Antiphospholipid Syndrome and the Kidney

Antiphospholipid syndrome (APS) is a rare autoimmune disorder characterized by the persistent positivity of antiphospholipid antibodies (aPLs) along with thrombotic manifestations, obstetrical complications, or nonthrombotic manifestations. The kidney is a major target organ in APS and is associated with poor prognosis. In light of the 2023 American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR) classification criteria for antiphospholipid syndrome, this review aims to cover the expanding data on the broad spectrum of renal involvement in aPL carriers and in patients with APS, including microvascular involvement (antiphospholipid syndrome nephropathy) and macrovascular involvement in native kidneys, and in transplant recipients with primary or secondary antiphospholipid syndrome.