Abbas K, Naqvi R, Musharraf W, Mubarak M, Lal J. Role of antiphospholipid antibodies in kidney disease: Risk factors, immunopathogenesis, and diagnosis. World J Nephrol 2025; 14(4): 110882 [DOI: 10.5527/wjn.v14.i4.110882]
Corresponding Author of This Article
Khawar Abbas, Professor, Department of Immunology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. drkhawar_imuno@yahoo.com
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Immunology
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Review
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 25, 2025 (publication date) through Dec 23, 2025
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Publication Name
World Journal of Nephrology
ISSN
2220-6124
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Abbas K, Naqvi R, Musharraf W, Mubarak M, Lal J. Role of antiphospholipid antibodies in kidney disease: Risk factors, immunopathogenesis, and diagnosis. World J Nephrol 2025; 14(4): 110882 [DOI: 10.5527/wjn.v14.i4.110882]
World J Nephrol. Dec 25, 2025; 14(4): 110882 Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.110882
Role of antiphospholipid antibodies in kidney disease: Risk factors, immunopathogenesis, and diagnosis
Khawar Abbas, Rubina Naqvi, Wajiha Musharraf, Muhammed Mubarak, Jawahar Lal
Khawar Abbas, Wajiha Musharraf, Department of Immunology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Rubina Naqvi, Department of Nephrology, Sindh Institute of Urology & Transplantation, Karachi 74200, Sindh, Pakistan
Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Jawahar Lal, Department of Internal Medicine, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Co-corresponding authors: Khawar Abbas and Wajiha Musharraf.
Author contributions: Abbas K and Musharraf W contributed equally to the conception and study design; Abbas K, Naqvi R, Musharraf W, and Mubarak M performed relevant research and participated in the primary and final drafting of the manuscript; Naqvi R, Mubarak M, and Lal J critically reviewed and approved the final manuscript. Abbas K and Musharraf W are designated as co-corresponding authors in recognition of their joint and complementary roles in the conceptualization, supervision, and overall management of this research. Both authors provided equal intellectual leadership and served as the primary points of contact throughout the study’s design, data interpretation, manuscript preparation, and revision stages. Abbas K led the methodological design, data analysis framework, and ensured the scientific rigor of the study, whereas Musharraf W coordinated the experimental execution, data validation, and synthesis of the manuscript narrative. Together, they jointly supervised the research team, guided the integration of interdisciplinary inputs, and oversaw correspondence with all collaborators and the journal editorial office. Their equal contribution in strategic decision-making, manuscript refinement, and final approval of the paper justifies their shared responsibility as co-corresponding authors.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Khawar Abbas, Professor, Department of Immunology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. drkhawar_imuno@yahoo.com
Received: June 18, 2025 Revised: July 8, 2025 Accepted: October 13, 2025 Published online: December 25, 2025 Processing time: 188 Days and 21.8 Hours
Abstract
Antiphospholipid antibodies (aPLs) are a heterogeneous group of autoantibodies that include anticardiolipin antibodies, anti-β2 glycoprotein I antibodies, and lupus anticoagulant. The presence of aPLs is the main characteristic feature of antiphospholipid syndrome (APS), an autoimmune disease with multifactorial etiology. Kidney involvement is a well-recognized complication associated with both primary and secondary APS. Kidney involvement in APS presents with renal artery thrombosis, renal vein thrombosis, allograft loss due to thrombosis after kidney transplantation, and injury to the renal microvasculature, also known as APS nephropathy (APSN). APSN is the characteristic manifestation of kidney involvement in APS and occurs as a result of vaso-occlusive disease in the intrarenal vasculature. Diagnosis and risk stratification of APS are complex and still evolving. This review synthesizes and updates the available evidence in literature regarding risk factors, pathogenesis, and diagnosis of APS and APSN.
Core Tip: Antiphospholipid syndrome (APS) is an autoimmune disorder defined by the presence of antiphospholipid antibodies such as anticardiolipin, anti-β2 glycoprotein I, and lupus anticoagulant. Renal involvement is a significant yet underrecognized complication of both primary and secondary APS. Manifestations include renal artery and vein thrombosis, APS nephropathy (APSN), and renal allograft thrombosis. APSN, a hallmark of renal APS, results from vaso-occlusive injury to the intrarenal microvasculature. Accurate diagnosis and risk assessment remain challenging due to evolving criteria and heterogeneous presentation. This review consolidates current evidence on APS and APSN, emphasizing risk factors, underlying mechanisms, and diagnostic approaches.
