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Determinants of protective humoral response to mRNA-1273 and BNT162b2 vaccines in peritoneal dialysis patients: a prospective cohort study

BMC Nephrology volume 25, Article number: 391 (2024) Cite this article

Abstract

Patients with chronic kidney disease (CKD) on dialysis have a higher mortality rate associated with SARS-CoV-2 infection. Although vaccines are now available, the protective response rates and determinants of humoral response to the vaccine are poorly described in patients on peritoneal dialysis. This was a prospective observational study describing the response rates of detectable and standardized protective antibody titers one month after each mRNA vaccine dose in a cohort of 88 patients on peritoneal dialysis. We found that the vast majority of patients produced protective levels of antibodies (73%) one month after the second vaccine dose. In the multivariate analysis, the single determinant for an adequate humoral response was the weekly Kt/V, a surrogate of dialysis dose. The response rate was higher, but not significantly, with the mRNA-1273 than with the BNT162b2 vaccine one month after the second dose (78.7 vs. 46.2%, respectively, p = 0.02). We found that patients on peritoneal dialysis had a satisfactory humoral response rate, which was much higher than in transplant recipients. PD patients with a poor humoral response, particularly those with a low wKT/V, may benefit from an additional dose of vaccine.

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Introduction

Patients with end-stage kidney disease (ESKD) are at a higher risk of contracting SARS-CoV-2 and experiencing severe symptoms. While the mortality rate for the general population is around 1.9%, it can range from 30 to 41% for dialysis patients [1,2,3,4,5]. As a result, ESKD patients have been prioritized for vaccination against SARS-CoV-2. However, these patients often exhibit a poor response to vaccinations, such as for hepatitis B, during advanced non-dialysis stages and while on dialysis [6, 7]. This decreased response is limited to thymo-dependent antigens like HBs, while the immune response to thymo-independent antigens like S. pneumoniae remains normal [8].

Studies have shown that a significant proportion of ESKD patients on dialysis develop anti-SARS-CoV-2 antibodies after receiving two doses of an mRNA vaccine, with rates ranging from 82 to 96% [9,10,11,12,13,14]. However, few studies have evaluated the efficacy of Covax in peritoneal dialysis patients [15,16,17], and have included only small numbers of patients, making it difficult to analyze predictive factors of response to vaccination.

Additionally, the lack of standardization in antibody measurement between different test manufacturers has made comparisons between studies challenging. The World Health Organization (WHO) has recently standardized the reporting of antibody level results, with one study suggesting that an antibody level greater than 264 binding antibody units (BAU)/mL provides 80% protection against symptomatic forms of COVID in the general population [18]. No study has directly compared the mRNA-1273 vaccine (Moderna) and the BNT162b2 vaccine (Pfizer-BioNTech) in peritoneal dialysis patients in terms of protective levels.

Our study aimed to quantify the rate of protective humoral response (defined as > 264 BAU/mL) and analyze the determinants of adequate response to vaccination in a larger cohort of peritoneal dialysis patients who received one of the two mRNA vaccines available on the European market.

Methods

We conducted a prospective, multicenter study across three peritoneal dialysis units within a single French region. The study included chronic peritoneal dialysis patients who had received two doses of an mRNA vaccine against SARS-CoV-2. Patients were excluded if they refused vaccination, had a contraindication to vaccination (such as allergy or recent COVID-19 infection), were pregnant, under 18 years of age, unable to give consent, or refused to participate in the study. All participating patients provided their consent, and the study protocol was approved by the ethics committee of the University Hospital of Strasbourg (CE-2021-45).

At the time of the first vaccine injection, we collected clinical and biological data and patient history from the computerized dialysis medical record. Biological tests were part of the patients’ regular follow-up, and no additional samples or examinations were required for the study apart from anti-SARS-CoV-2 serologies.

In accordance with current guidelines, all patients received two intramuscular injections of the same vaccine, either BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna), four weeks apart, depending on each unit’s supply.

We performed anti-nucleoplasmid protein (anti-NP) antibody testing at the time of the first vaccination to identify asymptomatic patients with pre-existing antibodies. Vaccination-specific anti-Spike antibodies were tested twice: at the time of the second vaccination and four weeks later. IgG antibodies to the S protein were measured using either the SARS-CoV-2 IgG II Quant Assay (Abbot) or the Elecsys Anti-SARS-CoV-2 S kit (Roche), depending on the unit. The threshold for antibody detection was set at 0.8 U/ml for the Roche test and 50 U/ml for the Abbot test, as recommended by the manufacturers. The threshold for protection was estimated at 50 U/ml for the Roche test and 1000 U/ml for the Abbot test when compared with a neutralization test [19].

