Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

SARS-CoV-2; Booster; HemodialysisSARS-CoV-2; Refuerzo; HemodiálisisSARS-CoV-2; Reforç; HemodiàlisiBackground Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results A total of 711 patients [67% male, median age (range) 67 (20–89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P = .001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P = .693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P = .001), lower time from booster (P = .043) and past breakthrough SARS-CoV-2 infection (P < .001). Conclusions In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection.The present project has been supported by Fresenius Medical Care, Diaverum, Vifor Pharma, Vircell, Fundación Renal Iñigo Álvarez de Toledo and ISCIII FEDER funds RICORS2040 (RD21/0005)

Influencia de la ingesta de sal en función del injerto renal del paciente trasplantado renal

La hipertensión arterial es un factor de riesgo para la ERC. El consumo de sal incrementa la PA y la proteinuria. Clásicamente se ha asumido que el consumo de sal afecta al curso de la ERC bien directamente o por sus efectos sobre la PA, de modo que la relación entre ambos es lineal. Sin embargo, estudios recientes sugieren una relación en forma de J entre la ingesta de sodio y los eventos cardiovasculares en la población general; por tanto ni en la población general ni en la afecta de ERC queda claro cuál es la ingesta recomendada o cuál es el umbral a partir del cual un pobre consumo de sal puede ser incluso perjudicial. Dados estos hallazgos, deseamos estudiar como un consumo excesivo de sal afectaría negativamente la función del injerto renal, planteándonos el siguiente objetivo: Evaluar la influencia de la ingesta de sal sobre el descenso del filtrado glomerular en el paciente trasplanta do renal. Para ello, realizaremos un estudio retrospectivo en trasplantados renales de forma sucesiva en el Hospital Virgen del Rocío en Sevilla desde el 01/01/2006 al 31/12/2010; estudiando sus datos demográficos, variables clínicas (PAS/PAD/PAM) y variables analíticas (Cr sérica, FGe por CKD-EPI, cociente proteina/Cr, EUNa, pérdida del FGe>5ml/min/año); al inicio de trasplante, al 6ºmes y anualmente hasta el 31/12/2014. El análisis de los datos se realizará determinando primero la normalidad de la distribución de la muestra con la prueba de Kolmogorov-Smirnov y posteriormente se realizará un análisis descriptivo de las variables demográficas, clínicas y analíticas

Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

Background Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results A total of 711 patients [67% male, median age (range) 67 (20-89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P = .001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P = .693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P = .001), lower time from booster (P = .043) and past breakthrough SARS-CoV-2 infection (P < .001). Conclusions In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection. Lay Summary Patients on hemodialysis present higher rates of complications derived from SARS-CoV-2 infections. Initial vaccination schedules have demonstrated suboptimal responses in those patients. The aim of the present study is to evaluate the time-course of the humoral response after a booster dose of SARS-CoV-2 RNA-based vaccines (BNT162b2 or mRNA-1273) in patients on hemodialysis. We included 711 patients that had received a booster dose: 545 (77%) 6 months before the initial vaccination and 166 (23%) between 6 and 9 months from the initial vaccination. After the booster, only 6