Vaccination in patients with kidney failure: lessons from COVID-19.
Nat Rev Nephrol
; 18(11): 708-723, 2022 11.
Article
in English
| MEDLINE | ID: covidwho-2000907
ABSTRACT
Infection is the second leading cause of death in patients with chronic kidney disease (CKD). Adequate humoral (antibody) and cellular (T cell-driven) immunity are required to minimize pathogen entry and promote pathogen clearance to enable infection control. Vaccination can generate cellular and humoral immunity against specific pathogens and is used to prevent many life-threatening infectious diseases. However, vaccination efficacy is diminished in patients with CKD. Premature ageing of the immune system and chronic systemic low-grade inflammation are the main causes of immune alteration in these patients. In the case of SARS-CoV-2 infection, COVID-19 can have considerable detrimental effects in patients with CKD, especially in those with kidney failure. COVID-19 prevention through successful vaccination is therefore paramount in this vulnerable population. Although patients receiving dialysis have seroconversion rates comparable to those of patients with normal kidney function, most kidney transplant recipients could not generate humoral immunity after two doses of the COVID-19 vaccine. Importantly, some patients who were not able to produce antibodies still had a detectable vaccine-specific T cell response, which might be sufficient to prevent severe COVID-19. Correlates of protection against SARS-CoV-2 have not been established for patients with kidney failure, but they are urgently needed to enable personalized vaccination regimens.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vaccines
/
Renal Insufficiency
/
Renal Insufficiency, Chronic
/
COVID-19
Type of study:
Observational study
Topics:
Long Covid
/
Vaccines
Limits:
Humans
Language:
English
Journal:
Nat Rev Nephrol
Journal subject:
Nephrology
Year:
2022
Document Type:
Article
Affiliation country:
S41581-022-00617-5
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