We assessed vaccination side effects by interviewing patients at each injection and one month later.

The primary endpoint of our study was the percentage of patients with protective antibody levels four weeks after receiving their second vaccine dose. Secondary endpoints included: the percentage of patients who developed a significant antibody response; the percentage of patients who developed antibodies above both the detection and protection thresholds after their first vaccine injection; and clinical determinants of response to vaccination.

Statistics

The position and dispersion parameters were expressed as a median and inter-quartile range (IQR) for numerical data and number and frequency with percentage for categorical and binary variables.

Nearly all numerical variables did not show a normal distribution, so these variables were compared with the Mann-Whitney-Wilcoxon test. In addition, the categorical variables were compared with Fisher’s exact test. The determinants of humoral response with detectable and protective antibodies titres were analyzed by logistic regression, first, in univariate analyses and, second, in a multivariate analysis, including parameters with P < 0.20 in the univariate analyses. Missing data were not imputed.

The following variables were used in the univariate analyses: age, gender, weight, body mass index (BMI), dialysis vintage, weekly Kt/V (wKt/V), residual daily diuresis, residual kidney function (RKF) [calculated as the arythmetic mean of measured urinary urea clearance + creatinine clearance], PD technique (APD or CAPD), smoking, coronary artery disease (CAD), peripheral arterial disease (PAD), hypertension, diabetes, history of organ transplantation, flu vaccine, response to HBV vaccine, treatment with immunosuppressive drug, angiotensin convertase inhibitor (ACEI), angiotensin receptor blocker (ARB), vitamin K antagonists (VKA) or antiplatelet agent (APA), plasma creatinine, potassium, bicarbonate, calcium, phosphate, serum total protein and albumin, CRP, iPTH, hemoglobin, vaccine brand (Pfizer-BioNTech or Moderna).

All statistical analysis was performed with STATA v13.1 software (StataCorp, TX, USA) and P < 0.05 was considered statistically significant.

Results

In the present investigation involving a cohort of 90 patients undergoing peritoneal dialysis, a total of 88 individuals consented to partake in the research study and were administered the initial dose of the vaccine. Subsequently, 82 of these participants received a second vaccine dose. Four patients were precluded from receiving the second dose owing to a documented history of SARS-CoV-2 infection either prior to or following the administration of the initial dose. Additionally, one patient was excluded due to the presence of a non-SARS-CoV-2-related infection and one patient died from cardiovascular cause after the first dose. Post-vaccination serological assessments were not conducted one month following the second dose in eight patients, 2 of whom had a non-Covid-related death and 6 for technical reasons. Consequently, a total of 74 patients were eligible for inclusion in the statistical analyses (Flowchart, Fig. 1).

Fig. 1
figure 1

Flowchart of the study population

Full size image

The median age of the subjects included in the analysis was 70.5 years, with an interquartile range of 62 to 79 years. Of these, 60.8% were male, and the median Body Mass Index (BMI) was 25.1 kg/m2, with an interquartile range of 22.5 to 29.9 kg/m2. The median peritoneal dialysis vintage was 16.7 [5.3–32.6] months. Diabetes was present in 46% of patients, while 94.6% had hypertension, 29.7% had coronary artery disease, and 18.9% peripheral arterial disease. Additional demographic and clinical characteristics of the study cohort are comprehensively detailed in Table 1.

Table 1 Baseline characteristics of the patients in the whole cohort and according to vaccine brand
Full size table

Prior to receiving the first vaccine dose, two patients had manifested symptomatic COVID-19; and required hospitalization, one of them in intensive care unit (ICU). Finally, in terms of vaccine type, 13 patients (17.6%) were administered the BNT162b2 vaccine developed by Pfizer-BioNTech, while the majority, 61 patients (82.4%), received the mRNA-1273 vaccine from Moderna.

Humoral response after the first dose

After the first dose of the vaccine, only 4.4% of patients developed anti-S antibodies at a protective level. All of these patients were vaccinated with the mRNA-1273 vaccine.

