tetano
Editor, Senior Moderator
Can J Kidney Health Dis
. 2024 Jan 29:11:20543581231224127.
doi: 10.1177/20543581231224127. eCollection 2024. Humoral Response Following 3 Doses of mRNA COVID-19 Vaccines in Patients With Non-Dialysis-Dependent CKD: An Observational Study
Omosomi Enilama[SUP] 1 2 [/SUP], Kevin Yau[SUP] 3 4 [/SUP], Lee Er[SUP] 5 [/SUP], Mohammad Atiquzzaman[SUP] 5 [/SUP], Matthew J Oliver[SUP] 3 6 [/SUP], Marc G Romney[SUP] 7 8 [/SUP], Jerome A Leis[SUP] 9 [/SUP], Kento T Abe[SUP] 10 11 [/SUP], Freda Qi[SUP] 11 [/SUP], Karen Colwill[SUP] 11 [/SUP], Anne-Claude Gingras[SUP] 10 11 [/SUP], Michelle A Hladunewich[SUP] 3 6 [/SUP], Adeera Levin[SUP] 5 12 13 [/SUP]
Affiliations
Background: Chronic kidney disease (CKD) is associated with a lower serologic response to vaccination compared to the general population. There is limited information regarding the serologic response to coronavirus disease 2019 (COVID-19) vaccination in the non-dialysis-dependent CKD (NDD-CKD) population, particularly after the third dose and whether this response varies by estimated glomerular filtration rate (eGFR).
Methods: The NDD-CKD (G1-G5) patients who received 3 doses of mRNA COVID-19 vaccines were recruited from renal clinics within British Columbia and Ontario, Canada. Between August 27, 2021, and November 30, 2022, blood samples were collected serially for serological testing every 3 months within a 9-month follow-up period. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike, anti-receptor binding domain (RBD), and anti-nucleocapsid protein (NP) levels were determined by enzyme-linked immunosorbent assay (ELISA).
Results: Among 285 NDD-CKD patients, the median age was 67 (interquartile range [IQR], 52-77) years, 58% were men, 48% received BNT162b2 as their third dose, 22% were on immunosuppressive treatment, and COVID-19 infection by anti-NP seropositivity was observed in 37 of 285 (13%) patients. Following the third dose, anti-spike and anti-RBD levels peaked at 2 months, with geometric mean levels at 1131 and 1672 binding antibody units per milliliter (BAU/mL), respectively, and seropositivity rates above 93% and 85%, respectively, over the 9-month follow-up period. There was no association between eGFR or urine albumin-creatinine ratio (ACR) with mounting a robust antibody response or in antibody levels over time. The NDD-CKD patients on immunosuppressive treatment were less likely to mount a robust anti-spike response in univariable (odds ratio [OR] 0.43, 95% confidence interval [CI]: 0.20, 0.93) and multivariable (OR 0.52, 95% CI: 0.25, 1.10) analyses. An interaction between age, immunoglobulin G (IgG) antibody levels, and time was observed in both unadjusted (anti-spike: P = .005; anti-RBD: P = .03) and adjusted (anti-spike: P = .004; anti-RBD: P = .03) models, with older individuals having a more pronounced decline in antibody levels over time.
Conclusion: Most NDD-CKD patients were seropositive for anti-spike and anti-RBD after 3 doses of mRNA COVID-19 vaccines and we did not observe any differences in the antibody response by eGFR.
Keywords: COVID-19; chronic kidney disease; non-dialysis-dependent; serology; vaccine.
. 2024 Jan 29:11:20543581231224127.
doi: 10.1177/20543581231224127. eCollection 2024. Humoral Response Following 3 Doses of mRNA COVID-19 Vaccines in Patients With Non-Dialysis-Dependent CKD: An Observational Study
Omosomi Enilama[SUP] 1 2 [/SUP], Kevin Yau[SUP] 3 4 [/SUP], Lee Er[SUP] 5 [/SUP], Mohammad Atiquzzaman[SUP] 5 [/SUP], Matthew J Oliver[SUP] 3 6 [/SUP], Marc G Romney[SUP] 7 8 [/SUP], Jerome A Leis[SUP] 9 [/SUP], Kento T Abe[SUP] 10 11 [/SUP], Freda Qi[SUP] 11 [/SUP], Karen Colwill[SUP] 11 [/SUP], Anne-Claude Gingras[SUP] 10 11 [/SUP], Michelle A Hladunewich[SUP] 3 6 [/SUP], Adeera Levin[SUP] 5 12 13 [/SUP]
Affiliations
- PMID: 38292817
- PMCID: PMC10826386
- DOI: 10.1177/20543581231224127
Background: Chronic kidney disease (CKD) is associated with a lower serologic response to vaccination compared to the general population. There is limited information regarding the serologic response to coronavirus disease 2019 (COVID-19) vaccination in the non-dialysis-dependent CKD (NDD-CKD) population, particularly after the third dose and whether this response varies by estimated glomerular filtration rate (eGFR).
Methods: The NDD-CKD (G1-G5) patients who received 3 doses of mRNA COVID-19 vaccines were recruited from renal clinics within British Columbia and Ontario, Canada. Between August 27, 2021, and November 30, 2022, blood samples were collected serially for serological testing every 3 months within a 9-month follow-up period. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike, anti-receptor binding domain (RBD), and anti-nucleocapsid protein (NP) levels were determined by enzyme-linked immunosorbent assay (ELISA).
Results: Among 285 NDD-CKD patients, the median age was 67 (interquartile range [IQR], 52-77) years, 58% were men, 48% received BNT162b2 as their third dose, 22% were on immunosuppressive treatment, and COVID-19 infection by anti-NP seropositivity was observed in 37 of 285 (13%) patients. Following the third dose, anti-spike and anti-RBD levels peaked at 2 months, with geometric mean levels at 1131 and 1672 binding antibody units per milliliter (BAU/mL), respectively, and seropositivity rates above 93% and 85%, respectively, over the 9-month follow-up period. There was no association between eGFR or urine albumin-creatinine ratio (ACR) with mounting a robust antibody response or in antibody levels over time. The NDD-CKD patients on immunosuppressive treatment were less likely to mount a robust anti-spike response in univariable (odds ratio [OR] 0.43, 95% confidence interval [CI]: 0.20, 0.93) and multivariable (OR 0.52, 95% CI: 0.25, 1.10) analyses. An interaction between age, immunoglobulin G (IgG) antibody levels, and time was observed in both unadjusted (anti-spike: P = .005; anti-RBD: P = .03) and adjusted (anti-spike: P = .004; anti-RBD: P = .03) models, with older individuals having a more pronounced decline in antibody levels over time.
Conclusion: Most NDD-CKD patients were seropositive for anti-spike and anti-RBD after 3 doses of mRNA COVID-19 vaccines and we did not observe any differences in the antibody response by eGFR.
Keywords: COVID-19; chronic kidney disease; non-dialysis-dependent; serology; vaccine.