Antibody response to mRNA SARS-CoV-2 vaccines in haemodialysis patients.

Autor: Paal M; Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany., Arend FM; Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany., Lau T; Dialysezentrum Bad Tölz und Wolfratshausen, Bad Tölz, Germany., Hasmann S; Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany., Soreth-Rieke D; KfH-Nierenzentrum Miesbach, Miesbach, Germany., Sorodoc-Otto J; KfH-Nierenzentrum Germering, Germering, Germany., Beuthien W; KfH-Nierenzentrum Germering, Germering, Germany., Krappe J; Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany., Toepfer M; Dialysezentrum Garmisch-Partenkirchen-Murnau-Weilheim, Murnau am Staffelsee, Germany., von Gersdorff G; Programm 'Qualität in der Nephrologie' (QiN), KfH-Kuratorium für Dialyse und Nierentransplantation, Neu-Isenburg, Germany., Thaller N; KfH-Nierenzentrum Miesbach, Miesbach, Germany., Rau S; Dialysezentrum Bad Tölz und Wolfratshausen, Bad Tölz, Germany., Northoff B; Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany., Teupser D; Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany., Bruegel M; Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany., Fischereder M; Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany., Schönermarck U; Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2021 Jul 06; Vol. 14 (10), pp. 2234-2238. Date of Electronic Publication: 2021 Jul 06 (Print Publication: 2021).
DOI: 10.1093/ckj/sfab127
Abstrakt: Background: Some studies have shown an attenuated immune response in haemodialysis patients after vaccination. The present study examines the humoral response after mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large population of haemodialysis patients from different outpatient dialysis centres.
Methods: We retrospectively assessed antibodies against SARS-CoV-2 spike protein and nucleocapsid protein (chemiluminescence immunoassays, Roche diagnostics) 3-6 weeks after the second mRNA vaccine dose in 179 maintenance haemodialysis and 70 non-dialysis patients (control cohort). Differences in anti-SARS-CoV-2 spike protein titers were statistically analysed with respect to patient-relevant factors, including age, gender, previous coronavirus disease 2019 (COVID-19) infection, systemic immunosuppressive therapy and time on dialysis.
Results: We found a favourable, but profoundly lower SARS-CoV-2 spike protein antibody response in comparison with a non-dialysis cohort (median 253.5 versus 1756 U/mL, P < 0.001). In multivariate analysis, previous COVID-19 infection (P < 0.001) and female gender were associated with a significantly higher vaccine response (P = 0.006) in haemodialysis patients, while there was a significant inverse correlation with increasing patient age and systemic immunosuppression (P < 0.001). There was no statistically significant correlation between the antibody titer and time on dialysis. Immune response in haemodialysis patients with a previous COVID-19 infection led to substantially higher antibody titers that were equal to those of vaccinated non-dialysis individuals with previous infection.
Conclusion: We strongly argue in favour of regular antibody testing after COVID-19 vaccination in haemodialysis patients. Further studies should elucidate the utility of booster vaccinations to foster a stronger and persistent antibody response.
(© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA.)
Databáze: MEDLINE
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