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. 2022 Sep 22;37(10):1868-1878.
doi: 10.1093/ndt/gfab313.

Safety and immediate humoral response of COVID-19 vaccines in chronic kidney disease patients: the SENCOVAC study

Borja Quiroga  1 , María José Soler  2 , Alberto Ortiz  3 , Shaira Martínez Vaquera  4 , Carlos Jesús Jarava Mantecón  4 , Gustavo Useche  4 , María Gabriela Sánchez Márquez  5 , Manuel Carnerero  4 , María Teresa Jaldo Rodríguez  6 , Patricia Muñoz Ramos  1 , Juan Carlos Ruiz San Millán  7 , Nestor Toapanta  2 , Carolina Gracia-Iguacel  3 , María Cinta Aguilar Cervera  8 , Noelia Balibrea Lara  9 , Alba Leyva  10 , José Rojas  10 , Ron T Gansevoort  11 , Patricia de Sequera  6 ; SENCOVAC Collaborative Network
Collaborators, Affiliations

Safety and immediate humoral response of COVID-19 vaccines in chronic kidney disease patients: the SENCOVAC study

Borja Quiroga et al. Nephrol Dial Transplant. .

Abstract

Background: Chronic kidney disease (CKD) patients are at high-risk for severe coronavirus disease 2019 (COVID-19). The multicentric, observational and prospective SENCOVAC study aims to describe the humoral response and safety of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in CKD patients. Safety and immediate humoral response results are reported here.

Methods: Four cohorts of patients were included: kidney transplant (KT) recipients, and haemodialysis (HD), peritoneal dialysis (PD) and non-dialysis CKD patients from 50 Spanish centres. Adverse events after vaccine doses were recorded. At baseline and on Day 28 after the last vaccine dose, anti-Spike antibodies were measured and compared between cohorts. Factors associated with development of anti-Spike antibodies were analysed.

Results: A total of 1746 participants were recruited: 1116 HD, 171 PD, 176 non-dialysis CKD patients and 283 KT recipients. Most patients (98%) received mRNA vaccines. At least one vaccine reaction developed after the first dose in 763 (53.5%) and after the second dose in 741 (54.5%) of patients. Anti-Spike antibodies were measured in the first 301 patients. At 28 days, 95% of patients had developed antibodies: 79% of KT, 98% of HD, 99% of PD and 100% of non-dialysis CKD patients (P < 0.001). In a multivariate adjusted analysis, absence of an antibody response was independently associated with KT (odds ratio 20.56, P = 0.001) and with BNT162b2 vaccine (odds ratio 6.03, P = 0.023).

Conclusion: The rate of anti-Spike antibody development after vaccination in KT patients was low but in other CKD patients it approached 100%, suggesting that KT patients require persistent isolation measures and booster doses of a COVID-19 vaccine. Potential differences between COVID-19 vaccines should be explored in prospective controlled studies.

Keywords: COVID-19; SARS-CoV-2; antibodies; humoral response; vaccine.

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