ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: SA-PO457

Better Anti-Spike IgG Antibody Response to SARS-CoV-2 Vaccine in Patients on Hemodiafiltration Than on Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Carrera, Fernando, DaVita, Leiria, Portugal
  • Jacobson, Stefan H., Danderyd Hospital, Stockholm, Sweden
  • Costa, Joana, DaVita, Leiria, Portugal
  • Marques, Marco Alexandre, Affidea Laboratory, Lisbon, Portugal
  • Ferrer, Francisco, DaVita, Leiria, Portugal

The antibody response to SARS-CoV-2 vaccine in hemodialysis (HD) patients is diminished compared to healthy subjects. The aim of this study was to compare the presence of reactive SARS-CoV-2 antibodies in patients with high-flux HD and on-line hemodiafiltration (HDF) three and six months after the second dose of SARS-CoV-2 vaccine since previous studies indicate that a sustained antibody response correlate with protection from disease.


We included 216 HD patients of which 157 had on-line HDF and 59 high-flux HD and 46 health care workers as controls and studied the presence of reactive anti-spike IgG antibodies three and six months after the second dose of SARS-CoV-2 vaccine. Clinical features between the patient groups were similar, but patients with on-line HDF had significantly higher Kt/V.


The percentage of participants with reactive antibodies was significantly lower in patients compared to controls, both three and six months after the second dose of vaccine. Furthermore, the proportion of patients with reactive anti-spike IgG ≥1.0 six months after the second dose of vaccine was significantly higher in patients with on-line HDF compared to in patients with high-flux HD. In logistic regression analyses adjusted for several clinical features, the variables associated with presence of reactive anti-spike IgG at three months after the second dose of vaccine were lower age, HDF treatment, not being obese and not having a previous solid organ transplant. The two variables with the strongest influence on the presence of reactive anti-spike IgG levels six months after the second dose of vaccine were treatment with on-line HDF and not having immunosuppressive therapy.


This is the first study to show that on-line HDF preserves the antibody response better than high-flux HD after vaccination with SARS-CoV-2 vaccine. Treatment strategies that sustain the vaccine response are essential to apply in this vulnerable group of patients.


  • Private Foundation Support