Kidney Week

Abstract: TH-PO1107

Series of Glomerular Diseases Developed After COVID-19 mRNA Vaccination

Session Information

• COVID-19 - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Abe, Kenichiro, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Kenichiro Abe,

• Suzuki, Hitoshi, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Hitoshi Suzuki,

• Umezawa, Yukako, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Yukako Umezawa,

• Hirose, Hitomi, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Hitomi Hirose,

• Koshida, Takeo, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Takeo Koshida,

• Hirasawa, Tomomi, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Tomomi Hirasawa,

• Kato, Arisa, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Arisa Kato,

• Fukuda, Hiromitsu, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Hiromitsu Fukuda,

• Takahara, Hisatsugu, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan

Hisatsugu Takahara,

• Suzuki, Yusuke, Juntendo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Bunkyo-ku, Tokyo, Japan

Yusuke Suzuki,

Introduction

The coronavirus disease 2019 (COVID-19) vaccine has been proven effective in preventing severe COVID-19 infection. Meanwhile, many vaccine-related adverse events have been reported with the increasing use of messenger RNA (mRNA)-based COVID-19 vaccines. In fact, cases of vaccine-related new-onset and relapsing glomerular diseases, including minimal change disease (MCD), anti-neutrophil cytoplasmic autoantibody-associated vasculitis, immunoglobulin (Ig)G4-related disease, and IgA nephropathy (IgAN), have been reported. Here, we report 40 patients who developed glomerular diseases after COVID-19 mRNA vaccination.

Case Description

We evaluated the clinical characteristics, vaccine types, and clinical outcomes of 40 patients whose urinalysis indicated proteinuria and/or occult blood after COVID-19 mRNA vaccination. For a definitive diagnosis, we performed a renal biopsy and evaluated their histological findings. Out of 40 patients, 27 (67.5%) were female, and 13 (32.5%) were male. The median patient age was 41 years (range, 15–78). Seventy-five percent of patients received BioNTech Pfizer vaccines, and 25% received Moderna vaccines. Gross hematuria was observed in 85% of patients, and 15% presented with nephrotic syndrome. Twenty-seven patients (67.5%) were diagnosed as IgAN by renal biopsy, while the remaining were diagnosed with MCD, TAFRO syndrome, membranous nephropathy, proliferative glomerulonephritis with monoclonal Ig deposits, thrombotic microangiopathy, and anti-glomerular basement membrane disease. Four patients with IgAN who previously diagnosed and underwent treatment showed exacerbation of urinary abnormalities.

Discussion

Various glomerular diseases developed after COVID-19 mRNA vaccination. However, the mechanisms underlying mRNA vaccine induced kidney disease remain unclear. Several hypotheses have been proposed regarding the mechanism by which an mRNA vaccine triggers an adaptive immune response to display its protective effect, which may stimulate a hyperinflammatory condition. Further studies are necessary to elucidate the underlying biological mechanisms and identify the exact causal relationship.