Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022;53(4):325-330.
doi: 10.1159/000523962. Epub 2022 Mar 30.

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

Roberta Fenoglio  1 , Stefania Lalloni  1 , Martina Marchisio  1 , Valentina Oddone  1 , Emanuele De Simone  1 , Giulio Del Vecchio  1 , Savino Sciascia  1 , Dario Roccatello  1
Affiliations

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

Roberta Fenoglio et al. Am J Nephrol. 2022.

Abstract

Introduction: To date, almost 7 billion doses of the different types of vaccine against SARS-CoV-2 have been administered worldwide. Although the severity of new cases of SARS-CoV-2 has progressively decreased, and the pressure on national health systems has declined, the development of de novo glomerular injuries has been suggested.

Methods: This study aimed to examine the patients who were hospitalized in our Unit between April and November 2021 and underwent renal biopsy for new-onset urinary abnormalities (UA) and/or renal impairment within 3 months of SARS-CoV-2 vaccination.

Results: We identified 17 patients who developed UA and/or renal insufficiency within 3 months of vaccination. Minimal change disease was the most common disease in our cohort (5 patients, 29.4%) followed by acute tubulointerstitial nephritis (TIN; 3 patients, 17.6%), membranous nephropathy (3 patients, 17.6%), and rapidly progressive IgA nephropathy (2 patients, 11.8%). The other 4 patients had a diagnosis of membranoproliferative glomerulonephritis (1 patient), systemic lupus erythematosus (1 patient), ANCA-associated vasculitis (1 patient), and tip-variant focal segmental glomerulosclerosis (1 patient), respectively. Eight out of the 17 patients (47.1%) developed acute kidney injury. Two patients with acute TIN had to start hemodialysis that was discontinued after 1 and 2 months, respectively, due to the recovery of renal function. All patients underwent treatment with corticosteroids and/or immunosuppressants.

Discussion: Although it is not possible to conclusively determine whether there is a causal relationship between SARS-CoV-2 vaccination and new-onset nephropathies, based on the appearance of UA and/or renal insufficiency shortly after vaccination, we hypothesize that the immune response to the COVID-19 vaccine may be a trigger of nephropathies. Therefore, our results highlight the need for pharmacovigilance. However, this report should not lead to vaccine hesitation during this pandemic as the benefits of vaccination strongly outweigh the potential risks.

Keywords: COVID vaccination; Glomerulopathies; Interstitial nephritis; Kidney biopsy.

PubMed Disclaimer

Comment in

References

    1. Li NL, Coates PT, Rovin BH. COVID-19 vaccination followed by activation of glomerular diseases: does association equal causation? Kidney Int. 2021 Nov;100((5)):959–65. - PMC - PubMed
    1. Gutiérrez S, Dotto B, Petiti JP, De Paul AL, Dionisio de Cabalier ME, Torres AI, et al. Minimal change disease following influenza vaccination and acute renal failure: just a coincidence? Nefrologia. 2012 May;32((3)):414–5. - PubMed
    1. Kikuchi Y, Imakiire T, Hyodo T, Higashi K, Henmi N, Suzuki S, et al. Minimal change nephrotic syndrome, lymphadenopathy and hyperimmunoglobulinemia after immunization with a pneumococcal vaccine. Clin Nephrol. 2002 Jul;58((1)):68–72. - PubMed
    1. Ozdemir S, Bakkaloğlu A, Oran O. Nephrotic syndrome associated with recombinant hepatitis B vaccination: a causal relationship or just a mere association? Nephrol Dial Transplant. 1998 Jul;13((7)):1888–9. - PubMed
    1. Clajus C, Spiegel J, Bröcker V, Chatzikyrkou C, Kielstein JT. Minimal change nephrotic syndrome in an 82 year old patient following a tetanus-diphteria-poliomyelitis-vaccination. BMC Nephrol. 2009 Aug;10:21. - PMC - PubMed

Substances