RESUMEN
BACKGROUND: There is scarce evidence on the fourth dose of severe acute respiratory syndrome coronavirus 2 vaccines in chronic kidney disease (CKD) patients. We evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), haemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients. METHODS: This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analysed factors associated with persistent negative humoral response and higher anti-Spike antibody titres as well as the efficacy of vaccination on coronavirus disease 2019 (COVID-19) severity. RESULTS: Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titres in HD (P = .001) and ND-CKD (P = .014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titres at 12 months were independently associated with repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titres and not being a KT recipient. Breakthrough COVID-19 was registered in 137 (6%) patients, 5% of whom required admission. Admitted patients had prior titres <620 UI/ml and median values were lower (P = .020) than in non-admitted patients. CONCLUSIONS: A fourth vaccine dose increased anti-Spike antibody titres or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titres or KT recipients) derived the least benefit in terms of antibody titres. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titres.
Asunto(s)
COVID-19 , Insuficiencia Renal Crónica , Humanos , Vacunas contra la COVID-19 , COVID-19/prevención & control , Estudios Prospectivos , SARS-CoV-2 , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/terapia , Anticuerpos AntiviralesRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Insuficiencia Renal Crónica/terapia , Diálisis Renal , Calidad de Vida , Factores de EdadRESUMEN
La psoriasis es una enfermedad cutánea con afectación sistémica, cuyo daño tisular se considera inmunomediado y que en la actualidad se trata eficazmente con etanercept. El daño renal de esta patología no está completamente aclarado en la literatura. Presentamos un caso de glomerulonefritis membranosa con depósitos de C1q que posteriormente desarrolló psoriasis. En este artículo hacemos una revisión de la posible asociación entre estas patologías y la respuesta a esta molécula biológica (AU)
Psoriasis is a cutaneous disease with systemic involvement. Tisular damage is consider to be immunomediated, and actually is being effectively treated with Etanercept. Kidney damage of this patological condition is not completely clarified in the literature. We present a case of Membranous Nephropathy with C1q deposits that subsequently developed psoriasis. In this article we make a review of a possible association between these diseases and the respose to that biological molecule (AU)
Asunto(s)
Humanos , Masculino , Adulto , Glomerulonefritis Membranosa/complicaciones , Psoriasis/complicaciones , Factores de Necrosis Tumoral/antagonistas & inhibidores , Enfermedades del Sistema Inmune/complicacionesRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Metadona/efectos adversos , Rabdomiólisis/inducido químicamente , Lesión Renal Aguda/inducido químicamente , Trastornos Relacionados con Sustancias/complicacionesRESUMEN
Psoriasis is a cutaneous disease with systemic involvement. Tissue damage is considered to be immune-mediated, and etanercept currently provides effective treatment. Kidney injury arising from this condition has not yet been fully explained in the literature. We present a case of membranous nephropathy with C1q deposits followed by development of psoriasis. In this article we will review the possible association between these conditions and the response to this biological molecule.
Asunto(s)
Glomerulonefritis Membranosa/complicaciones , Glomerulonefritis Membranosa/tratamiento farmacológico , Inmunoglobulina G/uso terapéutico , Inmunosupresores/uso terapéutico , Psoriasis/tratamiento farmacológico , Psoriasis/etiología , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Adulto , Etanercept , Humanos , MasculinoRESUMEN
No disponible