Humoral response after the second dose

After the second dose, 73% of patients developed anti-S antibodies at a protective level. In univariate analyses, those who did develop antibodies had: higher weekly KT/V (wKT/V) (p = 0.025) and higher serum albumin (p = 0.025) (Table 2). Patients responded significantly better to mRNA-1273 than to the BNT162b2 vaccine, 78.7% had a protective level with the Moderna vs. 46.2% with the Pfizer-BioNTech vaccine (p = 0.02). In the multivariate analysis, only wKT/V remained significant (p = 0.023) (Table 2).

Table 2 Uni- and multivariate analyses of the determinants of protective response after 2 vaccine doses
Full size table

Discussion

To our best knowledge, this is the first study assessing protective levels of antibodies after vaccination in peritoneal dialysis patients. Our study showed a reasonably good efficacy of vaccination against SARS-Cov-2, as 73% of the patients developed protective antibody levels after two vaccine doses. These figures were slightly lower than in our study on hemodialysis patients, where 86% of patients were protected by vaccination [12]. Several other studies that included a mix of both hemodialysis and peritoneal dialysis patients found conflicting results. Most studies found no difference between dialysis modalities [20,21,22,23,24] while one found better results in hemodialysis [24] and another a better response rate in peritoneal dialysis [25]. The small number of patients in those studies may explain the discordant results. Of note, the endpoint in these studies were detectable antibodies and not the protective threshold.

In our cohort, the single variable that was significantly associated with an adequate response to vaccination in the multivariate analysis was wKt/V, a surrogate of dialysis dose. Previous studies in peritoneal dialysis did not investigate the predictive factors due to smaller cohorts. In hemodialysis, the results were inconsistent; for most, Kt/V was not associated with vaccination efficacy [12, 14, 26], while for others, efficacy was correlated with Kt/V [27, 28]. The effect of wKt/V in PD has also been studied for other vaccines, such as hepatitis B. Again, the results were discordant, one study showed a beneficial effect [29] but the other did not [30]. Finally, one study found a beneficial effect of wKt/V but limited at the initiation of treatment and that vanished during follow-up [31]. These discordant results are difficult to interpret but probably explained by the small number of patients (30 to 40 each).

The precise mechanisms underlying the association between a higher dialysis dose and improved vaccine response remain unclear but may involve enhanced immune function through the more effective removal of uremic toxins. Uremic toxins such as indoxyl sulfate and p-cresyl sulfate are known to impair immune cells, including lymphocytes and dendritic cells, which are critical in mediating vaccine-induced immune responses.

Low serum total protein and albumin levels were important factors associated with the lack of antibody production in the univariate analysis, a feature also found in hemodialysis patients [11, 12, 21]. This protein profile probably identified malnourished patients who were less likely to respond to vaccination but maybe also related to peritoneal albumin losses or overhydration. Also, we cannot exclude that low protein/albumin levels were associated with an inflammatory state via the IL6 pathway. Still, high CRP was not significant in the uni- and multivariate analyses.

The response rate with the Moderna vaccine was higher one month after the second dose, with a more than 30% higher response rate. This statistically significant difference may have clinical consequences in a population at increased mortality risk in the case of SARS-CoV-2 infection. Our results are consistent with the few published in the literature. In PD patients, Quiroga et al. found a significantly higher antibody titres with the Moderna vaccine [32]. In dialysis patients, studies comparing the two vaccines showed a 10 to 20% difference in the response rate favouring the mRNA-1273 vaccine [9, 11, 12], an effect generally attributed to the higher dosage (100 mcg) in the Moderna vs. the Pfizer vaccine (30 mcg). Other differences, not tested in this study, relate to epitope-specific responses, with higher concentrations of receptor binding domain and N-terminal domain-specific IgA observed in recipiens of mRNA-1273. However, the difference in antibody responses between the two vaccines was not found in our multivariate analysis, possibly due to the small number of patients vaccinated with BNT162b2 (17.6% of the cohort).

Our study found that the results of vaccination against SARS-CoV-2 were significantly better than those for hepatitis B vaccination. We observed no correlation between the response to hepatitis B vaccination and the protective response to the anti-COVID-19 vaccine. These differences may be attributed to the type of antigens and the use of mRNA vaccine technology, supporting the development of an mRNA vaccine against hepatitis B.

