ABSTRACT
@#Introduction: Mass COVID-19 vaccination has been pivotal in the fight against this pandemic. The occurrence of glomerular disease following COVID-19 vaccinations particularly mRNA vaccine has been reported. The reported cases in the region are limited and number of cases reported are low in contrast to the total number of vaccine doses given worldwide, the healthcare providers should be alerted about such issues to provide swift and proper management. Case Series: Here, we report 3 cases of Focal segmental glomerulosclerosis (FSGS) following COVID-19 vaccination and their outcomes. Two of the patients received BNT162b2 vaccination and one received CoronaVac vaccination. The mean age of the patients was 33+/-7 years old. The mean duration onset of FSGS was 23+/-19 days post vaccinations. Two of the patients (BNT162b2 vaccination and CoronaVac vaccination) achieved complete remission after corticosteroid therapy. This is the first reported case of De Novo FSGS following CoronaVac vaccination in the literature. The third patient, who received BNT162b2 vaccination and presented late (42 days post vaccination) was not in remission despite three months of immunosuppressive treatment. Conclusion: The treating physician needs to be aware of the possibility of the development of FSGS associated with COVID-19 vaccination and how to proceed with vaccination schedule in these populations. Overall, the advantage of COVID-19 vaccination far outweighs the possibility of COVID-19 vaccine-associated glomerular disease.
ABSTRACT
Objective: Cardiovascular disease [CVD] is the main cause of morbidity and premature mortality in end stage renal failure patients [ESRD] receiving dialysis. The aim of our study was to evaluate the impact of various risk factors in this group of high CVD risk patients in local population
Methods: We carried out a cross-sectional retrospective study in a single hospital. A total of 136 ESRF patients, consisted of 43 haemodialysis [HD] and 93 continuous ambulatory peritoneal dialysis [CAPD] patients, were recruited and followed up for 36 months duration. Midweek clinical and laboratory data were collected. The occurrence of existing and new CVD events was recorded
Results: Multiple Logistic Regression showed pre-existing cardiovascular event [odds ratio, 4.124, 95% confidence interval [CI], 0.990 to 17.187], elevated total cholesterol level [odds ratio, 0.550, 95% CI, 0.315 to 0.963], elevated serum phosphate level [odds ratio, 5.862, 95% CI, 1.041 to 33.024] and elevated random blood glucose level [odds ratio, 1.193, 95% CI, 1.012 to 1.406] were significantly associated with occurrence of CVD events
Conclusions: History of cardiovascular event before the initiation of dialysis, elevated level of serum phosphate and random blood glucose levels are the risk factors of CVD whereas paradoxically a high total cholesterol level has CVD protective effect towards the ESRF patients