Clin Nephrol. 2022 Apr;97(4):242-245. doi: 10.5414/CN110753.
A number of reports have described new onset or relapse of existing glomerular disease after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. More and more of these cases continue to emerge, and the European Medicines Agency (EMA) has recently launched an in-depth investigation to ascertain the true frequency of such renal side effects. In comparison, acute interstitial nephritis after SARS-CoV-2 vaccination has only been described in 1 solitary case. Here, we describe a case of acute kidney injury due to biopsy-proven acute interstitial nephritis soon after SARS-CoV-2 vaccination with the Astra-Zeneca vaccine. The patient responded well to steroids, although he required temporary renal replacement therapy. A thorough medical history failed to elucidate any plausible explanation or trigger other than the preceding vaccination. We acknowledge the possibility that other factors could have triggered acute interstitial nephritis in the case described here. Similar uncertainty exists regarding glomerular disease reported in conjunction with SARS-CoV-2 vaccination. However, we note that acute interstitial nephritis associated with vaccination has been described before the pandemic, and we therefore feel that a link is possible. We suggest that nephrologists should be vigilant when they see cases of unexplained acute interstitial nephritis. A history of preceding SARS-CoV-2 vaccination should be explored, and cases should be reported within national systems of pharmacovigilance.
许多报告描述了严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）接种后新发或原有肾小球疾病的复发。越来越多的此类病例不断出现，欧洲药品管理局（EMA）最近启动了一项深入调查，以确定此类肾脏副作用的真实频率。相比之下，SARS-CoV-2 接种后发生急性间质性肾炎仅在 1 例中描述过。在这里，我们描述了 1 例在接种阿斯利康疫苗后不久因活检证实的急性间质性肾炎导致的急性肾损伤病例。尽管患者需要临时肾脏替代治疗，但他对类固醇反应良好。详细的病史未能阐明除了先前的接种之外的任何合理的解释或诱因。我们承认在描述的病例中，其他因素可能引发了急性间质性肾炎。与 SARS-CoV-2 接种相关的肾小球疾病的报告也存在类似的不确定性。然而，我们注意到与疫苗接种相关的急性间质性肾炎以前在大流行之前就已经描述过，因此我们认为这是有可能的。我们建议肾脏病医生在看到不明原因的急性间质性肾炎病例时应保持警惕。应探索先前 SARS-CoV-2 接种的病史，并应在国家药物警戒系统内报告病例。
