Journal
CANADIAN JOURNAL OF KIDNEY HEALTH AND DISEASE
Volume 8, Issue -, Pages -Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/20543581211058271
Keywords
COVID-19 vaccine; minimal change disease; acute kidney injury; SARS-CoV-2
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Although severe complications are rare with COVID-19 vaccine, cases of nephrotic syndrome and acute kidney injury have been reported post-vaccination. Minimal change disease with acute tubular injury is a potential rare complication associated with Pfizer-BioNTech COVID-19 vaccine, which can be effectively managed with appropriate interventions.
Rationale: While severe complications are generally uncommon with novel coronavirus disease 2019 (COVID-19) vaccine, there has been a steady increase in the number of patients presenting with nephrotic syndrome and acute kidney injury after the administration of COVID-19 vaccine. Physicians should be made aware of minimal change disease as a potential complication associated with COVID-19 vaccine. Presenting concerns: A 60-year-old male without significant past medical history presented with new onset of nephrotic syndrome approximately 10 days after his first dose of Pfizer-BioNTech COVID-19 vaccine. Laboratory findings showed hypoalbuminemia (20 g/L), elevated urine albumin/creatinine ratio (668 mg/mmol), and elevated creatinine of 116 mu mol/L from a baseline of 79 mu mol/L. Diagnosis: A diagnostic kidney biopsy was performed 6 weeks after the onset of the edema and approximately 8 weeks after his first dose of Pfizer-BioNTech COVID-19 vaccine. The kidney biopsy findings were consistent with minimal change disease with focal acute tubular injury. Interventions: The patient was treated conservatively with ramipril 10 mg and furosemide 80 mg daily 5 weeks after the onset of swelling. Prednisone 1 mg/kg was initiated immediately when the kidney biopsy result became available (approximately 6 weeks after the onset of edema). Outcomes: The patient remitted with rapid weight loss starting 2 weeks post prednisone initiation. Novel findings: De novo minimal change disease with acute tubular injury is a kidney manifestation following the administration of Pfizer-BioNTech COVID-19 vaccine. Minimal change disease is potentially a rare complication of Pfizer-BioNTech COVID-19 vaccine.
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