{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:19:38Z","timestamp":1790313578477,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","funder":[{"DOI":"10.13039\/501100009400","name":"Medizinische Fakult\u00e4t, Heinrich-Heine-Universit\u00e4t D\u00fcsseldorf","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009400","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014690","name":"Ministerium f\u00fcr Kultur und Wissenschaft des Landes Nordrhein-Westfalen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014690","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006603","name":"Bundesministerium f\u00fcr Bildung und Frauen","doi-asserted-by":"publisher","award":["COVIM 01KX2021"],"award-info":[{"award-number":["COVIM 01KX2021"]}],"id":[{"id":"10.13039\/501100006603","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2021,9]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Immune response to the coronavirus disease 2019 vaccination is significantly reduced in patients with kidney failure compared with controls without kidney failure.<\/jats:p>\n <\/jats:list-item>\n \n After two vaccinations, kidney transplant recipients show the lowest levels of IgGs specific to severe acute respiratory syndrome coronavirus 2, with the lowest neutralizing capacity.<\/jats:p>\n <\/jats:list-item>\n \n These data suggest that vaccination strategies need modification in kidney transplant recipients and patients on dialysis.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Patients with kidney failure on dialysis or after renal transplantation have a high risk for severe COVID-19 infection, and vaccination against SARS-CoV-2 is the only expedient prophylaxis. Generally, immune responses are attenuated in patients with kidney failure, however, systematic analyses of immune responses to SARS-CoV-2 vaccination in patients on dialysis and in kidney transplant recipients (KTRs) are still needed.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this prospective, multicentric cohort study, antibody responses to COVID-19 mRNA vaccines (BNT162b2 [BioNTech\/Pfizer] or mRNA-1273 [Moderna]) were measured in 32 patients on dialysis and in 28 KTRs. SARS-CoV-2\u2013specific antibodies and neutralization capacity were evaluated and compared with controls (\n n<\/jats:italic>\n =78) of a similar age range.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After the first vaccination, SARS-CoV-2\u2013specific antibodies were nearly undetectable in patients with kidney failure. After the second vaccination, 93% of the controls and 88% of patients on dialysis but only 37% of KTRs developed SARS-CoV-2\u2013specific IgG above cutoff. Moreover, mean IgG levels were significantly lower in KTRs (54\u00b193 BAU\/ml) compared with patients on dialysis (503\u00b1481 BAU\/ml;\n P<\/jats:italic>\n <0.01). Both KTRs and patients on dialysis had significantly lower IgG levels compared with controls (1992\u00b12485 BAU\/ml;\n P<\/jats:italic>\n <0.001 and\n P<\/jats:italic>\n <0.01, respectively). Importantly, compared with controls, neutralizing antibody titers were significantly lower in KTRs and patients on dialysis. After the second vaccination, 76% of KTRs did not show any neutralization capacity against SARS-CoV-2, suggesting impaired seroprotection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients with kidney failure show a significantly weaker antibody response compared with controls. Most strikingly, only one out of four KTRs developed neutralizing antibodies against SARS-CoV-2 after two doses of vaccine. These data suggest that vaccination strategies need modification in KTRs and patients on dialysis.<\/jats:p>\n \n Clinical Trial registry name and registration number:<\/jats:bold>\n Vaccination Against COVID-19 in Chronic Kidney Disease, NCT04743947\n <\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0003512021","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T10:40:14Z","timestamp":1626172814000},"page":"1491-1498","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":45,"title":["Impaired Immune Response to SARS-CoV-2 Vaccination in Dialysis Patients and in Kidney Transplant Recipients"],"prefix":"10.34067","volume":"2","clinical-trial-number":[{"clinical-trial-number":"nct04743947","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Thilo","family":"Kolb","sequence":"first","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"KfH Kuratorium f\u00fcr Dialyse und Nierentransplantation e.V, KfH-Nierenzentrum, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svenja","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"L\u00fcbke","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Hillebrandt","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Andr\u00e9e","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"Department of Nephrology, St\u00e4dtisches Klinikum Solingen, Solingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seher","family":"K\u00fc\u00e7\u00fckk\u00f6yl\u00fc","sequence":"additional","affiliation":[{"name":"MVZ DaVita Rhein-Ruhr, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Koster","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarethe","family":"Kittel","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical 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Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1636-4365","authenticated-orcid":false,"given":"Heiner","family":"Schaal","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Ivens","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"KfH Kuratorium f\u00fcr Dialyse und Nierentransplantation e.V, KfH-Nierenzentrum, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars C.","family":"Rump","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"KfH Kuratorium f\u00fcr Dialyse und Nierentransplantation e.V, KfH-Nierenzentrum, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7799-3045","authenticated-orcid":false,"given":"J\u00f6rg","family":"Timm","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8994-8102","authenticated-orcid":false,"given":"Johannes","family":"Stegbauer","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Faculty, University Hospital D\u00fcsseldorf, 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