(searched for: doi:10.1016/j.kint.2021.05.016)
Kidney International; https://doi.org/10.1016/j.kint.2021.07.026
Two cases of anti–neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis after SARS-CoV-2 vaccination have been reported to date, and both appeared after Moderna (mRNA) vaccination 1Sekar A, Campbell R, Tabbara J, Rastogi P. ANCA glomerulonephritis after the Moderna COVID-19 vaccination. Kidney Int. Published online May 31, 2021:S0085-2538(21)00555-X. doi:10.1016/j.kint.2021.05.017Google Scholar,2Anderegg MA, Liu M, Saganas C, et al. De novo vasculitis after mRNA-1273 (Moderna) vaccination. Kidney Int. Published online June 1, 2021:S0085-2538(21)00554-8. doi:10.1016/j.kint.2021.05.016Google Scholar.
Nephrology Dialysis Transplantation, Volume 36, pp 1565-1569; https://doi.org/10.1093/ndt/gfab215
Kidney International Reports, Volume 6, pp 2292-2304; https://doi.org/10.1016/j.ekir.2021.06.027
Introduction The effects of the coronavirus disease-2019 (COVID-19) pandemic, particularly among those with chronic kidney disease (CKD), who commonly have defects in humoral and cellular immunity, and the efficacy of vaccinations against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are uncertain. Methods To inform public health and clinical practice, we synthesized published studies and preprints evaluating surrogate measures of immunity after SARS-CoV-2 vaccination in patients with CKD, including those receiving dialysis or with a kidney transplant. Results We found 35 studies (28 published, 7 preprints), with sample sizes ranging from 23 to 1140 participants and follow-up ranging from 1 week to 1 month after vaccination. Seventeen of these studies enrolled a control group. In the 22 studies of patients receiving dialysis, the development of antibodies was observed in 18% to 53% after 1 dose and in 70% to 96% after 2 doses of mRNA vaccine. In the 14 studies of transplant recipients, 3% to 59% mounted detectable humoral or cellular responses after 2 doses of mRNA vaccine. After vaccination, there were a few reported cases of relapse or de novo glomerulonephritis, and acute transplant rejection, suggesting a need for ongoing surveillance. Conclusions Studies are needed to better evaluate the effectiveness of SARS-CoV-2 vaccination in these populations. Rigorous surveillance is necessary for detection of long-term adverse effects in patients with autoimmune disease and transplant recipients. For transplant recipients and those with suboptimal immune responses, alternate vaccination platforms and strategies should be considered. As additional data arise, the NephJC COVID-19 page will continue to be updated (http://www.nephjc.com/news/covid-vaccine).
American Journal of Kidney Diseases; https://doi.org/10.1053/j.ajkd.2021.06.004
The international deployment of mass vaccinations for coronavirus disease 2019 (COVID-19) has raised new concerns for caregivers who specialize in kidney disease. A number of reports question the ability of transplanted patients on chronic immunosuppression and patients with end stage kidney disease on dialysis to mount sufficient antibody responses to confer immunity against the virus. At the same time, nephrologists are faced with a small but growing literature of case reports linking COVID-19 vaccines with heightened off-target immune responses leading to the sudden development of de novo or relapsing glomerular diseases.