Several limitations of our study should be considered. Firstly, our focus was on the humoral response to vaccines, which represents only one aspect of the overall immune response to vaccination. A study in a small cohort of dialysis patients reported a dissociation between humoral and cellular responses [33]. Secondly, the “protective” thresholds used in our study were based on WHO specifications and may not accurately reflect protection in real-life conditions. Thirdly, the distribution of patients receiving either the mRNA-1273 Moderna vaccine or the BNT162b2 Pfizer-BioNTech vaccine was not randomized, and the number of patients receiving the Pfizer-BioNTech vaccine was too small to ensure a robust comparison. Fourthly, we used two different assays to assess humoral response based on their availability at each site. However, according to WHO specifications, standardizing antibody levels as binding antibody units (BAU) ensured comparability of protective levels in our study. Finally, our results regarding response rates cannot be extrapolated to non-mRNA vaccines such as ChAdOx1-SARS-COV-2 or Ad26.COV2.S.

Conclusion

In a cohort of 88 peritoneal dialysis patients, we found that a large majority (73%) developed protective antibody levels one month after receiving their second vaccine dose. In multivariate analysis, the only determinant of an adequate humoral response was weekly Kt/V, a measure of dialysis dose. The response rate was higher with the mRNA-1273 vaccine than with the BNT162b2 vaccine, although this difference was not statistically significant due to non-randomization.

Our study found an acceptable humoral response rate in peritoneal dialysis patients, much higher than in transplant recipiens but similar to that observed in hemodialysis patients. A third vaccine dose may be warranted for patients with an inadequate humoral response, particularly those with low wKt/V.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

References

  1. COVID-19 situation update for the EU/EEA. as of 24 June 2021. European Centre for Disease Prevention and Control. [cited 2021 Jun 24]. https://www.ecdc.europa.eu/en/cases-2019-ncov-eueea

  2. Scarpioni R, Manini A, Valsania T, De Amicis S, Albertazzi V, Melfa L et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale Guglielmo Da Saliceto in Piacenza. G Ital Nefrol Organo Uff Della Soc Ital Nefrol. 2020;37(2).

  3. Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection. Kidney Int. 2020;98(1):20–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020;98(1):27–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Valeri AM, Robbins-Juarez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, et al. Presentation and outcomes of patients with ESKD and COVID-19. J Am Soc Nephrol JASN. 2020;31(7):1409–15.

    Article  CAS  PubMed  Google Scholar 

  6. Dimitrov Y, Ducher M, Kribs M, Laurent G, Richter S, Fauvel JP. Variables linked to hepatitis B vaccination success in non-dialyzed chronic kidney disease patients: Use of a bayesian model. Nephrol Ther. 2019;15(4):215–9.

    Article  PubMed  Google Scholar 

  7. Soni R, Horowitz B, Unruh M. Immunization in end-stage renal disease: opportunity to improve outcomes. Semin Dial. 2013;26(4):416–26.

    Article  PubMed  Google Scholar 

  8. Raskova J, Ghobrial I, Czerwinski DK, Shea SM, Eisinger RP, Raska K. B-cell activation and immunoregulation in end-stage renal disease patients receiving hemodialysis. Arch Intern Med. 1987;147(1):89–93.

    Article  CAS  PubMed  Google Scholar 

  9. Anand S, Montez-Rath ME, Han J, Garcia P, Cadden L, Hunsader P, et al. Antibody response to COVID-19 vaccination in patients receiving Dialysis. J Am Soc Nephrol JASN. 2021;32(10):2435–8.

    Article  CAS  PubMed  Google Scholar 

  10. Garcia P, Anand S, Han J, Montez-Rath M, Sun S, Shang T et al. COVID19 vaccine type and humoral immune response in patients receiving dialysis. MedRxiv Prepr Serv Health Sci. 2021;2021.08.02.21261516.

  11. Hsu CM, Weiner DE, Aweh GN, Manley HJ, Ladik V, Frament J, et al. Seroresponse to SARS-CoV-2 vaccines among maintenance Dialysis patients. Am J Kidney Dis 2022;79(2):307–10.

