在CKD中,BNT162b2和CoronaVac对SARS-CoV-2 Omicron BA.2的疫苗有效性
Franco Wing Tak Cheng1, Vincent Ka Chun Yan1, Eric Yuk Fai Wan1,2,3
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Clinical journal of the American Society of Nephrology : CJASN
|December 26, 2023
概括
包括BNT162b2和CoronaVac在内的COVID-19疫苗显著降低了慢性病 (CKD) 患者的感染,住院和死亡风险. 三次剂量显示出强烈的有效性,即使只有一次剂量也能在这个高危人群中预防所有原因的死亡.
科学领域:
- 流行病学 流行病学
- 疫苗学 疫苗学 疫苗学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- COVID-19大流行不成比例地影响患有慢性病 (CKD) 的个体,增加他们出现严重结局的风险.
- 目前关于COVID-19疫苗在CKD患者中的有效性数据有限,特别是在非透析人群中.
研究的目的:
- 评估BNT162b2和CoronaVac疫苗在预防COVID-19感染,住院和患有CKD的成年人死亡率方面的有效性.
- 评估疫苗剂量对CKD患者群体有效性的影响.
主要方法:
- 一项病例控制研究利用了来自香港的电子健康记录,将COVID-19 PCR确诊病例与未接种疫苗的对照进行了匹配.
- 条件后勤回归分析调整为并发病和药物治疗史.
- 对BNT162b2和CoronaVac的疫苗有效性估计是针对感染,住院和全因死亡率.
主要成果:
- 三剂BNT162b2和CoronaVac显著降低了感染风险 (分别为64%和42%),住院 (82%和80%),以及死亡率 (94%和93%).
- 在CKD亚组中,疫苗对感染和住院治疗的有效性较低,预计球膜过率 (eGFR) <30毫升/分钟/1.73米2.
- 然而,即使是单一的疫苗剂量也有效地预防了所有CKD严重程度水平的全因死亡率.
结论:
- 对于BNT162b2和CoronaVac在CKD患者中对COVID-19感染和相关并发症的有效性存在剂量反应关系.
- 接种COVID-19疫苗对于减少慢性病患者的严重后果至关重要.
相关概念视频
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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However, dosage adjustments...
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However, dosage adjustments...
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01:06Renal Drug Clearance: Overview
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01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
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Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
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01:23Renal Clearance
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The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
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Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
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01:25Renal Drug Excretion: Tubular Reabsorption
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Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
185