Andhika Rizky, Anand Muhammad Iqbal, Tiara Marita Restie, Debora Josephine, Djauhari Hofiya, Susandi Evan, Mareta Adnes, Riswoko Asep, Susilawati Nopi, Indrati Agnes Rengga, Alisjahbana Bachti, Supriyadi Rudi
Division of Nephrology and Hypertension, Internal Medicine Department, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia.
Internal Medicine Department, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia.
Vaccines (Basel). 2023 Dec 1;11(12):1802. doi: 10.3390/vaccines11121802.
Patients with end-stage kidney disease on hemodialysis (ESKD-HD) have a high risk of contracting severe COVID-19. Vaccination can help reduce disease severity, but the immune dysregulation observed in these patients may result in an inadequate antibody response. Therefore, we aimed to evaluate the immune response postvaccination in ESKD-HD patients. This prospective cohort study was conducted in two hemodialysis centers in Indonesia. We enrolled ESKD-HD patients ( = 143) pre- and postvaccination and compared them to healthy subjects ( = 67). SARS-CoV-2 antibody response was assessed using anti-S-RBD antibodies and SVNT % inhibition tests. We performed bivariate and multivariate analysis to determine factors associated with SARS-CoV-2 antibody levels. Seropositive conversion was observed in 97% ESKD-HD subjects postvaccination. Compared with healthy subjects, ESKD-HD patients showed a comparable anti-S-RBD antibody titer postvaccination. mRNA vaccines remained a significant factor for the high immune response, while hypoalbuminemia correlated with lower immune response. In conclusion, ESKD-HD patients showed a robust immune response postvaccination. mRNA vaccines induced a stronger antibody response than other vaccines. Lower levels of serum albumin correlate with lower immune responses in ESKD-HD patients after vaccination.
接受血液透析的终末期肾病患者(ESKD-HD)感染重症COVID-19的风险很高。接种疫苗有助于降低疾病严重程度,但在这些患者中观察到的免疫失调可能导致抗体反应不足。因此,我们旨在评估ESKD-HD患者接种疫苗后的免疫反应。这项前瞻性队列研究在印度尼西亚的两个血液透析中心进行。我们在接种疫苗前后招募了ESKD-HD患者(n = 143),并将他们与健康受试者(n = 67)进行比较。使用抗S-RBD抗体和SVNT抑制率试验评估SARS-CoV-2抗体反应。我们进行了双变量和多变量分析,以确定与SARS-CoV-2抗体水平相关的因素。接种疫苗后,97%的ESKD-HD受试者出现血清学阳性转换。与健康受试者相比,ESKD-HD患者接种疫苗后的抗S-RBD抗体滴度相当。mRNA疫苗仍然是高免疫反应的一个重要因素,而低白蛋白血症与较低的免疫反应相关。总之,ESKD-HD患者接种疫苗后表现出强烈的免疫反应。mRNA疫苗比其他疫苗诱导更强的抗体反应。血清白蛋白水平较低与ESKD-HD患者接种疫苗后的免疫反应较低相关。