Acute interstitial nephritis following SARS-CoV-2 virus vaccination

Liew, Shaw Kang; Nair, Beena; So, Beng; Ponnusamy, Arvind; Bow, Andrew; Woywodt, Alexander

doi:10.5414/cn110753

Cited by 9 publications

(4 citation statements)

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“…The proportion of glomerular diseases increased or decreased significantly after the COVID-19 vaccination program or pandemic. Our Bayesian structural time-series models showed a significant increase in the diagnostic rate of AIN after initiating a nationwide vaccination program or pandemic, supporting the findings of previous case reports [29][30][31]. AIN after COVID-19 is believed to be a direct effect of a virus-induced immune mechanism or an indirect effect of other conditions associated with COVID-19 [31].…”

Section: Discussionsupporting

confidence: 87%

Glomerulonephritis following COVID-19 infection or vaccination: a multicenter study in South Korea

Kim,

Roh

et al. 2024

Kidney Res Clin Pract

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Background: Despite the widespread impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019, COVID-19) and vaccination in South Korea, our understanding of kidney diseases following these events remains limited. We aimed to address this gap by investigating the characteristics of glomerular diseases following the COVID-19 infection and vaccination in South Korea. Methods: Data from multiple centers were used to identify de novo glomerulonephritis (GN) cases with suspected onset following COVID-19 infection or vaccination. Retrospective surveys were used to determine the COVID-19–related histories of patients who were initially not implicated. Bayesian structural time series and autoregressive integrated moving average models were used to determine causality. Results: Glomerular diseases occurred shortly after the infection or vaccination. The most prevalent postinfection GN was podocytopathy (42.9%), comprising primary focal segmental glomerulosclerosis and minimal change disease, whereas postvaccination GN mainly included immunoglobulin A nephropathy (IgAN; 57.9%) and Henoch-Schönlein purpura nephritis (HSP; 15.8%). No patient progressed to end-stage kidney disease. Among the patients who were initially not implicated, nine patients with IgAN/HSP were recently vaccinated against COVID-19. The proportion of glomerular diseases changed during the pandemic in South Korea, with an increase in acute interstitial nephritis and a decrease in pauci-immune crescentic GN. Conclusion: This study showed the characteristics of GNs following COVID-19 infection or vaccination in South Korea. Understanding these associations is crucial for developing effective patient management and vaccination strategies. Further investigation is required to fully comprehend COVID-19’s impact on GN.

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Section: Discussionsupporting

confidence: 87%

Glomerulonephritis following COVID-19 infection or vaccination: a multicenter study in South Korea

Kim,

Roh

et al. 2024

Kidney Res Clin Pract

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“…Immunofluorescence showed focal deposition of C3 (2+) in the tubular basement membrane in 1 out of 3 cases. Currently, only 4 cases of acute TIN and acute kidney injury after COVID vaccination have been reported [ 10 , 11 , 23 , 31 ]. These cases share many aspects with our 3 patients.…”

Section: Discussionmentioning

confidence: 99%

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

et al. 2022

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Introduction: To date, almost 7 billion doses of the different types of vaccine against SARS-CoV-2 have been administered worldwide. Although the severity of new cases of SARS-CoV-2 has progressively decreased, and the pressure on national health systems has declined, the development of de novo glomerular injuries has been suggested. Methods: This study aimed to examine the patients who were hospitalized in our Unit between April and November 2021 and underwent renal biopsy for new-onset urinary abnormalities (UA) and/or renal impairment within 3 months of SARS-CoV-2 vaccination. Results: We identified 17 patients who developed UA and/or renal insufficiency within 3 months of vaccination. Minimal change disease was the most common disease in our cohort (5 patients, 29.4%) followed by acute tubulointerstitial nephritis (TIN; 3 patients, 17.6%), membranous nephropathy (3 patients, 17.6%), and rapidly progressive IgA nephropathy (2 patients, 11.8%). The other 4 patients had a diagnosis of membranoproliferative glomerulonephritis (1 patient), systemic lupus erythematosus (1 patient), ANCA-associated vasculitis (1 patient), and tip-variant focal segmental glomerulosclerosis (1 patient), respectively. Eight out of the 17 patients (47.1%) developed acute kidney injury. Two patients with acute TIN had to start hemodialysis that was discontinued after 1 and 2 months, respectively, due to the recovery of renal function. All patients underwent treatment with corticosteroids and/or immunosuppressants. Discussion: Although it is not possible to conclusively determine whether there is a causal relationship between SARS-CoV-2 vaccination and new-onset nephropathies, based on the appearance of UA and/or renal insufficiency shortly after vaccination, we hypothesize that the immune response to the COVID-19 vaccine may be a trigger of nephropathies. Therefore, our results highlight the need for pharmacovigilance. However, this report should not lead to vaccine hesitation during this pandemic as the benefits of vaccination strongly outweigh the potential risks.

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“…In addition, TIN was superimposed on glomerular pathologies in 25% of patients. Patients with isolated TIN after COVID-19 vaccination have been reported 20,39-42 and may be another unmasking mechanism by exacerbating an unrecognized GN.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, TIN was superimposed on glomerular pathologies in 25% of patients. Patients with isolated TIN after COVID-19 vaccination have been reported 20,[39][40][41][42] and may be another unmasking mechanism by exacerbating an unrecognized GN. According to WHO guidelines, adverse events (AE) following immunization can be defined as any untoward, unfavorable, or unintended medical occurrence after vaccination, not necessarily exhibiting a consistent, causal relationship with the vaccine product.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccination and New Onset Glomerular Disease: Results from the IRocGN2 International Registry

Waldman¹,

Sinaii

Lerma

et al. 2023

Kidney360

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Background:Cases of de novo glomerular disease with various renal histologies have been reported after vaccination against SARS-CoV-2. Causality has not been established and the long-term outcomes are not known. To better characterize the glomerular diseases and clinical course/outcomes, we created the International Registry of COVID-19 vaccination and Glomerulonephritis (IRocGN2) to study in aggregate de novo glomerulonephritis cases suspected after COVID-19 vaccine exposure Methods:A RedCap survey was used for anonymized data collection. Detailed information on vaccination type and timing and glomerular disease histology were recorded in the registry. We collected serial information on laboratory values (before and after vaccination and during follow-up), treatments, and kidney-related outcomes. Results: Ninety-eight glomerular disease cases were entered into the registry over eleven months from 44 centers throughout the world. Median follow-up was 89 days after diagnosis. IgA nephropathy (IgAN) and minimal change disease (MCD) were the most the common kidney diseases reported. Recovery of kidney function and remission of proteinuria was more likely in IgAN and MCD at 4-6 months than with pauci immune glomerulonephritis /vasculitis and membranous nephropathy. Conclusions:Development of glomerular disease after vaccination against SARS-CoV-2 may be a very rare adverse event. Temporal association is present for IgAN and MCD, but causality is not firmly established. Kidney outcomes for IgAN and MCD are favorable. No changes in vaccination risk-benefit assessment is recommended based on these findings.

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Acute interstitial nephritis following SARS-CoV-2 virus vaccination

Cited by 9 publications

References 0 publications

Glomerulonephritis following COVID-19 infection or vaccination: a multicenter study in South Korea

Glomerulonephritis following COVID-19 infection or vaccination: a multicenter study in South Korea

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

COVID-19 Vaccination and New Onset Glomerular Disease: Results from the IRocGN2 International Registry

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