Pneumococcal vaccination in patients with chronic renal disease and renal allograft recipients

Polyvalent pneumococcal vaccine was administered to 7 patients with chronic renal failure, 14 patients on chronic hemodialysis, 14 splenectomized and 11 nonsplenectomized renal allograft recipients, and 14 normal adults. Ninety-three percent of normal subjects had at least a twofold rise in serum antibody concentration after vaccination, with a geometric mean antibody concentration after vaccination greater than 200 ng N/ml. The response to vaccination in hemodialysis patients was similar to that in normal persons. Renal failure patients showed impaired antibody synthesis in response to the vaccine, with 43% achieving at least a twofold rise in antibody concentration. Allograft recipients had a lower antibody concentration before as well as after vaccination, and among splenectomized recipients the prevaccination antibody concentration was directly related to the interval between transplantation and antibody determination. But, 80% of allograft recipients achieved a twofold rise in antibody concentration after vaccination. The response to pneumococcal vaccine was quantitatively similar for splenectomized and nonsplenectomized allograft recipients.