RESUMO
BACKGROUND: There is scarce evidence on the fourth dose of severe acute respiratory syndrome coronavirus 2 vaccines in chronic kidney disease (CKD) patients. We evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), haemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients. METHODS: This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analysed factors associated with persistent negative humoral response and higher anti-Spike antibody titres as well as the efficacy of vaccination on coronavirus disease 2019 (COVID-19) severity. RESULTS: Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titres in HD (P = .001) and ND-CKD (P = .014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titres at 12 months were independently associated with repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titres and not being a KT recipient. Breakthrough COVID-19 was registered in 137 (6%) patients, 5% of whom required admission. Admitted patients had prior titres <620 UI/ml and median values were lower (P = .020) than in non-admitted patients. CONCLUSIONS: A fourth vaccine dose increased anti-Spike antibody titres or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titres or KT recipients) derived the least benefit in terms of antibody titres. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titres.
Assuntos
COVID-19 , Insuficiência Renal Crônica , Humanos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Estudos Prospectivos , SARS-CoV-2 , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Anticorpos AntiviraisRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Insuficiência Renal Crônica/terapia , Diálise Renal , Qualidade de Vida , Fatores EtáriosRESUMO
La psoriasis es una enfermedad cutánea con afectación sistémica, cuyo daño tisular se considera inmunomediado y que en la actualidad se trata eficazmente con etanercept. El daño renal de esta patología no está completamente aclarado en la literatura. Presentamos un caso de glomerulonefritis membranosa con depósitos de C1q que posteriormente desarrolló psoriasis. En este artículo hacemos una revisión de la posible asociación entre estas patologías y la respuesta a esta molécula biológica (AU)
Psoriasis is a cutaneous disease with systemic involvement. Tisular damage is consider to be immunomediated, and actually is being effectively treated with Etanercept. Kidney damage of this patological condition is not completely clarified in the literature. We present a case of Membranous Nephropathy with C1q deposits that subsequently developed psoriasis. In this article we make a review of a possible association between these diseases and the respose to that biological molecule (AU)
Assuntos
Humanos , Masculino , Adulto , Glomerulonefrite Membranosa/complicações , Psoríase/complicações , Fatores de Necrose Tumoral/antagonistas & inibidores , Doenças do Sistema Imunitário/complicaçõesRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Metadona/efeitos adversos , Rabdomiólise/induzido quimicamente , Injúria Renal Aguda/induzido quimicamente , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
Psoriasis is a cutaneous disease with systemic involvement. Tissue damage is considered to be immune-mediated, and etanercept currently provides effective treatment. Kidney injury arising from this condition has not yet been fully explained in the literature. We present a case of membranous nephropathy with C1q deposits followed by development of psoriasis. In this article we will review the possible association between these conditions and the response to this biological molecule.
Assuntos
Glomerulonefrite Membranosa/complicações , Glomerulonefrite Membranosa/tratamento farmacológico , Imunoglobulina G/uso terapêutico , Imunossupressores/uso terapêutico , Psoríase/tratamento farmacológico , Psoríase/etiologia , Receptores do Fator de Necrose Tumoral/uso terapêutico , Adulto , Etanercepte , Humanos , MasculinoRESUMO
No disponible