{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:39:40Z","timestamp":1760060380496,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Endothelial dysfunction is a common feature of end-stage kidney disease, requiring hemodialysis (HD) and antiphospholipid antibody (aPL) persistent positivity. Endothelial dysfunction can be assessed with noninvasive tests such as flow-mediated dilation (FMD). In the HD population, it is not known whether aPL persistent positivity is associated with a more severe endothelial dysfunction. Methods: We performed a cross-sectional study in our HD patients. The FMD of the brachial artery was measured in 17 aPL-positive patients who fulfilled the inclusion criteria and were matched to 17 controls according to age, gender, diabetes mellitus, smoking status and markers of dialysis adequacy (Kt\/V). Results: FMD was significantly lower in the aPL group with a mean of 6.9% and 11.8% in the aPL-positive and the control groups, respectively (mean difference (IC 95%): \u22124.9 (\u22128.3; \u22121.6), p = 0.006). aPL was associated with a higher c-reactive protein level, and longer HD vintage. There was no statistical difference between groups in terms of pre-dialysis urea and urinary output, dialysis adequacy (Kt\/V), and history of cardiovascular disease or treatments. Conclusions: aPL persistent positivity in HD patients was associated with worse endothelial dysfunction, reflected by FMD measurements. These findings have to be confirmed in larger studies.<\/jats:p>","DOI":"10.3390\/jcm14176115","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T12:25:57Z","timestamp":1756470357000},"page":"6115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antiphospholipid Antibody Persistent Positivity Is Associated with Worsened Endothelial Dysfunction in Hemodialysis Patients: A Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1442-9716","authenticated-orcid":false,"given":"Maxime","family":"Taghavi","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"},{"name":"Laboratory of Experimental Nephrology, Department of Biochemistry, Faculty of Medicine, Universit\u00e9 Libre de Bruxelles (ULB), 1070 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saleh","family":"Kaysi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"},{"name":"Laboratory of Experimental Nephrology, Department of Biochemistry, Faculty of Medicine, Universit\u00e9 Libre de Bruxelles (ULB), 1070 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lila","family":"Bekkai","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghita","family":"Debbarh","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8148-0349","authenticated-orcid":false,"given":"Lucas","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edouard","family":"Cubilier","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"},{"name":"Laboratory of Experimental Nephrology, Department of Biochemistry, Faculty of Medicine, Universit\u00e9 Libre de Bruxelles (ULB), 1070 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5198-8536","authenticated-orcid":false,"given":"Anne","family":"Demulder","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology and Haemostasis LHUB-ULB, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1673-5450","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Collart","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-1818","authenticated-orcid":false,"given":"Marie-H\u00e9l\u00e8ne","family":"Antoine","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Nephrology, Department of Biochemistry, Faculty of Medicine, Universit\u00e9 Libre de Bruxelles (ULB), 1070 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00eblle","family":"Nortier","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Department, Brugmann University Hospital, Universit\u00e9 Libre de Bruxelles (ULB), 1020 Brussels, Belgium"},{"name":"Laboratory of Experimental Nephrology, Department of Biochemistry, Faculty of Medicine, Universit\u00e9 Libre de Bruxelles (ULB), 1070 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41581-018-0098-z","article-title":"Endothelium structure and function in kidney health and disease","volume":"15","author":"Fakhouri","year":"2019","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.2215\/CJN.12811216","article-title":"Endothelium-Dependent and -Independent Vascular Function in Advanced Chronic Kidney Disease","volume":"12","author":"Kopel","year":"2017","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.2215\/CJN.01260211","article-title":"Flow-mediated vasodilation in end-stage renal disease","volume":"6","author":"Verbeke","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1177\/0003319708315304","article-title":"Flow-mediated arterial dilation in primary antiphospholipid syndrome","volume":"60","author":"Bilora","year":"2009","journal-title":"Angiology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Harlacher, E., Wollenhaupt, J., Baaten, C.C.F.M.J., and Noels, H. (2022). Impact of Uremic Toxins on Endothelial Dysfunction in Chronic Kidney Disease: A Systematic Review. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23010531"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vel\u00e1squez, M., Rojas, M., Abrahams, V.M., Escudero, C., and Cadavid, \u00c1.P. (2018). Mechanisms of Endothelial Dysfunction in Antiphospholipid Syndrome: Association with Clinical Manifestations. Front. Physiol., 9.","DOI":"10.3389\/fphys.2018.01840"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1093\/eurheartj\/ehz350","article-title":"Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans","volume":"40","author":"Thijssen","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1152\/japplphysiol.00039.2021","article-title":"Flow-mediated dilation analysis coupled with nitric oxide transport to enhance the assessment of endothelial function","volume":"131","author":"Ma","year":"2021","journal-title":"J. Appl. Physiol. (1985)"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1136\/ard-2023-224609","article-title":"2023 ACR\/EULAR antiphospholipid syndrome classification criteria","volume":"82","author":"Barbhaiya","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Feng, W., Qiao, J., Tan, Y., Liu, Q., Wang, Q., Yang, B., Yang, S., and Cui, L. (2024). Interaction of antiphospholipid antibodies with endothelial cells in antiphospholipid syndrome. