Impact of prior COVID-19 vaccination on major adverse kidney events in patients with non-dialysis dependent chronic kidney disease: a global retrospective study.

Abstract

Background: Vaccination prevents complications and death in patients with chronic kidney disease (CKD) and COVID-19, but concerns remain about post-vaccination kidney outcomes. This study assessed the real-world impact of prior COVID-19 vaccination on major adverse kidney events (MAKEs) in CKD patients with COVID-19.

Research design and methods: We conducted a global retrospective cohort study using the TriNetX database from 1 January 2020, to 31 May 2024. Propensity score matching created a 1:1 cohort of 8,520 vaccinated and 8,520 unvaccinated CKD patients with COVID-19. Outcomes included MAKEs and all-cause mortality within 30 days. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Subgroup and sensitivity analyses were performed.

Results: The vaccinated group had significantly lower risks of MAKEs or mortality (HR: 0.637; 95% CI: 0.581-0.689), MAKEs (HR: 0.792; 95% CI: 0.698-0.898), and mortality (HR: 0.549; 95% CI: 0.484-0.622). More outcome benefits were seen in those with ≥ 3 vaccine doses. Sensitivity analyses confirmed these findings.

Conclusions: In CKD patients with COVID-19, prior vaccination significantly reduced risks of MAKEs and mortality, especially with three or more doses. These findings underscore the clinical importance of adhering to recommended vaccination schedules to improve kidney outcomes and survival in this vulnerable population.