Details

Autor(en) / Beteiligte

• Kolb, Thilo
• Fischer, Svenja
• Müller, Lisa
• Lübke, Nadine
• Hillebrandt, Jonas
• Andrée, Marcel
• Schmitz, Michael
• Schmidt, Claudia
• Küçükköylü, Seher
• Koster, Lynn
• Kittel, Margarethe
• Weiland, Lea
• Dreyling, Karl W
• Hetzel, Gerd
• Adams, Ortwin
• Schaal, Heiner
• Ivens, Katrin
• Rump, Lars C
• Timm, Jörg
• Stegbauer, Johannes

Titel

Impaired Immune Response to SARS-CoV-2 Vaccination in Dialysis Patients and in Kidney Transplant Recipients

Ist Teil von

• Kidney360, 2021-09, Vol.2 (9), p.1491-1498

Ort / Verlag

United States: American Society of Nephrology

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Patients with kidney failure on dialysis or after renal transplantation have a high risk for severe COVID-19 infection, and vaccination against SARS-CoV-2 is the only expedient prophylaxis. Generally, immune responses are attenuated in patients with kidney failure, however, systematic analyses of immune responses to SARS-CoV-2 vaccination in patients on dialysis and in kidney transplant recipients (KTRs) are still needed. In this prospective, multicentric cohort study, antibody responses to COVID-19 mRNA vaccines (BNT162b2 [BioNTech/Pfizer] or mRNA-1273 [Moderna]) were measured in 32 patients on dialysis and in 28 KTRs. SARS-CoV-2-specific antibodies and neutralization capacity were evaluated and compared with controls ( =78) of a similar age range. After the first vaccination, SARS-CoV-2-specific antibodies were nearly undetectable in patients with kidney failure. After the second vaccination, 93% of the controls and 88% of patients on dialysis but only 37% of KTRs developed SARS-CoV-2-specific IgG above cutoff. Moreover, mean IgG levels were significantly lower in KTRs (54±93 BAU/ml) compared with patients on dialysis (503±481 BAU/ml; <0.01). Both KTRs and patients on dialysis had significantly lower IgG levels compared with controls (1992±2485 BAU/ml; <0.001 and <0.01, respectively). Importantly, compared with controls, neutralizing antibody titers were significantly lower in KTRs and patients on dialysis. After the second vaccination, 76% of KTRs did not show any neutralization capacity against SARS-CoV-2, suggesting impaired seroprotection. Patients with kidney failure show a significantly weaker antibody response compared with controls. Most strikingly, only one out of four KTRs developed neutralizing antibodies against SARS-CoV-2 after two doses of vaccine. These data suggest that vaccination strategies need modification in KTRs and patients on dialysis. Vaccination Against COVID-19 in Chronic Kidney Disease, NCT04743947.