COVID-19 and the Kidney

A special issue of Kidney and Dialysis (ISSN 2673-8236).

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 4323

Special Issue Editors


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Guest Editor
Division of Nephrology and Dialysis, Ospedale Santa Chiara, Trento, Italy
Interests: nephrology; chronic kidney disease; dialysis

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Guest Editor

Special Issue Information

Dear Colleagues,

SARS-CoV-2 has been ravaging the world for almost two years now. The epidemic has had a profound impact on the general population, but our chronic kidney disease, dialysis and kidney transplant patients have been facing an even greater share of the risk. The pandemic has posed new challenges to nephrologists: from virus-associated electrolyte disorders in intensive care units (ICUs) to the management of older patients with COVID-19 end-stage renal disease, refused by ICUs, in dialysis wards; new COVID-19-related kidney diseases have been discovered, and transplant programs have experienced an unprecedented slowdown. Furthermore, COVID-19-related acute kidney injury has been observed in up to 45% of ICU patients, with specific features and pathogenic mechanisms, contributing to the high mortality of the infection.

Moreover, the availability of vaccines has revealed the low response rate of immunodepressed patients and the lability of the immune response in the general population as well as in dialysis and transplant patients; as a result, the best vaccination schedule is still a matter of debate. Finally, the long-term renal consequences of SARS-CoV-2 infection are still unknown.

Protecting and taking care of our fragile patients has been our priority. During these busy months, our clinical and research work has never stopped; however, most of us did not have enough time to share our experiences and observations with the scientific community.

Kidney and Dialysis is a new and dynamic journal which aims to become a reference in the nephrology field. We would like to encourage you to share your experience concerning all aspects of the COVID-19 pandemic in CKD, dialysis and kidney transplant patients, and to submit your data to this Special Issue.

Dr. Giuliano Brunori
Dr. Massimo Torreggiani
Guest Editors

Manuscript Submission Information

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Keywords

  • SARS-CoV-2
  • chronic kidney disease
  • dialysis
  • kidney transplant
  • intensive care units
  • ICUs
  • COVID-19
  • vaccines
  • renal consequences
  • nephrology

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Published Papers (1 paper)

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Research

13 pages, 1290 KiB  
Article
SARS-CoV-2 mRNA Vaccine Immunogenicity in Hemodialysis Patients: Promising Vaccine Protection That May Be Hindered by Fluid Overload
by Hedia Hebibi, Marvin Edeas, Laure Cornillac, Severine Beaudreuil, Jedjiga Achiche, David Attaf, Samah Saibi, Charles Chazot, Fatah Ouaaz and Bernard Canaud
Kidney Dial. 2022, 2(1), 44-56; https://doi.org/10.3390/kidneydial2010006 - 28 Jan 2022
Cited by 2 | Viewed by 3576
Abstract
Background: Due to their immunocompromised conditions, hemodialysis (HD) patients are at high risk of being infected with SARS-CoV-2 with poor clinical outcomes. We explored safety, efficacy and variability factors associated with vaccine immune response in these patients. Methods: From 18 January [...] Read more.
Background: Due to their immunocompromised conditions, hemodialysis (HD) patients are at high risk of being infected with SARS-CoV-2 with poor clinical outcomes. We explored safety, efficacy and variability factors associated with vaccine immune response in these patients. Methods: From 18 January to 30 April 2021, 87 HD patients were enrolled in this study and subdivided in two sub-groups: SARS-CoV-2 positive prior to vaccination and naïve patients. The vaccination protocol included two intramuscular shots of the mRNA vaccine at a 28-day interval. The vaccine response was evaluated one month after the first and second shots by measuring anti-S antibody titers. Findings: 44% of the patients studied, were women; median age was 58 years. One month after the first shot, 64.3% of patients had anti-S antibody titers < 50 U/mL while 96.5% had anti-S antibody titers > 250 U/mL one month after the second shot. We show that the anti-SARS-CoV-2 spike mRNA vaccine elicits a great tolerability in HD patients. Importantlly, the vaccine response is characterized by a higher rate of seroconversion than conventional vaccination, as we have shown for the hepatitis B vaccine. We highlight two major factors of variability of the vaccine response. First, pre-exposure to SARS-CoV-2 boosts humoral response, as 95% of SARS-CoV-2 positive patients developed anti-S antibody titers > 250 U/L just after the first shot. Secondly, on the contrary fluid overload strikingly appears, limiting the vaccine response, as 84% of HD patients with fluid overload elicit lower anti-S antibody titers after the first shot. Interpretation: Our findings show that the immunogenic profile induced by mRNA vaccines in HD patients represents a promising a protective strategy that is associated with greater tolerability. Fluid overload may be considered as a novel factor that hinders the immune response in HD patients and further studies will be needed to investigate this working hypothesis. Full article
(This article belongs to the Special Issue COVID-19 and the Kidney)
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