Thrombotic Microangiopathy and the Kidney

Clin J Am Soc Nephrol. 2018 Feb 7;13(2):300-317. doi: 10.2215/CJN.00620117. Epub 2017 Oct 17.

Abstract

Thrombotic microangiopathy can manifest in a diverse range of diseases and is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and organ injury, including AKI. It can be associated with significant morbidity and mortality, but a systematic approach to investigation and prompt initiation of supportive management and, in some cases, effective specific treatment can result in good outcomes. This review considers the classification, pathology, epidemiology, characteristics, and pathogenesis of the thrombotic microangiopathies, and outlines a pragmatic approach to diagnosis and management.

Keywords: Acute Kidney Injury; Anemia; Complement; Hemolytic; Purpura; Thrombotic Microangiopathies; Thrombotic Thrombocytopenic; atypical hemolytic uremic syndrome; glomerular disease; kidney.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / therapy
  • Animals
  • Complement Inactivating Agents / therapeutic use
  • Disease Progression
  • Hemolytic-Uremic Syndrome* / diagnosis
  • Hemolytic-Uremic Syndrome* / epidemiology
  • Hemolytic-Uremic Syndrome* / therapy
  • Humans
  • Plasma Exchange
  • Prognosis
  • Purpura, Thrombocytopenic* / diagnosis
  • Purpura, Thrombocytopenic* / epidemiology
  • Purpura, Thrombocytopenic* / therapy
  • Risk Assessment
  • Risk Factors

Substances

  • Complement Inactivating Agents