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1361519"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jaut.2009.07.004","article-title":"Patients with antiphospholipid syndrome display endothelial perturbation","volume":"34","author":"Cugno","year":"2010","journal-title":"J. Autoimmun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1016\/j.jacc.2017.02.058","article-title":"Antiphospholipid Syndrome: Role of Vascular Endothelial Cells and Implications for Risk Stratification and Targeted Therapeutics","volume":"69","author":"Corban","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1001\/jama.2009.1346","article-title":"Vascular abnormalities, paraoxonase activity, and dysfunctional HDL in primary antiphospholipid syndrome","volume":"302","author":"Charakida","year":"2009","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/0961203319897958","article-title":"New insights into antiphospholipid-related endothelial dysfunction by assessment of vascular glycocalyx layer: Results from a preliminary cross-sectional study","volume":"29","author":"Miranda","year":"2020","journal-title":"Lupus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s11926-013-0324-4","article-title":"Inhibition of nitric oxide and antiphospholipid antibody-mediated thrombosis","volume":"15","author":"Mineo","year":"2013","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Taghavi, M., Jabrane, A., Jacobs, L., Mesquita, M.D.C.F., Demulder, A., and Nortier, J. (2024). Antiphospholipid Antibodies Associated with Native Arteriovenous Fistula Complications in Hemodialysis Patients: A Comprehensive Review of the Literature. Antibodies, 13.","DOI":"10.3390\/antib13010001"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"sfae308","DOI":"10.1093\/ckj\/sfae308","article-title":"Antiphospholipid antibody positivity is associated with maturation failure and thrombosis of native arteriovenous fistula: A retrospective study in HD patients","volume":"17","author":"Taghavi","year":"2024","journal-title":"Clin. Kidney J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1038\/ki.2011.477","article-title":"IgA antibodies against \u03b22 glycoprotein I in hemodialysis patients are an independent risk factor for mortality","volume":"81","author":"Serrano","year":"2012","journal-title":"Kidney Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/hdi.12847","article-title":"Antiphospholipid antibodies in end-stage renal disease: A systematic review and meta-analysis","volume":"24","author":"Ames","year":"2020","journal-title":"Hemodial. Int."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Taghavi, M., Lengel\u00e9, A., Laureys, M., Jacobs, L., Kaysi, S., Collart, F., Demulder, A., and Nortier, J. (2024). Antiphospholipid antibodies positivity as a potential risk factor for restenosis following arteriovenous fistula stenting in hemodialysis patients: A pilot study. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1497810"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1016\/j.ekir.2024.04.056","article-title":"Endothelial Dysfunction Biomarkers and CKD Incidence in the REGARDS Cohort","volume":"9","author":"Short","year":"2024","journal-title":"Kidney Int. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/eci.12392","article-title":"TLR4 and NALP3 inflammasome in the development of endothelial dysfunction in uraemia","volume":"45","author":"Caballo","year":"2015","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.atherosclerosis.2011.02.017","article-title":"Endothelial dysfunction, inflammation and atherosclerosis in chronic kidney disease\u2014A cross-sectional study of predialysis, dialysis and kidney-transplantation patients","volume":"216","author":"Banerjee","year":"2011","journal-title":"Atherosclerosis"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.freeradbiomed.2016.12.019","article-title":"Divergent roles of endothelial nitric oxide synthases system in maintaining cardiovascular homeostasis","volume":"109","author":"Godo","year":"2017","journal-title":"Free Radic. Biol. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"102813","DOI":"10.1016\/j.jaut.2022.102813","article-title":"Cardiovascular disease risk in antiphospholipid syndrome: Thrombo-inflammation and atherothrombosis","volume":"128","author":"Tektonidou","year":"2022","journal-title":"J. Autoimmun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1159\/000537679","article-title":"Effect of Hemodialysis with Medium Cut-Off versus High-Flux Membranes on Endothelial Function of Patients with Chronic Kidney Disease","volume":"53","author":"Armani","year":"2024","journal-title":"Blood Purif."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Stanisavljevic, N., Stojanovich, L., Djokovic, A., Todic, B., Dopsaj, V., Saponjski, J., Saponjski, D., Markovic, O., Belizna, C., and Zdravkovic, M. (2022). Asymmetric Dimethylarginine Is a Marker of Endothelial Dysfunction in Thrombotic Antiphospholipid Syndrome Patients. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232012309"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1161\/01.CIR.0000029802.88087.5E","article-title":"A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis","volume":"106","author":"Verma","year":"2002","journal-title":"Circulation"},{"key":"ref_29","first-page":"26","article-title":"Arteriovenous fistula thrombosis in patients on regular hemodialysis: A report of 171 patients","volume":"9","author":"Roozbeh","year":"2006","journal-title":"Arch. Iran. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s10557-020-07010-z","article-title":"Apixaban Downregulates Endothelial Inflammatory and Prothrombotic Phenotype in an In Vitro Model of Endothelial Dysfunction in Uremia","volume":"35","author":"Palomo","year":"2021","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Villari, A., Giurdanella, G., Bucolo, C., Drago, F., and Salomone, S. (2017). Apixaban Enhances Vasodilatation Mediated by Protease-Activated Receptor 2 in Isolated Rat Arteries. Front. Pharmacol., 8.","DOI":"10.3389\/fphar.2017.00480"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1159\/000535618","article-title":"Relationship of Warfarin and Apixaban with Vascular Function in Patients with Atrial Fibrillation","volume":"61","author":"Junejo","year":"2024","journal-title":"J. Vasc. Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Taghavi, M., Jacobs, L., Kaysi, S., Dernier, Y., Cubilier, E., Chebli, L., Laureys, M., Collart, F., Demulder, A., and Antoine, M.H. (2025). Assessment of Arteriovenous Fistula Maturation in Hemodialysis Patients with Persistently Positive Antiphospholipid Antibody: A Prospective Observational Cohort Study. Life, 15.","DOI":"10.3390\/life15020168"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:35:14Z","timestamp":1760034914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":33,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14176115"],"URL":"https:\/\/doi.org\/10.3390\/jcm14176115","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,8,29]]}}}