MALNUTRITION IS A RISK FACTOR FOR LOWER HUMORAL IMMUNE RESPONSE AFTER ANTI-SARS-COV-2 VACCINATION IN PATIENTS ON HEMODIALYSIS: RESULTS OF A MULTI-CENTER PROSPECTIVE COHORT

E-Poster

https://storage.unitedwebnetwork.com/files/1099/5141b49426e559c3fd17759b507a98e5.pdf

Abstract Title

First Name *

Luis

Last Name *

Toro

Co-author 1

Rene Clavero rclavero@nephrochile.cl Hospital Gustavo Fricke Nephrology Viña del Mar

Co-author 2

Alfredo Parra-Lucares aparra@nephrochile.cl Hospital Clinico Universidad de Chile Cardiology Santiago

Co-author 3

Gabriel Mendez-Valdes gmendez@biomedchile.cl Facultad de Medicina Universidad de Chile Medicine Santiago

Co-author 4

Eduardo Villa evilla@biomedchile.cl Facultad de Medicina Universidad de Chile Medicine Santiago

Co-author 5

Karin Bravo kbravo@biomedchile.cl Facultad de Medicina Universidad de Chile Medicine Santiago

Co-author 6

Evelyn Mondaca emondaca@nephrochile.cl Centro Renal SpA Hemodialysis Villa del Mar

Co-author 7

Josseline Aranda jaranda@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 8

Rose Brignardello rbrignardello@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 9

Cynthia Gajardo cgajardo@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 10

Angelica Ordenes aordenes@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 11

Evelyn Colombo ecolombo@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 12

Jessica Tapia jtapia@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 13

Andoni Etcheverry aetcheverry@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 14

Jose Zuñiga jzuniga@nephrochile.cl Centro Renal SpA Hemodialysis Viña del Mar

Co-author 15

Introduction

Malnutrition is frequent in patients with end-stage renal disease (ESRD). This condition is an independent risk factor for developing adverse events, including severe infections and infection-related deaths. Previous studies have shown that patients with malnutrition, both in the general population and ESRD patients, have an impaired immune response. Additionally, malnutrition is associated with a reduced humoral immune response after vaccination compared to patients with normal nutritional status. Currently, there is little data on malnutrition's effects on the induction of the immune response to anti-SARS-CoV-2 vaccination. Therefore, our objective was to evaluate the impact of malnutrition on the humoral immune response after anti-SARS-CoV-2 vaccination in ESRD patients on hemodialysis.

Methods

Prospective cohort of ESRD patients on chronic hemodialysis who received a three-dose anti-SARS-CoV-2 immunization schedule between 2021 and 2022. We measured the plasma levels of anti-SARS-CoV-2 IgG antibodies before vaccination, four months after doses 2,3 and 4. Based on anthropometric parameters and subjective global assessment (SGA), we stratified patients according to their baseline nutritional status. In addition, we evaluated potential predictors of humoral response using multivariate analysis.

Results

214 patients were evaluated in four hemodialysis centers. Age: 63.7 ± 16.3 years, men: 116 (54.2%). 41 patients (19.1%) were diagnosed with malnutrition. Malnourished patients had a lower humoral response after anti-SARS-CoV-2 vaccination compared to those without malnutrition (4 months after the second dose: 61.3% vs. 79.4%, p<0.01; 4 months after the third dose: 78.3% vs 93.1%, p<0.01; Figures 1 and 2). Multivariate analysis indicated that malnutrition is an independent risk factor for a decreased humoral immune response after vaccination (OR: 3.1, [1.5-9.9], p=0.01).

Conclusions

Our results suggest malnutrition is a risk factor for a lower humoral response after anti-SARS-CoV-2 vaccination in ESRD patients on hemodialysis. These data suggest that improving nutritional status can improve the post-vaccination immune response, which should be evaluated in future studies.

This abstract was presented in the ASN Kidney Week 2023 in Philadelphia, PA, in November 2023.

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