Abstract：
BACKGROUND: Although vaccination has been reported to reduce the morbidity and severity of COVID-19 infection in patients with kidney disease, gross hematuria is frequently reported following vaccination in patients with IgA nephropathy. We investigated the frequency of gross hematuria following COVID-19 vaccination and its effect on renal function in IgA nephropathy patients.
METHODS: Adverse reactions after two or more COVID-19 vaccine doses were investigated in 295 IgA nephropathy patients attending Osaka Cty general hospital from September 2021 to November 2022. We compared differences in background characteristics and other adverse reactions between groups with and without gross hematuria after vaccination, and examined changes in renal function and proteinuria.
RESULTS: Twenty-eight patients (9.5%) had gross hematuria. The median age of patients with and without gross hematuria was 44 (29-48) and 49 (42-61) years, respectively, indicating a significant difference. The percentage of patients with microscopic hematuria before vaccination differed significantly between those with (65.2%) and without (32%) gross hematuria. Adverse reactions, such as fever, chills, headache and arthralgia, were more frequent in patients with gross hematuria. There was no difference in renal functional decline after approximately 1 year between patients with and without gross hematuria. We also found no significant changes in estimated glomerular filtration rate or proteinuria before and after vaccination in the gross hematuria group. However, some patients clearly had worsening of renal function.
CONCLUSIONS: While COVID-19 vaccination is beneficial, care is required since it might adversely affect renal function in some patients.
METHODS: Adverse reactions after two or more COVID-19 vaccine doses were investigated in 295 IgA nephropathy patients attending Osaka Cty general hospital from September 2021 to November 2022. We compared differences in background characteristics and other adverse reactions between groups with and without gross hematuria after vaccination, and examined changes in renal function and proteinuria.
RESULTS: Twenty-eight patients (9.5%) had gross hematuria. The median age of patients with and without gross hematuria was 44 (29-48) and 49 (42-61) years, respectively, indicating a significant difference. The percentage of patients with microscopic hematuria before vaccination differed significantly between those with (65.2%) and without (32%) gross hematuria. Adverse reactions, such as fever, chills, headache and arthralgia, were more frequent in patients with gross hematuria. There was no difference in renal functional decline after approximately 1 year between patients with and without gross hematuria. We also found no significant changes in estimated glomerular filtration rate or proteinuria before and after vaccination in the gross hematuria group. However, some patients clearly had worsening of renal function.
CONCLUSIONS: While COVID-19 vaccination is beneficial, care is required since it might adversely affect renal function in some patients.
摘要：
背景：尽管有报道称接种疫苗可以降低肾病患者COVID-19感染的发病率和严重程度，IgA肾病患者接种疫苗后经常发生肉眼血尿。我们调查了IgA肾病患者接种COVID-19疫苗后肉眼血尿的频率及其对肾功能的影响。
方法：对2021年9月至2022年11月在大阪总医院就诊的295例IgA肾病患者进行了两次或两次以上COVID-19疫苗接种后的不良反应调查。我们比较了接种疫苗后有和无肉眼血尿组的背景特征和其他不良反应的差异，并检查肾功能和蛋白尿的变化。
结果：28例患者（9.5%）有肉眼血尿。伴有和不伴有肉眼血尿的患者的中位年龄为44岁（29-48岁）和49岁（42-61岁），分别,表明存在显著差异。接种前镜下血尿患者的百分比在有（65.2％）和没有（32％）肉眼血尿的患者之间存在显着差异。不良反应,比如发烧，发冷,头痛和关节痛，在肉眼血尿患者中更为常见。有和没有肉眼血尿的患者在大约1年后肾功能下降没有差异。我们还发现，在肉眼血尿组疫苗接种前后，估计的肾小球滤过率或蛋白尿没有显着变化。然而,部分患者肾功能明显恶化。
结论：虽然接种COVID-19疫苗是有益的，需要护理，因为它可能会对某些患者的肾功能产生不利影响。
方法：对2021年9月至2022年11月在大阪总医院就诊的295例IgA肾病患者进行了两次或两次以上COVID-19疫苗接种后的不良反应调查。我们比较了接种疫苗后有和无肉眼血尿组的背景特征和其他不良反应的差异，并检查肾功能和蛋白尿的变化。
结果：28例患者（9.5%）有肉眼血尿。伴有和不伴有肉眼血尿的患者的中位年龄为44岁（29-48岁）和49岁（42-61岁），分别,表明存在显著差异。接种前镜下血尿患者的百分比在有（65.2％）和没有（32％）肉眼血尿的患者之间存在显着差异。不良反应,比如发烧，发冷,头痛和关节痛，在肉眼血尿患者中更为常见。有和没有肉眼血尿的患者在大约1年后肾功能下降没有差异。我们还发现，在肉眼血尿组疫苗接种前后，估计的肾小球滤过率或蛋白尿没有显着变化。然而,部分患者肾功能明显恶化。
结论：虽然接种COVID-19疫苗是有益的，需要护理，因为它可能会对某些患者的肾功能产生不利影响。
