#2765 EVALUATION OF ANTIBODY RESPONSES TO SARS-COV-2 VACCINES IN PATIENTS WITH CKD
Authors: Abdullaev Sherzod , Sharapov Olimkhon , Igamberdieva Ranokhon 
Published: June 2023

Abstract

Background and Aims
Patients with CKD are highly vulnerable to the serious complications of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infections and thus stand to benefit from vaccination. Therefore, our aim is to evaluate the effectiveness of available COVID-19 vaccines in patients with CKD.

Method
A total of 198 consecutive adult CKD patients in a single center in Uzbekistan were evaluated. Patients were divided into four cohorts: haemodialysis (HD) (n=116), peritoneal dialysis (PD) (n=11), kidney transplant (KT) recipients (n=22) and non-dialysis CKD (stages 4 and 5, eGFR &lt;30 mL/min/1.73 m2) (n=49) patients (Fig. 1). All the screened participants received the complete vaccination with any of the available vaccines: Pfizer-BioNTech®, Moderna®, AstraZeneca®, Sputnik V®, ZF-UZ-VAC2001®. At baseline and on day 28 after the last vaccine dose, antibodies were measured and compared between cohorts. Factors associated with development of antibodies were analyzed.

Results
Among the 198 participants in screened group, 109 (55%) were male and the mean age was 54.3 ± 11.2 years. Vaccine distribution was as follows: 25 patients (12.6%) received Pfizer-BioNTech, 42 (21.2%) Moderna, 28 (14.1%) AstraZeneca, 36 (18.2%) Sputnik V and 67 (33.9%) ZF-UZ-VAC2001 vaccines. The distribution of the different types of vaccines differed between groups (Table 1). Development of antibody responses at 28 days after completing vaccination has been tested in 155 patients (97 HD, 8 PD, 16 KT recipients, 34 non-dialysis CKD patients). After the 28 days of completing vaccination, 137 patients (88%) presented antibody responses, 3 (2%) were doubtful and 15 (10%) had a negative result. Patients that did not develop antibody responses after vaccination included: 3 (2%) HD patients, 2 (1%) PD patients, 2 (1%) non-dialysis CKD patients and 8 (6%) KT recipients (P &lt; 0.01). Patients receiving Pfizer-BioNTech, Moderna and AstraZeneca developed higher antibody titres than those receiving Sputnik V and ZF-UZ-VAC2001 vaccines (P &lt; 0.01). These differences were significant in all cohort of patients. Factors associated with negative antibody response were also increasing age (p&lt;0.01), history of CVD (p = 0.02), lower eGFR (P &lt; 0.05). Previous COVID-19 infection was associated with higher antibody titres at 28 days (P &lt; 0.05). We did not find significant association between antibody response and gender, ethnicity, BMI, diabetes and donor type.

Conclusion
Our study has shown a much lower seropositivity rate among the KT recipients after of SARS-COV-2 vaccine than other cohort of CKD patients, suggesting that KT patients require persistent isolation measures and booster doses of a COVID-19 vaccine. Increasing age, history of CVD and lower eGFR were factors associated with a non-response. Potential differences between COVID-19 vaccines should be explored in prospective long-term follow-up studies. These findings complement those of earlier studies and highlight the need for a tailored approach to the vaccination.