A RECENT study has found that patients on peritoneal dialysis (PD) mount a strong antibody response to mRNA COVID-19 vaccines, although certain factors, such as dialysis dose, influence the level of protection. The prospective study followed 88 PD patients, assessing their antibody response one month after each dose of either the mRNA-1273 or BNT162b2 vaccine.
Results showed that 73% of patients achieved protective antibody levels after the second vaccine dose, with the mRNA-1273 vaccine eliciting a slightly higher response (78.7%) compared to BNT162b2 (46.2%). In a multivariate analysis, the primary determinant of a strong antibody response was the weekly Kt/V, a measure of dialysis dose. Patients with a higher weekly Kt/V were more likely to achieve protective antibody levels.
The findings suggest that most PD patients respond well to mRNA COVID-19 vaccines, with antibody levels comparable to or even better than those in transplant recipients. However, patients with lower weekly Kt/V values, indicating a lower dialysis dose, may need an additional vaccine dose to boost their immune response.
These results underscore the importance of considering dialysis dose when assessing vaccine efficacy in PD patients. The study supports an adaptive approach for patients with weaker responses, helping to ensure effective protection against COVID-19 in this vulnerable group.
Reference
Dimitrov Y et al. Determinants of protective humoral response to mRNA-1273 and BNT162b2 vaccines in peritoneal dialysis patients: a prospective cohort study. BMC Nephrol. 2024;DOI:10.1186/s12882-024-03789-3.
