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Study provides insights into how the immune system of kidney transplant recipients responds to COVID-19

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Kidney transplant recipients (KTRs) have experienced severe symptoms and poor outcomes with COVID-19. Because the long-term antirejection immunosuppressive drugs that KTRs take could inhibit the development of protective anti-COVID-19 immunity, most hospitals have reduced the drugs’ doses in KTRs with COVID-19. Surprisingly, reported rates of acute rejection have been low despite reduced immunosuppression in these patients. A new study in JASN provides a potential explanation.

To study KTRs’ immune responses in the face of COVID-19, a team lead by Madhav C. Menon, MBBS, MD (Yale University School of Medicine and Icahn School of Medicine at Mount Sinai) analyzed the blood of 64 KTRs with COVID-19, including 31 acute cases (< 4 weeks from diagnosis) and 33 post-acute cases (>4 weeks). Patients were enrolled form Mount Sinai and Montefiore hospital (Albert Einstein College of Medicine)—two hospitals at the forefront of the pandemic in its early months. Read the full story in Medical Xpress.

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Inflammation Associated with Mortality in Kidney Transplant Recipients

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No specific inflammatory pathway was considered causative to long-term mortality in kidney transplant recipients.

Investigators observed strong association between low-grade systemic inflammation in the 10 weeks following kidney transplantation and long-term mortality in a recent cohort study from Norway.

Generally, low-grade systemic inflammation has been established as a risk factor for all-cause mortality as has been known to increase the severity and risk of diseases including cardiovascular disease and cancer. Read more on HCP Live.

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Steroids Cut Risk for Serious Renal Events in IgA Nephropathy

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“Oral steroids helped reduce the risk of major kidney outcomes for patients with immunoglobulin A (IgA) nephropathy, the TESTING study found.

In a randomized trial of 503 participants, those who received oral methylprednisolone saw a 47% risk reduction for a composite kidney outcome — defined as a 40% eGFR decline or kidney failure resulting in dialysis, transplantation, or kidney disease-related death — meeting the primary endpoint (event rate 7.0 vs 11.8/100 patient-years; HR 0.53, 95% CI 0.39-0.72, P<0.0001), reported Vlado Perkovic, MBBS, PhD, of the University of New South Wales in Sydney.”

Learn more here.

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