    Article  CAS  Google Scholar 

  12. Dimitrov Y, Krummel T, Chantrel F, Faller AL, Ott J, David D, et al. Protective antibody response to mRNA-1273 and BNT162b2 vaccines in patients on maintenance haemodialysis: a prospective cohort study. Clin Kidney J. 2022;15(9):1720–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Frantzen L, Cavaillé G, Thibeaut S, El-Haik Y. Efficacy of the BNT162b2 mRNA COVID-19 vaccine in a haemodialysis cohort. Nephrol Dial Transplant off Publ Eur Dial Transpl Assoc -. Eur Ren Assoc. 2021;36(9):1756–7.

    CAS  Google Scholar 

  14. Lacson E, Argyropoulos CP, Manley HJ, Aweh G, Chin AI, Salman LH, et al. Immunogenicity of SARS-CoV-2 vaccine in Dialysis. J Am Soc Nephrol JASN. 2021;32(11):2735–42.

    Article  CAS  PubMed  Google Scholar 

  15. Rodríguez-Espinosa D, Broseta JJ, Maduell F, Bedini JL, Vera M. Humoral response of the mRNA-1273 SARS-CoV-2 vaccine in peritoneal dialysis patients. Kidney Int. 2021;100(2):476–7.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Beilhack G, Monteforte R, Frommlet F, Gaggl M, Strassl R, Vychytil A. Antibody response and safety after mRNA-1273 SARS-CoV-2 Vaccination in Peritoneal Dialysis patients - the Vienna Cohort. Front Immunol. 2021;12:780594.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Haase M, Lesny P, Haase-Fielitz A, Anderson M, Cloherty G, Stec M, et al. Immunogenicity and tolerability of COVID-19 vaccination in peritoneal dialysis patients-A prospective observational cohort study. Semin Dial. 2022;35(3):269–77.

    Article  PubMed  Google Scholar 

  18. Feng S, Phillips DJ, White T, Sayal H, Aley PK, Bibi S, et al. Correlates of protection against symptomatic and asymptomatic SARS-CoV-2 infection. Nat Med. 2021;27(11):2032–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Perkmann T, Perkmann-Nagele N, Koller T, Mucher P, Radakovics A, Marculescu R, et al. Anti-spike protein assays to Determine SARS-CoV-2 antibody levels: a Head-to-Head comparison of five quantitative assays. Microbiol Spectr. 2021;9(1):e0024721.

    Article  PubMed  Google Scholar 

  20. Yanay NB, Freiman S, Shapira M, Wishahi S, Hamze M, Elhaj M et al. Experience with SARS-COV-2 BNT162b2 mRNA vaccine in dialysis patients. Kidney Int. 2021. 99(6):1496-1498

  21. Agur T, Ben-Dor N, Goldman S, Lichtenberg S, Herman-Edelstein M, Yahav D, et al. Antibody response to mRNA SARS-CoV-2 vaccine among dialysis patients - a prospectivecohort study. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc - Eur Ren Assoc; 2021.

  22. Longlune N, Nogier MB, Miedougé M, Gabilan C, Cartou C, Seigneuric B, et al. High immunogenicity of a messenger RNA based vaccine against SARS-CoV-2 in chronic dialysis patients. Nephrol Dial Transplant 2021; 36(9):1704-1709

  23. Tylicki L, Piotrowska M, Biedunkiewicz B, Zieliński M, Dąbrowska M, Tylicki P et al. Humoral response to COVID–19 vaccination in patients treated with peritoneal dialysis: the COViNEPH Project. Pol Arch Intern Med. 2021;131(10):16091

  24. Boongird S, Chuengsaman P, Phanprasert S, Kitpermkiat R, Assanatham M, Nongnuch A, et al. Anti-SARS-CoV-2 spike protein S1 receptor-binding domain antibody after vaccination with inactivated whole-virus SARS-CoV-2 in end-stage kidney disease patients: an initial report. Kidney Int. 2021;100(5):1136–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Murt A, Altiparmak MR, Ozbey D, Yalin SF, Sert Yadigar S, Karaali R, et al. Antibody responses to inactivated SARS-CoV-2 vaccine in peritoneal dialysis patients. Semin Dial. 2022;35(3):264–8.

    Article  PubMed  Google Scholar 

  26. Grupper A, Sharon N, Finn T, Cohen R, Israel M, Agbaria A, et al. Humoral response to the Pfizer BNT162b2 vaccine in patients undergoing maintenance hemodialysis. Clin J Am Soc Nephrol CJASN. 2021;16(7):1037–42.

