Determinants of protective humoral response to mRNA-1273 and BNT162b2 vaccines in peritoneal dialysis patients: a prospective cohort study

BMC Nephrol. 2024 Oct 31;25(1):391. doi: 10.1186/s12882-024-03789-3.

Abstract

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.

Keywords: Chronic kidney disease; Covid19 mRNA vaccines; Peritoneal dialysis.

Publication types

  • Observational Study

MeSH terms

  • 2019-nCoV Vaccine mRNA-1273* / immunology
  • Adult
  • Aged
  • Antibodies, Viral / blood
  • BNT162 Vaccine* / immunology
  • COVID-19 Vaccines / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Cohort Studies
  • Female
  • Humans
  • Immunity, Humoral
  • Male
  • Middle Aged
  • Peritoneal Dialysis*
  • Prospective Studies
  • Renal Insufficiency, Chronic / immunology
  • Renal Insufficiency, Chronic / therapy
  • SARS-CoV-2 / immunology

Substances

  • BNT162 Vaccine
  • 2019-nCoV Vaccine mRNA-1273
  • Antibodies, Viral
  • COVID-19 Vaccines