Various vaccines against COVID-19 have been developed and proven to be effective, but their side effects, especially on kidney function, are not yet known in detail. In this study, we report the clinical courses and histopathologic findings of new-onset kidney diseases after COVID-19 vaccination as confirmed via kidney biopsy. Five patients aged 42 to 77 years were included in this study, and baseline kidney function was normal in all patients. The biopsy-proven diagnosis indicated newly developed kidney diseases: (1) IgA nephropathy presenting with painless gross hematuria, (2) minimal change disease presenting with nephrotic syndrome, (3) thrombotic microangiopathy, and (4) two cases of acute tubulointerstitial nephritis presenting with acute kidney injury. Individualized treatment was applied as per disease severity and underlying pathology, and the treatment outcomes of all patients were improved. Since this is not a controlled study, the specific pathophysiologic link and causality between the incidence of kidney diseases and COVID-19 vaccination are difficult to confirm. However, clinicians need to consider the possibility that kidney diseases may be provoked by vaccines in patients who have renal symptoms.
The coronavirus disease 2019 (COVID-19) pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is still ongoing globally. Although therapeutic agents that successfully suppress COVID-19 have not yet been developed, several vaccines against SARS-CoV-2 can help in the prevention of COVID-19 and alleviation of the disease’s severity.
Two main types of vaccine are currently used to prevent COVID-19: (1) mRNA vaccines, such as BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna); and (2) vectored vaccines, such as AZD1222 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen). Several clinical studies have demonstrated that these vaccines have excellent protective effects against COVID-19, but their side effects are not yet well-known [1,2]. To prove a causal relationship between side effects after vaccination is difficult, so the side effects of vaccines are occasionally overlooked.
Several studies have reported on kidney diseases that occurred after COVID-19 vaccinations, but the number of cases was few, and the histopathologic abnormalities and clinical courses were heterogeneous [3,4]. This limited information could delay the diagnosis and treatment of renal side effects after COVID-19 vaccination, resulting in a poor prognosis. Therefore, in this study, we present five cases of new-onset renal pathology confirmed by kidney biopsy from a tertiary hospital in Korea, which were clinically presented as acute kidney injury or urinary abnormalities after COVID-19 vaccination. Table 1 shows the details of the cases.
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