Kidney Week

Abstract: TH-PO1108

The Severity of Microscopic Hematuria in IgA Nephropathy Correlates with the Incidence of Gross Hematuria Following SARS-CoV-2 mRNA Vaccination

Session Information

• COVID-19 - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Yokote, Shinya, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Shinya Yokote,

• Tsuboi, Nobuo, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Nobuo Tsuboi,

• Shimizu, Akihiro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Akihiro Shimizu,

• Okabe, Masahiro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Masahiro Okabe,

• Haruhara, Kotaro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Kotaro Haruhara,

• Sasaki, Takaya, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Takaya Sasaki,

• Ueda, Hiroyuki, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Hiroyuki Ueda,

• Yokoo, Takashi, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan

Takashi Yokoo,

Background

Since the initiation of a global vaccination program against the COVID-19 pandemic, numerous cases of newly diagnosed or worsening immunoglobulin A nephropathy (IgAN) with gross hematuria have been reported following SARS-CoV-2 mRNA vaccination. Recent case studies have indicated a possible link between baseline urinary findings and the appearance of gross hematuria following SARS-CoV-2 mRNA vaccination.

Methods

Outpatients with biopsy-proven IgAN aged 18 years or older were included in this study. The association between pre-vaccination microscopic hematuria (urine sediment < 5 /HPF) or proteinuria (< 0.3 g/gCr) and post-vaccination gross hematuria was retrospectively analyzed.

Results

A total of 417 IgAN patients (mean age, 51 years; 56 % female; eGFR, 58 mL/min/1.73 m²) were included. The frequency of post-vaccination gross hematuria was higher in patients (20/123; 16.3%) with pre-vaccination microscopic hematuria than in patients (5/294; 1.7%) without pre-vaccination microscopic hematuria (p < 0.001). There was no association between pre-vaccination proteinuria and post-vaccination gross hematuria. After adjustment for potential confounders such as gender (female), age group (< 50 years), eGFR category (≥ 60 mL/min/1.73m²), and prior tonsillectomy or corticosteroid therapy, microscopic hematuria was still associated with post-vaccination gross hematuria (OR 8.98, p < 0.001). Notably, as the severity of pre-vaccination microscopic hematuria increased, the incidence of post-vaccination gross hematuria increased (Figure 1).

Conclusion

These results suggest that baseline microscopic hematuria predicts gross hematuria after SARS-CoV-2 mRNA vaccination in patients already diagnosed with IgAN. The correlation between the severity of pre-vaccination microscopic hematuria and the incidence of post-vaccination gross hematuria suggests that IgAN disease activity is involved in this association.