Vudathaneni Vijaya Krishna Prasad, Nadella Swetha Bharathi, Hema Duddukuri, Boyapati Ramanarayana
Department of Medicine, Albert Einstein College of Medicine, New York, USA.
Baystate Medical Center, 759 Chestnut St, Springfield, MA, USA.
Indian J Community Med. 2023 Mar-Apr;48(2):214-219. doi: 10.4103/ijcm.ijcm_654_22. Epub 2023 Apr 7.
Renal complications have previously been reported with various vaccinations, including those for influenza and hepatitis. On a similar note, a spectrum of nephrological complications, both , and flare-ups, were reported after immunization with various coronavirus disease 2019 (COVID-19) vaccines, causing concerns among patients as well as physicians.
A systematic search of the literature published on renal complications seen post-COVID-19 vaccination was performed up to April 2022 using electronic databases such as PubMed and Google Scholar.
Immunoglobulin A (IgA) nephropathy, minimal change disease, glomerulonephritis, acute kidney injury, nephrotic syndrome, and anti-neutrophil cytoplasmic antibody-associated vasculitis were some of the renal complications reported upon administration of COVID-19 vaccines. The causality and underlying pathogenic mechanisms linking these complications and COVID-19 vaccination remain unclear. Nonetheless, a temporal relationship has been established with dysregulated T-cell response, transient systemic pro-inflammatory cytokine response, molecular mimicry, delayed hypersensitivity reaction to the vaccine, and other mechanisms such as hyperresponsive IgA, dysregulation of neutrophil extracellular traps were hypothesized as the possible mechanisms linking renal complications and COVID-19 vaccination.
This review emphasizes the need for rigorous surveillance and reporting of the adverse events following COVID-19 vaccination and explores the underlying mechanisms instigating these renal complications in individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
先前已有报道称，包括流感疫苗和肝炎疫苗在内的多种疫苗会引发肾脏并发症。同样，在接种各种2019冠状病毒病（COVID-19）疫苗后，也出现了一系列肾脏并发症及病情复发情况，这引起了患者和医生的担忧。
截至2022年4月，通过PubMed和谷歌学术等电子数据库，对已发表的关于COVID-19疫苗接种后出现的肾脏并发症的文献进行了系统检索。
接种COVID-19疫苗后报告的肾脏并发症包括免疫球蛋白A（IgA）肾病、微小病变性肾病、肾小球肾炎、急性肾损伤、肾病综合征以及抗中性粒细胞胞浆抗体相关性血管炎。这些并发症与COVID-19疫苗接种之间的因果关系和潜在致病机制仍不明确。尽管如此，已确定存在时间关系，推测T细胞反应失调、短暂的全身促炎细胞因子反应、分子模拟、对疫苗的迟发型超敏反应以及其他机制，如IgA反应过度、中性粒细胞胞外陷阱失调，是将肾脏并发症与COVID-19疫苗接种联系起来的可能机制。
本综述强调了对COVID-19疫苗接种后不良事件进行严格监测和报告的必要性，并探讨了在接种严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗的个体中引发这些肾脏并发症的潜在机制。
