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

Abstract

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.

De Novo ANCA-Negative Pauci-Immune Crescentic Glomerulonephritis After COVID-19 mRNA Vaccination: A Case Report

“…Minimal change disease and IgA nephropathy were the most common among these, and the others included pauci-immune CrGN, membranous nephropathy, and collapsing GN. 6 7 8 9 10 11 12 13 14 To our knowledge, this is the first case report of de novo “ANCA-negative” pauci-immune CrGN with extrarenal involvement after COVID-19 mRNA vaccination in an adult patient, with prominent extrarenal involvement which is unusual in ANCA-negative vasculitis. 15 …”

Acute kidney disease following COVID-19 vaccination: a single-center retrospective study

“…We observed that almost all IgAN exhibited gross hematuria (within 2–3 days) after COVID-19 vaccination, similar to the rapid development of IgAN following upper respiratory tract or gastrointestinal tract infection. The post-vaccination glomerular disease mostly evaluated by the changes in eGFR and proteinuria other than hematuria in cohort studies may make IgAN largely underestimated ( 16 , 28 ). As the second most nephritic form in this renal registry, all four patients with de novo biopsy-proven AAN also exhibited nephrotic-range proteinuria to indicate podocyte injury.…”

Vaccination in kidney disease: what did we learn from COVID-19 pandemic

“…IgA nephropathy and minimal change disease were the most dominant kidney disease (more common after mRNA-based vaccines). Standard immunosuppression regimens led to disease remission [72 ▪ ]. Another study investigated the risks of relapsing glomerular disease using data from a centralized pathology registry.…”