Department of nephrology & dialysis, Centre Hospitalier de Haguenau, Haguenau, France.
Renal Research Division, AURAL, 5 rue Henri Bergson, Strasbourg, 67087, France.
BMC Nephrol. 2024 Oct 31;25(1):391. doi: 10.1186/s12882-024-03789-3.
Patients with chronic kidney disease (CKD) on dialysis have a higher mortality rate associated with SARS-CoV-2 infection. Although vaccines are now available, the protective response rates and determinants of humoral response to the vaccine are poorly described in patients on peritoneal dialysis. This was a prospective observational study describing the response rates of detectable and standardized protective antibody titers one month after each mRNA vaccine dose in a cohort of 88 patients on peritoneal dialysis. We found that the vast majority of patients produced protective levels of antibodies (73%) one month after the second vaccine dose. In the multivariate analysis, the single determinant for an adequate humoral response was the weekly Kt/V, a surrogate of dialysis dose. The response rate was higher, but not significantly, with the mRNA-1273 than with the BNT162b2 vaccine one month after the second dose (78.7 vs. 46.2%, respectively, p = 0.02). We found that patients on peritoneal dialysis had a satisfactory humoral response rate, which was much higher than in transplant recipients. PD patients with a poor humoral response, particularly those with a low wKT/V, may benefit from an additional dose of vaccine.
接受透析治疗的慢性肾脏病 (CKD) 患者因 SARS-CoV-2 感染而导致的死亡率更高。虽然现在有疫苗可用，但腹膜透析患者对疫苗的体液反应的保护反应率和决定因素描述甚少。这是一项前瞻性观察性研究，描述了 88 名腹膜透析患者在每剂 mRNA 疫苗后一个月内可检测到的标准化保护性抗体滴度的反应率。我们发现，绝大多数患者在第二剂疫苗后一个月产生了保护性抗体水平（73%）。在多变量分析中，充足的体液反应的唯一决定因素是每周 Kt/V，它是透析剂量的替代指标。mRNA-1273 疫苗在第二剂后一个月的反应率更高，但无统计学意义（分别为 78.7%和 46.2%，p=0.02）。我们发现，腹膜透析患者的体液反应率令人满意，远高于移植受者。体液反应不佳的 PD 患者，特别是那些 wKT/V 较低的患者，可能受益于额外剂量的疫苗。
