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Vaccination in patients with kidney failure: lessons from COVID-19

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 hu...

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Autores principales: Babel, Nina, Hugo, Christian, Westhoff, Timm H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397175/
https://www.ncbi.nlm.nih.gov/pubmed/35999285
http://dx.doi.org/10.1038/s41581-022-00617-5
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author Babel, Nina
Hugo, Christian
Westhoff, Timm H.
author_facet Babel, Nina
Hugo, Christian
Westhoff, Timm H.
author_sort Babel, Nina
collection PubMed
description 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.
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spelling pubmed-93971752022-08-23 Vaccination in patients with kidney failure: lessons from COVID-19 Babel, Nina Hugo, Christian Westhoff, Timm H. Nat Rev Nephrol Review Article 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. Nature Publishing Group UK 2022-08-23 2022 /pmc/articles/PMC9397175/ /pubmed/35999285 http://dx.doi.org/10.1038/s41581-022-00617-5 Text en © Springer Nature Limited 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Review Article
Babel, Nina
Hugo, Christian
Westhoff, Timm H.
Vaccination in patients with kidney failure: lessons from COVID-19
title Vaccination in patients with kidney failure: lessons from COVID-19
title_full Vaccination in patients with kidney failure: lessons from COVID-19
title_fullStr Vaccination in patients with kidney failure: lessons from COVID-19
title_full_unstemmed Vaccination in patients with kidney failure: lessons from COVID-19
title_short Vaccination in patients with kidney failure: lessons from COVID-19
title_sort vaccination in patients with kidney failure: lessons from covid-19
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397175/
https://www.ncbi.nlm.nih.gov/pubmed/35999285
http://dx.doi.org/10.1038/s41581-022-00617-5
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