Unexpected renal side effects of mRNA COVID-19 vaccines; a single-center experience and short review

Am J Med Sci. 2025 Jun;369(6):739-744. doi: 10.1016/j.amjms.2025.01.002. Epub 2025 Jan 7.

Abstract

Background: In late 2019, the World Health Organization declared Coronavirus disease 2019 a global emergency. Since then, many vaccines have been developed to combat the pandemic. Millions of people have received one of the approved COVID-19 vaccines; unfortunately, some adverse events also have been recorded.

Methods: In the local health system, patients could get either mRNA vaccines (either Pfizer-BioNTech or Moderna), adenoviral vector vaccine (AstraZeneca), or the vaccine based on inactivated virus (Sinovac). We investigated what immune-mediated adverse events occurred in our department after the COVID-19 vaccination.

Results: We evaluated six patients from our center who received mRNA vaccines and developed suspected immune-mediated adverse events. The immune-mediated adverse events are characterized by de novo or relapsing glomerular diseases and are further confirmed with percutaneous kidney biopsies. During A follow-up of more than two years, remission occurred in five patients, and glomerulonephritis persisted in one of them.

Conclusions: Vaccinations are pivotal in effectively protecting and preventing various epidemics. As such, it is essential to maintain a high level of vigilance concerning post-vaccination adverse events. This heightened level of suspicion leads to earlier detection, better understanding, and optimal prevention and management of these events. To this end, developing a specific vaccine/patient risk profile is necessary to categorize the target population selectively.

Keywords: Adverse events post-vaccine; COVID-19 vaccine; Glomerulonephritis; Immunological; Viral vector-based vaccines; mRNA vaccines.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • BNT162 Vaccine
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Kidney Diseases* / chemically induced
  • Male
  • Middle Aged
  • SARS-CoV-2
  • Vaccines, Synthetic / adverse effects
  • Young Adult

Substances

  • BNT162 Vaccine
  • COVID-19 Vaccines
  • Vaccines, Synthetic