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Clin Exp Nephrol . Association between COVID-19 vaccination and relapse of glomerulonephritis

tetano

Editor, Senior Moderator
Clin Exp Nephrol


. 2022 Nov 23.
doi: 10.1007/s10157-022-02299-6. Online ahead of print.
Association between COVID-19 vaccination and relapse of glomerulonephritis


Yuki Ota[SUP] 1 [/SUP], Ryoma Kuroki[SUP] 2 [/SUP], Mayu Iwata[SUP] 2 [/SUP], Hiroshi Taira[SUP] 3 [/SUP], Sayumi Matsuo[SUP] 4 [/SUP], Masafumi Kamijo[SUP] 2 [/SUP], Kumiko Muta[SUP] 4 [/SUP], Tomoya Nishino[SUP] 4 [/SUP]



Affiliations

Abstract

Background: Vaccines for coronavirus disease 2019 (COVID-19) have been developed and are recommended for patients with chronic kidney disease; however, it has been reported that glomerulonephritis worsens after vaccination. We aimed to elucidate the incidence and association between COVID-19 vaccination and glomerulonephritis relapse.
Methods: We investigated the onset of renal events and adverse reactions after COVID-19 vaccination in 111 patients diagnosed with glomerulonephritis. Renal events were defined as worsening hematuria, increased proteinuria, and an increased creatine level over 1.5-fold from baseline.
Results: Patients were 57 ± 18 years old (55.9% female) and had an estimated glomerular filtration rate of 57.0 ± 25.0 ml/min/1.73 m[SUP]2[/SUP]. A pathological diagnosis of IgA nephropathy was confirmed in 55.0%, minimal change disease in 22.5%, and membranous nephropathy in 10.8% of the patients. The BNT162b2 (Pfizer) and mRNA-1273 (Moderna) vaccines were administered in 88.2% and 11.7% of the cases, respectively. Renal events were observed in 22.5% of patients, 10.8% had increased proteinuria, 12.6% had worsening hematuria, and 1.8% received additional immunosuppressive treatment. Only 0.9% required temporary hemodialysis from exacerbation of renal dysfunction. Renal events were higher in younger patients (P = 0.02), being highest in those with IgA nephropathy, but there was no difference in the incidence between pathological diagnoses. There was a significantly higher incidence of renal events in patients with fever (P = 0.02).
Conclusions: COVID-19 vaccination and glomerulonephritis relapse may be related, but further research is needed.

Keywords: COVID-19 vaccination; Glomerulonephritis; Relapse.
 
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