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. 2021 Sep 16;2(11):1770-1780.
doi: 10.34067/KID.0005372021. eCollection 2021 Nov 25.

Glomerular Disease in Temporal Association with SARS-CoV-2 Vaccination: A Series of 29 Cases

Tiffany N Caza  1 , Clarissa A Cassol  1 , Nidia Messias  1 , Andrew Hannoudi  2 , Randy S Haun  1 , Patrick D Walker  1 , Rebecca M May  1 , Regan M Seipp  3 , Elizabeth J Betchick  4 , Hassan Amin  5 , Mandolin S Ziadie  6 , Michael Haderlie  7 , Joy Eduwu-Okwuwa  8 , Irina Vancea  9 , Melvin Seek  10 , Essam B Elashi  11 , Ganesh Shenoy  12 , Sayeed Khalillullah  13 , Jesse A Flaxenburg  14 , John Brandt  15 , Matthew J Diamond  16 , Adam Frome  17 , Eugene H Kim  18 , Gregory Schlessinger  19 , Erlandas Ulozas  20 , Janice L Weatherspoon  21 , Ethan Thomas Hoerschgen  22 , Steven L Fabian  23 , Sung Yong Bae  24 , Bilal Iqbal  25 , Kanwalijit K Chouhan  26 , Zeina Karam  27 , James T Henry  28 , Christopher P Larsen  1
Affiliations

Glomerular Disease in Temporal Association with SARS-CoV-2 Vaccination: A Series of 29 Cases

Tiffany N Caza et al. Kidney360. .

Abstract

Background: Immune responses to vaccination are a known trigger for a new onset of glomerular disease or disease flare in susceptible individuals. Mass immunization against SARS-CoV-2 in the COVID-19 pandemic provides a unique opportunity to study vaccination-associated autoimmune kidney diseases. In the recent literature, there are several patient reports demonstrating a temporal association of SARS-CoV-2 immunization and kidney diseases.

Methods: Here, we present a series of 29 cases of biopsy-proven glomerular disease in patients recently vaccinated against SARS-CoV-2 and identified patients who developed a new onset of IgA nephropathy, minimal change disease, membranous nephropathy, ANCA-associated GN, collapsing glomerulopathy, or diffuse lupus nephritis diagnosed on kidney biopsies postimmunization, as well as recurrent ANCA-associated GN. This included 28 cases of de novo GN within native kidney biopsies and one disease flare in an allograft.

Results: The patients with collapsing glomerulopathy were of Black descent and had two APOL1 genomic risk alleles. A brief literature review of patient reports and small series is also provided to include all reported cases to date (n=52). The incidence of induction of glomerular disease in response to SARS-CoV-2 immunization is unknown; however, there was no overall increase in incidence of glomerular disease when compared with the 2 years prior to the COVID-19 pandemic diagnosed on kidney biopsies in our practice.

Conclusions: Glomerular disease to vaccination is rare, although it should be monitored as a potential adverse event.

Keywords: ANCA; APOL1; COVID-19; IgA nephropathy; SARS-CoV-2 vaccine; collapsing glomerulopathy; crescentic glomerulonephritis; glomerular and tubulointerstitial diseases; lupus nephritis; membranous nephropathy; minimal change disease.

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Conflict of interest statement

J.T. Henry reports ownership interest in Fort Smith Regional Dialysis. G. Schlessinger reports consultancy agreements with Medtronic and ownership interest in US Renal Care. Z. Karam reports honoraria from Spherix. R.M. Seipp reports honoraria from M3 Global Research and Spherix Global Insights. P.D. Walker reports consultancy agreements with Apellis and Travere and honoraria from Apellis and Travere. All remaining authors have nothing to disclose.

Figures

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References

    1. Windpessl M, Bruchfeld A, Anders HJ, Kramer H, Waldman M, Renia L, Ng LFP, Xing Z, Kronbichler A: COVID-19 vaccines and kidney disease. Nat Rev Nephrol 17: 291–293, 2021. 10.1038/s41581-021-00406-6 - DOI - PMC - PubMed
    1. Patel C, Shah HH: Vaccine-associated kidney diseases: A narrative review of the literature. Saudi J Kidney Dis Transpl 30: 1002–1009, 2019. 10.4103/1319-2442.270254 - DOI - PubMed
    1. Segal Y, Shoenfeld Y: Vaccine-induced autoimmunity: The role of molecular mimicry and immune crossreaction. Cell Mol Immunol 15: 586–594, 2018. 10.1038/cmi.2017.151 - DOI - PMC - PubMed
    1. May RM, Cassol C, Hannoudi A, Larsen CP, Lerma E, Haun RS, Braga JR, Hassen SI, Wilson J, VanBeek C, Vankalakunti M, Barnum L, Walker PD, Bourne TD, Messias NC, Ambruzs JM, Boils CL, Sharma SS, Cossey LN, Baxi PV, Palmer M, Zuckerman J, Walavalkar V, Urisman A, Gallan A, Al-Rabadi LF, Rodby R, Luyckx V, Espino G, Santhana-Krishnan S, Alper B, Lam SG, Hannoudi GN, Matthew D, Belz M, Singer G, Kunaparaju S, Price D, Chawla S, Rondla C, Abdalla MA, Britton ML, Paul S, Ranjit U, Bichu P, Williamson SR, Sharma Y, Gaspert A, Grosse P, Meyer I, Vasudev B, El Kassem M, Velez JCQ, Caza TN: A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19) [published online ahead of print August 3, 2021]. Kidney Int 10.1016/j.kint.2021.07.015 - DOI - PMC - PubMed
    1. Velez JCQ, Caza T, Larsen CP: COVAN is the new HIVAN: The re-emergence of collapsing glomerulopathy with COVID-19 [published correction appears in Nat Rev Nephrol 16: 614, 2020]. Nat Rev Nephrol 16: 565–567, 2020 - PMC - PubMed