Kidney Week

Abstract: TH-PO1162

Impact of Gross Hematuria after COVID-19 mRNA Vaccination on Renal Outcome in Patients with IgAN

Session Information

• COVID-19
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Yokote, Shinya, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Shinya Yokote, MD, PhD

• Tsuboi, Nobuo, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Nobuo Tsuboi, MD, PhD, FASN

• Shimizu, Akihiro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Akihiro Shimizu, MD, PhD

• Okabe, Masahiro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Masahiro Okabe, MD, PhD

• Haruhara, Kotaro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Kotaro Haruhara, MD, PhD

• Hatanaka, Saeko, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Saeko Hatanaka, MD

• Sasaki, Takaya, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Takaya Sasaki, MD

• Ueda, Hiroyuki, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Hiroyuki Ueda, MD, PhD

• Yokoo, Takashi, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Takashi Yokoo, MD, PhD

Background

The long-term renal prognosis of patients with immunoglobulin A nephropathy (IgAN) presenting with gross hematuria (GH) after COVID-19 mRNA vaccination is unknown. In this study, we aimed to determine whether the post-vaccination GH was associated with long-term renal prognosis of patients already diagnosed with IgAN.

Methods

Japanese patients with biopsy-proven IgAN who visited four Jikei university-affiliated hospitals between 1 February 2021 and 20 September 2021 were recruited. The change in estimated glomerular filtration rate (eGFR) was calculated from the change in eGFR between the baseline and the observation point, divided by the number of days in the outpatient visit period and converted to 365 days. We investigated the relationship between post-vaccination GH and the change in eGFR (ΔeGFR). The factors associated with ΔeGFR were also assessed.

Results

A total of 442 Japanese patients with IgAN (median age, 51 years; 56% female; eGFR, 57.4 mL/min/1.73 m²) were included. Patients were divided into three groups: unvaccinated group (n=25), post-vaccination GH group (n=25) and post-vaccination no GH group (n=392). ΔeGFR (ml/min/1.73m²/year) at the midpoint, measured at a median of 597 days from the baseline, was lowest in the GH group at -2.61, compared with -1.16 in the unvaccinated group and -1.03 in the no GH group (Figure 1A, P=0.02). In a multivariable analysis, the presence of post-vaccination GH was associated with ΔeGFR at the midpoint observation (OR 3.01, P=0.04). However, at the last observation, measured at a median of 756 days from the base line, there was no difference in ΔeGFR between groups (-0.45 in the unvaccinated group, -1.93 in the no GH group and -1.72 in the GH group, Figure 1B) and no association between the presence of post-vaccination GH and ΔeGFR at the last observation.

Conclusion

This study suggests that the rate of decline in renal function over about 2 years was similar in IgAN patients with and without post-vaccination GH.