Renal Prognosis in Patients With IgAN and Gross Hematuria After COVID-19 Vaccination

Few data are available on the long-term renal prognosis of patients with immunoglobulin A Nephropathy (IgAN) who present with gross hematuria (GH) following vaccination with COVID-19 mRNA vaccine.

Researchers at Tokyo Jikeikai Ika Daigaku, Minato-ku, Japan, led by Shinya Yokote, MD, PhD, presented results during a poster session at ASN 2024 of a study to determine whether there is an association between post-vaccination GH and long-term renal prognosis in patients with previously diagnosed IgAN. The poster was title Impact of Gross Hematuria After COVID-19 mRNA Vaccination on Renal Outcome in Patients with IgAN.

The study cohort included 442 patients with biopsy-proven IgAN who visited one of four Jikeikai University-affiliated hospitals between February 1, 2021, and September 20, 2021. Estimated glomerular filtration rare (eGFR) was calculated from the change in eGFR between the baseline and the observation point, divided by the number of days in the outpatient visit period and converted to 365 days. In addition to investigating the association between post-vaccination GH and change in eGFR, the researchers assessed the factors associated with change in eGFR.

Median age of the cohort was 51 years, 56% were female, and median eGFR was 57.4 mL/min/1.73 m². The cohort was stratified into three groups: (1) unvaccinated, n=25; (2) those with post-vaccination GH (n=25); and (3) those without post-vaccination GH (n=392). At the study midpoint, the change in eGFR (measured at a median of 597 days from baseline) was lowest in the GH group (–2.61 mL/min/1.73 m² vs –1.16 mL/min/1.73 m² in the unvaccinated group and –1.03 mL/min/1.73 m² in the group without GH).

Results of multivariable analysis demonstrated an association between the presence of post-vaccination GH and change in eGFR at the study midpoint (odds ratio, 3.01; P=.04). However, at the  final study observation (median of 756 days from baseline), there was no difference among the groups in change in eGFR (–0.45 in the unvaccinated group, –1.93 in the group without GH, and –1.72 in the group with GH). Further, at the last observation, there was no association between the presence of post-vaccination GH and change in eGFR.

“This study suggests that the rate of decline in renal function over about 2 years was similar in IgAN patients with and without post-vaccination GH,” the authors said.

Source: Yokote S, Tsuboi N, Shimizu A, et al. Impact of gross hematuria after COVID-19 mRNA vaccination on renal outcomes in patients with IgAN. TH-PO1162. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2024; October 24, 2024; San Diego, California.