The impact of COVID-19 vaccination on renal function in patients with chronic kidney disease

Abstract Background Patients with chronic kidney disease (CKD) are at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Newly developed SARS-CoV-2 vaccines have been proven to be effective against infection during the COVID-19 pandemic. The vaccines are safe for patients with CKD, with only sporadic cases of nephrotic syndrome or acute kidney injury (AKI) having been reported following COVID-19 vaccination. However, the causal relationship between vaccines and AKI remain to be identified. To our knowledge, no cohort study has investigated the impact of COVID-19 vaccination on renal function in patient with CKD. Therefore, we conducted a retrospective study to investigate changes in renal function after vaccination. Methods 318 CKD patients with CKD in stage 3 to 5 received two doses of the COVID-19 vaccine. Changes in the estimated glomerular filtration rate (eGFR) and urine protein creatinine ratio (UPCR) were measured between before and after vaccination and compared with relevant values in the previous year (control period). Results The average changes in eGFR between before and after COVID-19 vaccination and during the control period were 1.52 ± 0.63 (SEM) and − 0.95 ± 0.74 mL/min/1.73m2, respectively. The mean difference was 2.47 mL/min/1.73m2 (95% confidence interval [CI], 0.69–4.25; p = 0.007). The average changes in UPCR between before and after COVID-19 vaccination and during the control period were 296.16 ± 73.35 and 40.32 ± 51.30 mg/g, respectively. The mean difference was 336.48 mg/g (95% CI, 165.14–507.83; p < 0.001). Conclusions COVID-19 vaccination could result in increased eGFR and UPCR in patients with CKD.