The urgent need to vaccinate dialysis patients against severe acute respiratory syndrome coronavirus 2: a call to action

Francis, Anna; Baigent, Colin; İkizler, T. Alp; Cockwell, Paul; Jha, Vivekanand

doi:10.1016/j.kint.2021.02.003

Cited by 88 publications

(99 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Few, if any, patient groups have been affected to the same extent as patients with chronic kidney disease (CKD). These patients have amongst the poorest of outcomes if they contract the virus and, in the case of patients on unit based haemodialysis (HD), have been unable to shelter in place to protect themselves [ 1 ] [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients With CKD

Carr

Kronbichler

Graham-Brown

et al. 2021

Kidney International Reports

107

108

View full text Add to dashboard Cite

Introduction The effects of the coronavirus disease 19 (COVID-19) pandemic in particular affect 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) is 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), sample size from 23 to 1140 patients, and follow-up from one week to 1 month after vaccination. 17 of the 35 studies enrolled a control group. In the 22 studies of patients receiving dialysis, the development of antibodies was observed in 18 to 53% after one dose, and in 70 to 96% after two 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 are a few reported cases of relapse or de novo glomerulonephritis, and acute transplant rejection suggesting ongoing surveillance is important. Conclusion Studies are needed to better evaluate the effectiveness of SARS-CoV-2 vaccination in these populations. Rigorous surveillance for long-term adverse effects in patients with autoimmune disease and transplant recipients is required. 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 be updated ( http://www.nephjc.com/news/covid-vaccine ).

show abstract

Section: Introductionmentioning

confidence: 99%

Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients With CKD

Carr

Kronbichler

Graham-Brown

et al. 2021

Kidney International Reports

107

108

View full text Add to dashboard Cite

show abstract

“…The devastation of the COVID-19 (coronavirus disease 2019) pandemic has been rippling through the population of dialyzed patients. Previous studies have reported horrifyingly disproportionate age-adjusted rates of cases, with fatality rates varying from 16% to 32% deaths [ 1 , 2 ]. In the absence of an effective COVID-19 treatment, vaccination is the only chance to improve the extremely poor prognosis in this population.…”

Section: Introductionmentioning

confidence: 99%

Safety and Tolerability of the BNT162b2 mRNA COVID-19 Vaccine in Dialyzed Patients. COViNEPH Project

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: The Pfizer-BioNTech (BNT162b2) COVID-19 mRNA vaccine has demonstrated excellent efficacy and safety in phase 3 trials. However, no dialyzed patients were included, and therefore safety data for this patient group is lacking. The aim of the study was to assess the safety and tolerances of vaccinations with BNT162b2 performed in chronically dialyzed patients. Materials and Methods: We performed a prospective cohort study including a group of 190 dialyzed patients (65% male) at median age 68.0 (55–74) years. 169 (89.0%) patients were treated with hemodialysis and 21 (11.0%) with peritoneal dialysis. The control group consisted of 160 people (61% male) without chronic kidney disease at median age 63 (range 53–77) years. Both groups were vaccinated with BNT162b2 with a 21-day interval between the first and the second dose. Solicited local and systemic reactogenicity, unsolicited adverse events and antipyretic and pain medication use were assessed with a standardized questionnaire. The toxicity grading scales were derived from the FDA Center for Biologics Evaluation and Research guidelines. Results: 59.8% (dose 1), 61.4% (dose 2) and 15.9% (dose 1), 29.4% (dose 2) dialyzed patients reported at least one local and one systemic reaction respectively within seven days after the vaccination. Many local and systemic solicited reactions were observed less frequently in dialyzed patients than in the age and sex matched control group and much less frequently than reported in the pivotal study. They were mostly mild to moderate, short-lived, and more frequently reported in younger individuals and women. No related unsolicited adverse events were observed. Conclusions: We have shown here that BNT162b2, an mRNA vaccine from Pfizer-BioNTech against SARS-COV-2 is safe and well-tolerated by dialyzed patients. The results can be useful for the nephrological community to resolve patients’ doubts and reduce their vaccine hesitancy.

