10.1111/ajt.16851 [PMC free article] [PubMed] [CrossRef] [Google Scholar]. (17)45 (19)152 (6)83 (5)?Diabetes19 (10)123 (30)12 (30)156 (33)74 (31)540 (22)308 (20)?Hypertension53 (28)294 (74)26 (65)293 (61)147 (61)1553 (63)968 (63)?Cancer11 (6)33 (8)3 (8)41 (9)12 (5)71 (3)44 (3)?Stroke17 (7)4 (10)41 (9)21 (9)126 (5)82 (5)?Dementia2 (1)1 (0)1 (0)?Lung disease16 (9)45 (11)6 (15)71 (15)34 (14)166 (7)94 (6)?Liver cirrhosis4 (2)6 (1)4 (2)24 (1)13 (1)?HIV/aids4 (1)2 (1)6 (0)5 (0)Primary kidney disease, (%)?Diabetes76 (18)39 (18)120 (5)73 (6)?Hypertension110 (26)57 (26)156 (8)91 (7)?Glomerulonephritis51 (12)33 (15)406 (20)240 (19)?Interstitial nephritis37 (9)16 (7)151 (8)90 (7)?PCKD41 (10)25 (11)343 (17)240 (19)?Congenital/hereditary8 (2)1 (0)66 (3)42 (3)?Autoimmune disease38 (9)20 (9)101 (5)69 (6)?Other35 (8)17 (7)538 (27)339 (27)?Unknown34 (8)13 (6)112 (6)66 (5)Dialysis modality, (%)?Hemodialysis334 (70)166 (69)?Peritoneal dialysis78 4-Aminohippuric Acid (16)42 (17)?Unknown68 (14)34 (14)Dialysis vintage, median (IQR), months26 (11C50)24 (11C50)Previous transplantation, (%)?Yes66 (14)31 (13)Time between transplantation and 2nd or 3rd vaccination, median (IQR), months92 (47C163)104 (57C171)Time between transplantation and 2nd or 3rd vaccination, (%)?<6 months36 (1)2 (0)?6 months1913 (78)1210 (78)?Unknown519 (21)335 (22)Type of transplant, (%)?DBD430 (17)282 (18)?DCD280 (11)172 (11)?Living1239 (50)758 (49)?Unknown519 (21)335 (22)Immunosuppressive treatment, (%)?Yes22 (6)9 (23)84 (18)38 (16)1583 (64)964 (62)?No378 (95)31 (78)396 (83)204 (84)?Unknown885 (36)583 (38)Type of immunosuppressive treatmenta, (%)?Corticosteroids17 (4)6 (15)66 (14)31 (13)1145 (72)710 (74)?CNIs5 (1)1 (3)39 (8)19 (8)1297 (82)781 (81)?MMF3 (1)2 (5)14 (3)7 (3)1029 (65)609 (63)?mTOR inhibitors1 (0)1 (3)2 (0)2 (1)116 (7)90 (9)?Azathioprine5 (1)2 (5)3 (1)2 (1)166 (11)97 (10)?Other0 (C)0 (C)0 (C)21 (1)10 (1)Two-dose vaccination scheme, (%)?mRNA-1273186 (100)273 (68)411 (86)2297 (93)?BNT162b2114 (29)52 (11)117 (5)?AZD122213 (3)17 (4)54 (2)Three-dose vaccination scheme?3 mRNA-12732 (5)16 (7)99 (6)?2 mRNA-1273, 1 BNT162b219 (48)177 (73)1280 (83)?3 BNT162b215 (38)28 (12)79 (5)?Other4 (10)21 (9)89 (6)Time between vaccination and antibody measurement, days, mean (SD)?2nd vaccination to 1st antibody measurement 28 (1)32 (7)33 (10)38 (9)37 (8)33 (8)33 (7)?3rd vaccination to 2nd antibody measurement37 (8)41 (8)42 (7)Time between 2nd and 3rd vaccination, days, mean (SD)172 (22)177 (19)178 (18) Open in a separate window aTotal numbers and % can vary because of missing values. CNIs: calcineurin inhibitors; BMI: body mass index; eGFR: estimated glomerular filtration rate; DBD: donation after brain death; DCD: donation after circulatory death; mTOR inhibitors: mammalian target of rapamycin; PCKD: polycystic kidney disease. A subcohort of 40 patients with CKD G4/5, 242 dialysis patients and 1547 KTR received a third SARS-CoV-2 vaccination followed by a second blood sample. In total, 1519 patients were excluded of which 73 patients had COVID-19 between their second and third vaccination (Supplementary data, Fig. S1). In this subcohort, 9 patients with 4-Aminohippuric Acid CKD G4/5 (23%) and 38 dialysis patients (16%) used immunosuppressive drugs. Patients predominantly received BNT162b2 vaccine as their third vaccination (Table?1). Baseline characteristics of dialysis patients and KTR included for analysis after three vaccinations did not differ from dialysis patients and KTR who were excluded from analysis. CKD G4/5 patients included for analysis after three vaccinations were significantly older (67??9 vs 64??12 years) and more often used immunosuppressive drugs (23% vs 4%) as compared with CKD G4/5 patients who were excluded for analysis (Supplementary data, Table S1). Antibody level after SARS-CoV-2 vaccination The median [interquartile range (IQR)] RBD IgG antibody level after two vaccinations was 3713 (2291C6451) BAU/mL in control subjects and all these subjects seroconverted. In comparison with control subjects, antibody levels and seroconversion rates were significantly lower in patients with CKD G4/5 [2097 (828C4077) BAU/mL and 96% seroconversion; (%)400 (100)378 (94)22 (6)40 (100)31 (78)9 (22)?RBD IgG Ab level (BAU/mL)2097 (828C4077)2186 (887C4160)1110 (34C2456).0031551 (459C3225)1680 (631C3466)11 (3C739).01?RBD IgG seroconversion rate, (%)384 (96)368 (97)16 (73)<.00132 (80)29 (94)3 (33)<.001?RBD IgG antibody level >1000 BAU/mL, (%)286 (72)275 (73)11 (50).0222 (55)20 (65)2 (22).03Dialysis patients, (%)480 (100)396 (83)84 (18)242 (100)204 (84)38 (16)?RBD IgG Ab level (BAU/mL)1375 (431C2896)1798 (667C3073)291 (29C748)<.0011727 (570C4254)2309 (867C4741)200 (9C1102)<.001?RBD IgG seroconversion rate, (%)443 (92)386 DP2 (97)57 (68)<.001222 (92)199 (98)23 (61)<.001?RBD IgG antibody level >1000 BAU/mL, (%)274 (57)260 (66)14 (17)<.001153 (63)143 (70)10 (26)<.001 4-Aminohippuric Acid Open in a separate window Note: Antibody levels, seroconversion rates, and rates of high-level antibody response (>1000 BAU/ml) after two and three.