    Article  CAS  PubMed  Google Scholar 

  27. Espi M, Charmetant X, Barba T, Koppe L, Pelletier C, Kalbacher E, et al. The ROMANOV study found impaired humoral and cellular immune responses to SARS-CoV-2 mRNA vaccine in virus-unexposed patients receiving maintenance hemodialysis. Kidney Int. 2021;100(4):928–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Danthu C, Hantz S, Dahlem A, Duval M, Ba B, Guibbert M, et al. Humoral response after SARS-CoV-2 mRNA vaccination in a cohort of Hemodialysis patients and kidney transplant recipients. J Am Soc Nephrol JASN. 2021;32(9):2153–8.

    Article  CAS  PubMed  Google Scholar 

  29. Svác J, Skladaný L, Sekerková Z, Javorský P, Leskova L, Mizla P, et al. Peritoneal dialysis is the better therapy choice for successful anti-hepatitis B vaccination. Adv Perit Dial Conf Perit Dial. 2005;21:151–3.

    Google Scholar 

  30. Dervisoglu E, Simsek M, Yilmaz A. Antibody response following Hepatitis B vaccination in peritoneal dialysis patients: does normalized urea clearance matter? Clinics. 2011;66(9):1559–62.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Dacko C, Holley JL. The influence of nutritional status, dialysis adequacy, and residual renal function on the response to hepatitis B vaccination in peritoneal dialysis patients. Adv Perit Dial Conf Perit Dial. 1996;12:315–7.

    CAS  Google Scholar 

  32. Quiroga B, Soler MJ, Ortiz A, Bernat A, Muñoz Díaz AB, Jarava Mantecón CJ, et al. Loss of humoral response 3 months after SARS-CoV-2 vaccination in the CKD spectrum: the multicentric SENCOVAC study. Nephrol Dial Transplant 2022;37(5):994–9.

    Google Scholar 

  33. Monzó JJB, Rodríguez-Espinosa D, Soruco E, Maduell F. Weekly seroconversion rate of the mRNA-1273 SARS-CoV-2 vaccine in hemodialysis patients. Nephrol Dial Transplant 2021;36(9):1754-1755

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Acknowledgements

We are indebted to all the health professionals involved in this study: Project manager: S. Le Calvez (AURAL). Nephrologists: Dr C. Preissig-Dirhold (Mulhouse Hospital), Dr L. Bencheikh (Strasbourg Universitary Hospital), Dr L. Beguin, Dr L. Georgieva, Dr E. Leon, Dr B. Muller, Dr J. Ott, Dr E. Scheidt (Haguenau Hospital). Biologists: Dr J. Exinger (Haguenau Hospital). Clinical research associate: AC Bertaux. Study nurses: I. Friedmann, N. Richard, H. Mountassir, JM. Daessle.

Funding

AURAL funded part of the serological costs.

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Authors and Affiliations

  1. Department of nephrology & dialysis, Centre Hospitalier de Haguenau, Haguenau, France

    Yves Dimitrov & Marc Kribs

  2. Renal Research Division, AURAL, 5 rue Henri Bergson, Strasbourg, 67087, France

    Yves Dimitrov, François Chantrel, Françoise Heibel, Marc Kribs & Thierry Hannedouche

  3. Department of nephrology, dialysis & transplantation, Centre Hospitalo-Universitaire de Strasbourg, Strasbourg, France

    Thierry Krummel & Françoise Heibel

  4. Department of nephrology & dialysis, Groupe Hospitalier de Mulhouse-Sud Alsace, Mulhouse, France

    François Chantrel

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Contributions

Authorship: YD and TH conceived the study. FC, FH, MK were involved in protocol development, gaining ethical approval, patient recruitment and data analysis. TK performed the statistical analysis. YD and TH wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

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Correspondence to Thierry Hannedouche.

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Ethical approval

The study protocol was approved by the Ethics Committee of the University Hospital of Strasbourg (CE-2021-45).

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Written informed consent was obtained from all subjects at inclusion in the study. All methods were performed in accordance with the local guidelines and regulations.

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Not applicable.

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The authors declare no competing interests.

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Dimitrov, Y., Krummel, T., Chantrel, F. et al. Determinants of protective humoral response to mRNA-1273 and BNT162b2 vaccines in peritoneal dialysis patients: a prospective cohort study. BMC Nephrol 25, 391 (2024). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12882-024-03789-3

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BMC Nephrology

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