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Influenza virus vaccination and kidney graft rejection: causality or coincidence.

Fischer AS, Møller BK, Krag S, Jespersen B - Clin Kidney J (2015)

Bottom Line: They all had different native diseases and were all vaccinated in the same season of 2009-10.The time span from vaccination to decline of kidney function is shorter than the time to diagnosis since the three patients only had blood tests every 3 months or when symptoms became severe.These reports do not justify a change of current recommendations regarding influenza vaccination in renal transplant recipients, but they support the continued attention and registration of vaccinations to monitor side effects.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology , Aarhus University Hospital, Skejby , Århus N DK-8200 , Denmark.

ABSTRACT
Influenza can cause significant morbidity and mortality in renal transplant recipients especially with a high rate of lower respiratory disease. Annual influenza vaccination is therefore recommended to renal transplant recipients. We report the first three cases of acute kidney injury in renal transplant recipients following influenza vaccination that all led to graft loss. They all had different native diseases and were all vaccinated in the same season of 2009-10. The time span from vaccination to decline of kidney function is shorter than the time to diagnosis since the three patients only had blood tests every 3 months or when symptoms became severe. These reports do not justify a change of current recommendations regarding influenza vaccination in renal transplant recipients, but they support the continued attention and registration of vaccinations to monitor side effects.

No MeSH data available.


Related in: MedlinePlus

The three figures show estimated glomerular filtration rate (e-GFR) for the cases over time. The graphs end when dialysis was initiated. The arrow indicates the time of vaccination. e-GFR is estimated using the MDRD study equation [16].
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SFV027F2: The three figures show estimated glomerular filtration rate (e-GFR) for the cases over time. The graphs end when dialysis was initiated. The arrow indicates the time of vaccination. e-GFR is estimated using the MDRD study equation [16].

Mentions: These were the first reported cases of AKI in renal transplant recipients following influenza vaccination that all led to graft loss. Although we cannot exclude that the onset of AKI is a coincidence, we would like to point out these three cases with striking association to the vaccinations (Table 1). All patients were vaccinated in the same winter season of 2009–10. They were all diagnosed with different native renal diseases, but the symptoms of renal failure developed after the vaccination, which led to admission 1–2 months after the vaccinations. There were no signs of infection or urinary obstruction in any of the cases. One could suspect that an activation of the immune system led to late rejections and/or relapse of the native renal disease and thus to graft loss. The time span from vaccination to decline of kidney function in our study was shorter than the time to diagnosis since the three patients only had blood tests every 3 months or when symptoms became severe (Figure 2).Table 1.


Influenza virus vaccination and kidney graft rejection: causality or coincidence.

Fischer AS, Møller BK, Krag S, Jespersen B - Clin Kidney J (2015)

The three figures show estimated glomerular filtration rate (e-GFR) for the cases over time. The graphs end when dialysis was initiated. The arrow indicates the time of vaccination. e-GFR is estimated using the MDRD study equation [16].
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440474&req=5

SFV027F2: The three figures show estimated glomerular filtration rate (e-GFR) for the cases over time. The graphs end when dialysis was initiated. The arrow indicates the time of vaccination. e-GFR is estimated using the MDRD study equation [16].
Mentions: These were the first reported cases of AKI in renal transplant recipients following influenza vaccination that all led to graft loss. Although we cannot exclude that the onset of AKI is a coincidence, we would like to point out these three cases with striking association to the vaccinations (Table 1). All patients were vaccinated in the same winter season of 2009–10. They were all diagnosed with different native renal diseases, but the symptoms of renal failure developed after the vaccination, which led to admission 1–2 months after the vaccinations. There were no signs of infection or urinary obstruction in any of the cases. One could suspect that an activation of the immune system led to late rejections and/or relapse of the native renal disease and thus to graft loss. The time span from vaccination to decline of kidney function in our study was shorter than the time to diagnosis since the three patients only had blood tests every 3 months or when symptoms became severe (Figure 2).Table 1.

Bottom Line: They all had different native diseases and were all vaccinated in the same season of 2009-10.The time span from vaccination to decline of kidney function is shorter than the time to diagnosis since the three patients only had blood tests every 3 months or when symptoms became severe.These reports do not justify a change of current recommendations regarding influenza vaccination in renal transplant recipients, but they support the continued attention and registration of vaccinations to monitor side effects.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology , Aarhus University Hospital, Skejby , Århus N DK-8200 , Denmark.

ABSTRACT
Influenza can cause significant morbidity and mortality in renal transplant recipients especially with a high rate of lower respiratory disease. Annual influenza vaccination is therefore recommended to renal transplant recipients. We report the first three cases of acute kidney injury in renal transplant recipients following influenza vaccination that all led to graft loss. They all had different native diseases and were all vaccinated in the same season of 2009-10. The time span from vaccination to decline of kidney function is shorter than the time to diagnosis since the three patients only had blood tests every 3 months or when symptoms became severe. These reports do not justify a change of current recommendations regarding influenza vaccination in renal transplant recipients, but they support the continued attention and registration of vaccinations to monitor side effects.

No MeSH data available.


Related in: MedlinePlus