show abstract

“…To the editor: The coronavirus pandemic resulted in devastatingly high rates of infection and mortality (up to 20% and 32%, respectively) for patients receiving in-center hemodialysis (ICHD). 1 The arrival of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines was anxiously awaited. Large trials reported vaccine efficacy of 62% to 95%.…”

Section: Sars-cov-2 Vaccination Programmentioning

confidence: 99%

“…2,3 Data from other vaccines suggested benefit in kidney patients, despite attenuated immune responses. 4 Given the devastating toll of coronavirus disease 2019 (COVID-19), and the kidney community's call to action, 1 we advocated for urgent provision of SARS-CoV-2 vaccines for patients receiving ICHD.…”

Section: Sars-cov-2 Vaccination Programmentioning

confidence: 99%

“…To the editor: We read with great interest the study of Bardin et al, who found an association between longstanding untreated gout and medullary echogenicity, likely due to urate deposition. 1 The linked commentary highlights the controversy regarding the pathogenetic role of gout in kidney damage and chronic kidney disease (CKD). 2 The role of asymptomatic hyperuricemia remains unclear, but a recent study suggests that hyperuricemia with crystal deposition determines progression to CKD.…”

Section: Medullary Tophi: Multiple Microscopic Lesions Can Amount To Significant Renal Damagementioning

confidence: 99%

See 1 more Smart Citation

Answering the call to action: rapid implementation of an in-center hemodialysis SARS-CoV-2 vaccination program

Gleeson

Martin

Bedi

et al. 2021

Kidney International

View full text Add to dashboard Cite

in Singapore, with a 20-station inpatient dialysis center, a large renal inpatient service, and a renal transplant program. Universal masking and visitor screening were implemented 4 ; symptomatic patients were segregated in a dedicated dialysis room, with staff using personal protective equipment. All symptomatic inpatients were tested for SARS-CoV-2 and common RVIs via multiplex polymerase chain reaction.The incidence of HA-RVI during the pandemic dramatically decreased to 0.5 cases per 1000 admissions (1 case, 2186 admissions), compared with 21.7 cases per 1000 admissions (70 cases, 3223 admissions) over the previous 2 years (incidence rate ratio, 0.02; 95% confidence interval, 0.001-0.13; P < 0.001). Notably, zero episodes of HA-RVI were recorded from February to December 2020 (Figure 1). There was no significant difference in the proportion of inpatients tested for common RVIs (26.5%, 581 of 2186 admissions tested during the pandemic; vs. 28.8%, 929 of 3223 admissions tested prepandemic; odds ratio, 0.89; 95% confidence interval, 0.77-1.08; P ¼ 0.07). Despite managing $1600 COVID-19 cases, there was no nosocomial acquisition. Infection prevention measures introduced for COVID-19 mitigate HA-RVI among renal inpatients and should be continued postpandemic. ACKNOWLEDGMENTSAs this study utilized aggregated anonymized data collected as part of routine surveillance, waiver of informed consent was obtained from our hospital's institutional review board. AUTHOR CONTRIBUTIONSWLE conceived and designed the study. WLE and EPC analyzed the data. WLE, CST, and IV drafted the manuscript. CST and IV supervised. 1. Thaunat O, Legeai C, Anglicheau D, et al. French nationwide Registry of Solid Organ Transplant Recipients with COVID-19. IMPact of the COVID-19 epidemic on the moRTAlity of kidney transplant recipients and candidates in a French Nationwide registry sTudy (IMPORTANT). Kidney Int. 2020;98: 1568-1577. 2. Torreggiani M, Fessi H, Piccoli GB. On the need to better protect hemodialysis patients: a comment on "IMPact of the COVID-19 epidemic on the moRTAlity of kidney transplant recipients and candidates in a French Nationwide registry sTudy (IMPORTANT).

show abstract

The urgent need to vaccinate dialysis patients against severe acute respiratory syndrome coronavirus 2: a call to action

Abstract: Graphical abstract

Cited by 88 publications

References 5 publications

Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients With CKD

Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients With CKD

Safety and Tolerability of the BNT162b2 mRNA COVID-19 Vaccine in Dialyzed Patients. COViNEPH Project

Answering the call to action: rapid implementation of an in-center hemodialysis SARS-CoV-2 vaccination program

Contact Info

Product

Resources

About