How do you approach COVID-19 vaccination in those with a prior history of glomerular disease?

It is well documented that patients with kidney disease are at increased risk for morbidity and mortality from SARS-CoV2 infection including increased rates of hospitalization, AKI and death. Those with preexisting glomerular disease (GD) have demonstrated impaired GFR recovery following AKI in the setting of SARS-CoV2 infection (Waldman et al., PMID: 35373130).

Patients with nephrotic syndrome may also have impaired ability to gain adequate protection from vaccination due to increased urinary lo...

There have been an increasing number of reports describing the association of the COVID19 vaccine and glomerular disease (both de novo and relapsing).

Minimal change disease, IgA Nephropathy, Membranous nephropathy, pauci-immune vasculitis, anti GBM have all been reported. (Klomjit et al., PMID 34632166)

However, the actual incidence of glomerular disease post-vaccination is likely very rare as reported in this registry, where 98 patients were entered from 44 centers around the world. Waldman et a...