The vaccine is well tolerated in patients with this renal disease, especially in cases where the severity of the disorder remains stable
What is known about the effects of the Covid vaccination on those with Berger’s disease?
He answers Arrigo SchieppatiCoordination Center Regional Network for Rare Diseases, Mario Negri Institute, Bergamo (GO TO THE FORUM)
Among the alleged complications of Covid vaccination there have been reports of new onset or relapse of kidney disease (including the Berger’s diseasewhich designates a form of glomerulonephritis called mesangial deposits of immunoglobulin A, more simply: IgA nephropathy, or NIgA), opening the debate whether these events are caused by the vaccine or are random associations. The analysis of the (not numerous) cases of new nephropathy (or disease relapse) led to the conclusion that the absolute incidence of these adverse events is low and the Covid vaccine is generally well toleratedDespite these cases, the protective benefits offered by vaccination far outweigh its risks in patients with NIgA. In any case, doctors recommend, after vaccination, to carefully monitor patients already affected by IgA nephropathy to detect early recurrence of the disease.
Here is an overview of studies on the topic. An English job examined 48 patient cases reported from 36 scientific papers. Minimal change nephropathy (19 cases), the most frequent pathology observed, was reported, followed by IgA nephropathy (14) and vasculitis (10). Other cases include relapse of membranous nephropathy, acute kidney transplant rejection, relapse of IgG4 nephritis, new onset renal thrombotic microangiopathy, and scleroderma renal crisis after Covid vaccination. No patients died: all but one recovered and have not needed renal replacement therapy (dialysis or transplant). A group of Swiss researchers calculated the frequency of different forms of glomerulonephritis, including IgA nephropathy, in the adult population. The frequency of glomerulonephritis observed during the anti-Covid vaccination campaign (January-August 2021) is no different from that recorded in the years preceding the pandemic, between 2015 and 2019.
This study established that the risk of developing new-onset glomerulonephritis, diagnosed with a kidney biopsy, not increased by the administration of the vaccine and that the frequency of new cases during the vaccination campaign is what one would expect in normal times. A Chinese study examined 965 patients with IgA nephropathy, of whom 46% (443 out of 965) had received at least one dose of the Covid vaccine. They have been reported two exacerbation events. Two weeks after the first dose, one patient experienced an episode of gross haematuria (blood in the urine). A nephrotic syndrome (i.e. a significant loss of protein in the urine, with swelling) developed in one patient three months after the second dose. Both subjects initiated or intensified immunosuppressive therapy after exacerbation of the complaints.
Further analysis revealed that three patients showed a reduction in renal function and three others had worsening proteinuria (loss of protein in the urine) over the next three months. The conclusion of the researchers that, overall, the absolute incidence of adverse events low and the Covid vaccine well tolerated in patients with IgA nephropathy, especially if the disease is relatively stable. Although a decrease in glomerular filtration rate (i.e worsening of kidney function), the temporary state change.
December 2, 2022 (change December 2, 2022 | 08:57)
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