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. 2023 Dec 1;11(12):1802.
doi: 10.3390/vaccines11121802.

Antibody Response to SARS-CoV-2 Vaccination in Patients with End-Stage Kidney Disease on Hemodialysis

Rizky Andhika  1 , Muhammad Iqbal Anand  2 , Marita Restie Tiara  3 , Josephine Debora  2 , Hofiya Djauhari  3 , Evan Susandi  2 , Adnes Mareta  3 , Asep Riswoko  4 , Nopi Susilawati  3 , Agnes Rengga Indrati  5 , Bachti Alisjahbana  3   6 , Rudi Supriyadi  1
Affiliations

Antibody Response to SARS-CoV-2 Vaccination in Patients with End-Stage Kidney Disease on Hemodialysis

Rizky Andhika et al. Vaccines (Basel). .

Abstract

Patients with end-stage kidney disease on hemodialysis (ESKD-HD) have a high risk of contracting severe COVID-19. Vaccination can help reduce disease severity, but the immune dysregulation observed in these patients may result in an inadequate antibody response. Therefore, we aimed to evaluate the immune response postvaccination in ESKD-HD patients. This prospective cohort study was conducted in two hemodialysis centers in Indonesia. We enrolled ESKD-HD patients (n = 143) pre- and postvaccination and compared them to healthy subjects (n = 67). SARS-CoV-2 antibody response was assessed using anti-S-RBD antibodies and SVNT % inhibition tests. We performed bivariate and multivariate analysis to determine factors associated with SARS-CoV-2 antibody levels. Seropositive conversion was observed in 97% ESKD-HD subjects postvaccination. Compared with healthy subjects, ESKD-HD patients showed a comparable anti-S-RBD antibody titer postvaccination. mRNA vaccines remained a significant factor for the high immune response, while hypoalbuminemia correlated with lower immune response. In conclusion, ESKD-HD patients showed a robust immune response postvaccination. mRNA vaccines induced a stronger antibody response than other vaccines. Lower levels of serum albumin correlate with lower immune responses in ESKD-HD patients after vaccination.

Keywords: COVID-19; antibody level; chronic kidney disease; vaccination.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient enrollment.
Figure 2
Figure 2
Anti-S-RBD antibody level (AU/mL) of all prevaccination subjects based on time collected. * p < 0.05.
Figure 3
Figure 3
Anti-S-RBD antibody level (a) and SVNT % inhibition (b) in all subjects pre- and postvaccination based on vaccine types. Grey lines depict the median; ns: nonsignificant; * p < 0.05; ** p < 0.001.
Figure 4
Figure 4
Anti-S-RBD antibody level (a) and SVNT % inhibition (b) in all subjects pre- and postvaccination based on albumin level. Grey lines depict the median; ns: nonsignificant; * p < 0.05; ** p < 0.001.
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