Joint Research Team From Japanese Society of Nephrology and the Progressive Renal Diseases Research, Research on Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan, Special Study Group for IgA Nephropathy, Tokyo, Japan.
Kyoto University Health Service, Kyoto, Japan.
Clin Exp Nephrol. 2022 Apr;26(4):316-322. doi: 10.1007/s10157-021-02157-x. Epub 2021 Nov 13.
Recent clinical reports indicate a correlation between gross hematuria after the coronavirus 2019 (COVID-19) vaccination in patients with glomerulonephritis, especially immunoglobulin A nephropathy (IgAN). Furthermore, healthcare workers in Japan were initially vaccinated with an mRNA vaccine from February 17, 2021, and some of them experienced gross hematuria after receiving the vaccination.
We conducted a web-based survey of the councilor members of the Japanese Society of Nephrology (581 members, 382 facilities) to elucidate the relationship between gross hematuria and COVID-19 vaccination.
In the first survey, 27 cases (female: 22, 81.5%) of gross hematuria were reported after receiving a COVID-19 vaccination. Of them, 19 (70.4%) patients were already diagnosed with IgAN at the occurrence of gross hematuria. Proteinuria appeared in eight of the 14 (57.1%) cases with no proteinuria before vaccination and hematuria in five of the seven (71.4%) cases with no hematuria before vaccination. The second survey revealed that a renal biopsy was performed after vaccination in four cases, all of whom were diagnosed with IgAN. Only one case showed a slightly increased serum creatinine level, and no patients progressed to severe renal dysfunction.
This study clarified the clinical features of gross hematuria after a COVID-19 vaccination. Because there was no obvious progression to severe renal dysfunction, safety of the COVID-19 vaccination is warranted at least in the protocol of inoculation twice.
最近的临床报告表明，在肾小球肾炎患者，尤其是免疫球蛋白 A 肾病（IgAN）患者中，接种 2019 年冠状病毒（COVID-19）疫苗后出现肉眼血尿与疫苗接种之间存在相关性。此外，日本的医护人员于 2021 年 2 月 17 日开始接种 mRNA 疫苗，其中一些人在接种疫苗后出现肉眼血尿。
我们对日本肾脏病学会的顾问成员（581 名成员，382 个设施）进行了一项基于网络的调查，以阐明肉眼血尿与 COVID-19 疫苗接种之间的关系。
在第一次调查中，报告了 27 例（女性 22 例，81.5%）接种 COVID-19 疫苗后出现肉眼血尿。其中，19 例（70.4%）患者在出现肉眼血尿时已被诊断为 IgAN。在 14 例无蛋白尿的病例中，有 8 例（57.1%）出现蛋白尿，在 7 例无血尿的病例中，有 5 例（71.4%）出现血尿。第二次调查显示，4 例在接种疫苗后进行了肾活检，均被诊断为 IgAN。仅 1 例血清肌酐水平略有升高，且无患者进展为严重肾功能不全。
本研究阐明了 COVID-19 疫苗接种后肉眼血尿的临床特征。由于没有明显进展为严重肾功能不全，至少在两次接种方案中，COVID-19 疫苗接种是安全的。
