ArticleInternational urology and nephrology2026
Glomerulonephritis before and after BNT162b2 mRNA vaccine rollout: biopsy-based trends, histopathological spectrum, and temporal associations.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionmRNA-based vaccines developed against the COVID-19 pandemic have been reported to trigger immune-mediated glomerular diseases in rare cases. However, it remains unclear whether these cases have a direct causal relationship with the vaccine or whether they result from the "unmasking" of latent pathologies. This study aims to compare biopsy-based proportions and the histopathological spectrum of glomerulonephritis (GN) before versus after the rollout of the Pfizer-BioNTech (BNT162b2) mRNA vaccine, and to explore temporal associations between vaccination/infection and GN presentation among biopsied patients.
methodsIn this single-center retrospective cohort study conducted at Ankara Bilkent City Hospital, renal biopsy data from the periods before (April 1, 2020- March 31, 2021) and after (April 1, 2021- March 31, 2022) mRNA vaccination were compared. GN diagnosis rates, subtype distributions, and the temporal relationship between symptom onset and vaccination/infection were analyzed. Logistic regression analyses were performed to identify risk factors for GN development.
resultsAmong patients undergoing native kidney biopsy, the proportion of biopsies yielding GN was higher in the post-rollout period than in the pre-rollout period (70.5% vs 60.2%; biopsy-based OR 1.58, p = 0.026). However, in a temporal-proximity analysis based on the interval from vaccination to biopsy, the GN proportion among patients biopsied within 3 months of vaccination (68.5%) was similar to that of patients biopsied >3 months after vaccination or unvaccinated (67.6%) (OR = 1.04; p = 1.00). In the histopathological spectrum, the proportion of IgA Nephropathy (IgAN) increased from 16.5% to 26.2% (p = 0.040); exploratory subtype analyses suggested higher IgAN odds in the temporally proximate group (unadjusted OR = 2.57; p = 0.0129).
conclusionOur biopsy-based analyses suggest no higher odds of GN among patients biopsied within 3 months of vaccination compared with other biopsied patients, and the observed post-rollout changes may reflect diagnostic awareness and an unmasking phenomenon rather than a direct vaccine effect. The observed increase in IgAN diagnoses warrants further investigation in larger, population-based studies and should be interpreted cautiously given potential confounding and multiple comparisons.
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