&lt;p&gt;Current Knowledge of Vaccinations in Chronic Kidney Disease Patients&lt;/p&gt;

Haddiya, I.

doi:10.2147/ijnrd.s231142

Cited by 30 publications

(32 citation statements)

References 54 publications

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“…( 7 , 8 ) Chronic kidney disease is associated with impaired innate and adaptive immunity, and inadequate antibody production after vaccination has been reported in this population. ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Antibody response to SARS-CoV-2 mRNA vaccine among kidney transplant recipients: a prospective cohort study

Rozen‐Zvi

Yahav

Agur

et al. 2021

Clinical Microbiology and Infection

196

212

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Objectives We aimed to evaluate rates of antibody response to mRNA SARS-CoV-2 vaccine among kidney transplant recipients, and to identify factors associated with reduced immunogenicity. Methods A prospective cohort study including consecutive kidney transplant recipients in a single referral transplant center. Participants were tested for anti-spike (anti-S) antibodies 2-4 weeks following second vaccine dose. Primary outcome was rate of seropositivity. Univariate and multivariate analyses were conducted to identify factors associated with seropositivity. Results Of 308 kidney transplant recipients included, only 112 (36.4%) tested positive for anti-S antibodies 2-4 weeks after receiving the second dose of BNT162b2 vaccine. Median antibody titer was 15.5 AU/mL (interquartile range [IQR] 3.5-163.6). Factors associated with antibody response were higher estimated glomerular filtration rate (eGFR) (odds ratio [OR] 1.025 per ml/min/1.73m 2 , 95% confidence interval [CI] 1.014 - 1.037, p<0.001), lower mycophenolic acid dose (OR 2.347 per 360 mg decrease, 95% CI 1.782 - 3.089, p<0.001), younger age (OR 1.032 per year decrease, 95% CI 1.015 - 1.05, p<0.001) and lower calcineurin inhibitors (CNI) blood level (OR 1.987, 95% CI 1.146 - 3.443, p=0.014). No serious adverse events to the vaccine were reported. Conclusions Kidney transplant recipients demonstrated inadequate antibody response to mRNA SARS-CoV-2 vaccination. Immunosuppression level was a significant factor in this response. Strategies to improve immunogenicity should be examined in future studies.

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Section: Discussionmentioning

confidence: 99%

Antibody response to SARS-CoV-2 mRNA vaccine among kidney transplant recipients: a prospective cohort study

Rozen‐Zvi

Yahav

Agur

et al. 2021

Clinical Microbiology and Infection

196

212

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“…Besides, low kidney function has been shown to impair both the innate and the adaptive immune response with decreased B and T lymphocyte counts, poor lymphocyte activation, impaired monocyte function, inadequate antigen presentation, weakened memory cell generation and low antibody production. These changes become more profound the further the kidney function declines towards CKD 4 and 5 [ 31 ]. In addition, endothelial dysfunction, uremic toxins, oxidative stress, mineral bone disease and persistent low-grade inflammation, which accompany renal impairment, exert a profound detrimental effect on vaccine response [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the antibody response to SARS-COV-2 vaccination amongst kidney transplant recipients at a single nephrology centre

et al. 2022

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Background and objectives Kidney transplant recipients are highly vulnerable to the serious complications of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infections and thus stand to benefit from vaccination. Therefore, it is necessary to establish the effectiveness of available vaccines as this group of patients was not represented in the randomized trials. Design, setting, participants, & measurements A total of 707 consecutive adult kidney transplant recipients in a single center in the United Kingdom were evaluated. 373 were confirmed to have received two doses of either the BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford-AstraZeneca) and subsequently had SARS-COV-2 antibody testing were included in the final analysis. Participants were excluded from the analysis if they had a previous history of SARS-COV-2 infection or were seropositive for SARS-COV-2 antibody pre-vaccination. Multivariate and propensity score analyses were performed to identify the predictors of antibody response to SARS-COV-2 vaccines. The primary outcome was seroconversion rates following two vaccine doses. Results Antibody responders were 56.8% (212/373) and non-responders 43.2% (161/373). Antibody response was associated with greater estimated glomerular filtration (eGFR) rate [odds ratio (OR), for every 10 ml/min/1.73m2 = 1.40 (1.19–1.66), P<0.001] whereas, non-response was associated with mycophenolic acid immunosuppression [OR, 0.02(0.01–0.11), p<0.001] and increasing age [OR per 10year increase, 0.61(0.48–0.78), p<0.001]. In the propensity-score analysis of four treatment variables (vaccine type, mycophenolic acid, corticosteroid, and triple immunosuppression), only mycophenolic acid was significantly associated with vaccine response [adjusted OR by PSA 0.17 (0.07–0.41): p<0.001]. 22 SARS-COV-2 infections were recorded in our cohort following vaccination. 17(77%) infections, with 3 deaths, occurred in the non-responder group. No death occurred in the responder group. Conclusion Vaccine response in allograft recipients after two doses of SARS-COV-2 vaccine is poor compared to the general population. Maintenance with mycophenolic acid appears to have the strongest negative impact on vaccine response.

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“…35 While patients with renal disease retained a lessened immunologic response, fruitful immunization of them is likely, which will reduce the possibility of problems from vaccine-preventable illnesses. 36 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of COVID-19 Vaccines in Patients Under Maintenance Hemodialysis

Mahallawi¹,

Ibrahim²,

Mumena³

2021

RMHP

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Background Several published data on the dialysis population showed that antibody levels decreased after COVID-19 vaccinations in comparison to the overall population. We aimed to illustrate the persistence of humoral response after receiving second dose of the Pfizer or AstraZeneca vaccines in patients under maintenance hemodialysis (HD). Methods A total of 119 adult patients on HD who were recruited from a single hemodialysis center in Madinah, Saudi Arabia. An enzyme-linked immunosorbent assay (ELISA) was utilized to measure the specific antibody response to the spike protein in the serum samples. Results Mean age of patients was 48.5 ± 13.5 years, while mean time since starting the renal dialysis was 5.09 ± 5.29 years. Blood samples were collected after 89.2 ± 25.7 days of receiving the second dose of the vaccines. A very high positive correlation between anti-S IgG antibodies in pre- and post-dialysis was found (r s = 0.93, p < 0.001). Additionally, there was a high positive correlation between anti-S IgG antibody collected at baseline and follow-up blood samples (30 days apart) (r s = 0.82, p < 0.001). Moreover, patients who received Pfizer had significantly higher mean change in anti-S IgG antibodies compared to patients who received AstraZeneca (0.41 ± 0.94 vs 0.03 ± 0.30, respectively, p = 0.026). Conclusion The majority of the patients included in this study were able to yield an immune response to the vaccine after receiving the two doses. Persistence of IgG antibodies in the majority of the patients on HD in response to COVID-19 vaccines is encouraging in terms of continuing to vaccinate this category of patients in addition to monitoring them.

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<p>Current Knowledge of Vaccinations in Chronic Kidney Disease Patients</p>

Cited by 30 publications

References 54 publications

Antibody response to SARS-CoV-2 mRNA vaccine among kidney transplant recipients: a prospective cohort study

Antibody response to SARS-CoV-2 mRNA vaccine among kidney transplant recipients: a prospective cohort study

Evaluating the antibody response to SARS-COV-2 vaccination amongst kidney transplant recipients at a single nephrology centre

Effectiveness of COVID-19 Vaccines in Patients Under Maintenance Hemodialysis

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