![]() Type 2 diabetes mellitus, chronic hepatitis B, hyperlipidemia LM: diffuse thickening of the capillary wall with capillary loop doubling, hyaline thrombi in glomeruli, intact tubules and interstitium, mild infiltration of lymphocytes in the interstitium, arterial fibrointimal thickeningĮM: duplications of the glomerular basement membranes with cellular interpositions, endothelial swelling and hypertrophy with occlusion of the lumens, glomerular intracapillary fibrin deposition with entrapped cellular debris, diffuse foot process loss LM: normal glomeruli, intact tubules and interstitium LM: mesangial hypercellular with increased mesangial matrix, cellular crescent, segmental sclerosis, endocapillary proliferationĮM: many large mesangial electron dense deposits, focal foot process loss Response (Follow-Up Duration after Diagonsis) Symptom Onset Time/Biopsy Time after Vaccination, Days Therefore, in this study, we present five cases of new-onset renal pathology confirmed by kidney biopsy from a tertiary hospital in Korea, which were clinically presented as acute kidney injury or urinary abnormalities after COVID-19 vaccination. ![]() This limited information could delay the diagnosis and treatment of renal side effects after COVID-19 vaccination, resulting in a poor prognosis. Several studies have reported on kidney diseases that occurred after COVID-19 vaccinations, but the number of cases was few, and the histopathologic abnormalities and clinical courses were heterogeneous. To prove a causal relationship between side effects after vaccination is difficult, so the side effects of vaccines are occasionally overlooked. Several clinical studies have demonstrated that these vaccines have excellent protective effects against COVID-19, but their side effects are not yet well-known. ![]() Two main types of vaccine are currently used to prevent COVID-19: (1) mRNA vaccines, such as BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) and (2) vectored vaccines, such as AZD1222 (Oxford-AstraZeneca) and (Janssen). Although therapeutic agents that successfully suppress COVID-19 have not yet been developed, several vaccines against SARS-CoV-2 can help in the prevention of COVID-19 and alleviation of the disease’s severity. The coronavirus disease 2019 (COVID-19) pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is still ongoing globally. However, clinicians need to consider the possibility that kidney diseases may be provoked by vaccines in patients who have renal symptoms. Since this is not a controlled study, the specific pathophysiologic link and causality between the incidence of kidney diseases and COVID-19 vaccination are difficult to confirm. Individualized treatment was applied as per disease severity and underlying pathology, and the treatment outcomes of all patients were improved. The biopsy-proven diagnosis indicated newly developed kidney diseases: (1) IgA nephropathy presenting with painless gross hematuria, (2) minimal change disease presenting with nephrotic syndrome, (3) thrombotic microangiopathy, and (4) two cases of acute tubulointerstitial nephritis presenting with acute kidney injury. Five patients aged 42 to 77 years were included in this study, and baseline kidney function was normal in all patients. In this study, we report the clinical courses and histopathologic findings of new-onset kidney diseases after COVID-19 vaccination as confirmed via kidney biopsy. Various vaccines against COVID-19 have been developed and proven to be effective, but their side effects, especially on kidney function, are not yet known in detail.
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