13: 298-304.
  5. Amiga M. C, Garcia-Torres R., Robles M. et al. Renal involvement in primary antiphospholipid syndrome. J. Rheumatol. 1992; 19: 1181-1185.
  6. Daugas E., Nochy D., Thi Huong et al. Antiphospholipid syndrome nephropathy in systemic lupus erythematosus. J. Am. Soc. Nephrol. 2002; 13: 42-52.
  7. Kant K. S., Pollak V. E., Weiss M. A. et al. Glomerular thrombosis in systemic lupus erythematosus: prevalence and significance. Medicine (Baltimore) 1981; 60: 71-86.
  8. Kincaid-Smith P., Fairley K. F., Kloss M. Lupus anticoagulant associated with renal thrombotic microangiography and pregnancy-related renal failure. Quart. J. Med. 1988; 69: 795-815.
  9. Scolari F., Savoldi S., Costantino E. et al. Antiphospholipid syndrome and glomerular thrombosis in the absence of overt lupus nephritis. Nephrol. Dial. Transplant. 1993; 8: 1274-1276.
  10. Hamidou M. A., Moreau A., Jego P. et al. Captopril and aspirin in treatment of renal microangiopathy in primary antiphospholipid syndrome. Am. J. Kidney Dis. 1995; 25: 486-488.
  11. Pietie J. Ch., Kleinknecht D., Bach J. F. Renal manifestation in the antiphospholipid syndrome. In: Asherson R., Cervera R.,Piette J. Ch., Shoenfeld Y., eds. The antiphospholipid syndrome. Boca Raton; New York: CRC Press; 1996: 169-181.
  12. Wilson W. A., Gharavi A. E., Koike T. et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome, Arthr. and Rheum. 1999; 42: 1309-1311.
  13. Козловская Н. Л., Бобкова И. Н., Тареева И. Е., Пономарева И. К. Применение низкомолекулярного гепарина эноксапарина в лечении больных хроническим гломерулонефритом. Клин, фармакол. и тер. 2001; 10: 47-49.
  14. Moss К., Isenberg D. Comparison of renal disease severity and outcome in patients with primary antiphospholipid syndrome, antiphospholipid syndrome secondary to systemic lupus erythematosus (SLE) and SLE alone. Rheumatology 2001; 40: 863-867.
  15. Козловская Н. Л., Швецов М. Ю., Козловская Л. В. Поражение почек у больных системной красной волчанкой с антифосфолипидным синдромом и первичным антифосфолипидным синдромом. В кн.: Успехи нефрологии. М.; 2001. 227-236.
  16. Кутырина И. М., Никишова Т. А., Тареева И. Е. Гипотензивное и диуретическое действие гепарина у больных хроническим гломерулонефритом. Тер. арх. 1985; 6: 78-81.
  17. Gambaro G., Baggio В. Glicosoaminoglicans: a new paradigm in the prevention of proteinuria and progression of glomerular disease. Nephrol. Dial. Transplant. 1996; 11: 762-764.



Abstract - 69


Article Metrics

Metrics Loading ...


  • There are currently no refbacks.

Copyright (c) 2003 Kozlovskaya N.L., Shakhnova E.A., Kushnir V.V., Shilov E.M.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:


© 2018 "Consilium Medicum" Publishing house

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies