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Renal outcomes in IgA nephropathy following inactivated SARS-CoV-2 vaccination

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Abstract

Introduction

There are increasing case reports on de novo or relapsing IgA nephropathy (IgAN) following SARS-CoV-2 vaccines, although the follow-up information on renal outcomes in IgAN patients post-SARS-CoV-2 vaccination is limited. In this study, we evaluated the renal outcomes of IgAN patients following inactivated vaccines.

Methods

We investigated the change in eGFR, proteinuria and hematuria in 113 primary IgAN patients post-vaccination. Worsening proteinuria was defined as an increase in proteinuria by more than 0.5 times and proteinuria > 1 g/d. Univariate and multivariable logistic regression analysis were used to evaluate possible predictors of worsening proteinuria. We then compared the renal outcomes of vaccinated patients after 6 months with 101 unvaccinated patients who were followed during the same period.

Results

A 2.54% (0.64, 8.61) decrease in renal function was observed in post-vaccination patients. Subgroup analysis revealed a significant decrease in eGFR in patients with 30 ≤ eGFR < 60 (mL/min/1.73 m2) post second SARS-CoV-2 dose (n = 18, p = 0.01). In addition, 10 individuals displayed worsening proteinuria post-vaccination, with the proteinuria subsequently ameliorating significantly after 6-month. Multivariate analysis showed that higher eGFR levels was an independent protective factor for worsening proteinuria. The renal outcome tended towards a decrease in eGFR in vaccinated patients after 6 months follow-up, although the difference was not significant (p = 0.06).

Conclusion

Kidney function in IgAN patients tended to worsen after SARS-CoV-2 vaccination, particularly those with initial poor kidney function. This pattern of disease flare appears to be clinically mild, and further research is needed to determine whether the impact on kidney function is long-term.

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Data availability

Data collection and analysis methods for this study are included in this article. Further information may be obtained by asking authors.

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Funding

This study was supported by the Natural Science Foundation of China (NSFC: 81930120).

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Authors and Affiliations

  1. Division of Nephrology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China

    Ke Sun, Da Shang, Chuanming Hao & LingYun Lai

Authors
  1. Ke Sun
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  2. Da Shang
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  3. Chuanming Hao
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  4. LingYun Lai
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Contributions

LYL and CH designed the study protocol. KS and DS contributed to the protocol design. KS drafted the manuscript. LYL revised and approved the final manuscript. All authors revised and approved the final manuscript.

Corresponding author

Correspondence to LingYun Lai.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This study protocol was reviewed and approved by the Ethics Committee of Huashan Hospital, Fudan University (Approval No. KY2023-605). All informed consent will be obtained from all individuals included in the study.

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Cite this article

Sun, K., Shang, D., Hao, C. et al. Renal outcomes in IgA nephropathy following inactivated SARS-CoV-2 vaccination. Clin Exp Nephrol 28, 23–30 (2024). https://doi.org/10.1007/s10157-023-02398-y

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  • DOI: https://doi.org/10.1007/s10157-023-02398-y

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