Changes in post-vaccination immunity to whooping cough in children with chronic kidney disease stages 3 and 5

Introduction. Staging of chronic kidney disease (CKD) is used in nephrology practice to assess the risk of kidney disease progression and determine the timing of renal replacement therapy (RRT). Infections, including vaccine-preventable ones, remain among the main causes of decreased overall and renal survival after kidney transplantation, necessitating monitoring of the complete implementation of preventive measures before initiating RRT. The aim: to determine the presence and persistence of post-vaccination immunity to whooping cough in children in the pre-transplant period at stages 3 and 5 of CKD.

Materials and methods. A retrospective analysis of the medical records of 91 patient was conducted: 42 children with CKD stage 3 (group 1) and 49 children with CKD stage 5 (group 2), aged 7 to 17 years, with an assessment of the presence of protective IgG levels to the pertussis pathogen Bordetella pertussis (BP) after previous vaccination. The comparison group consisted of 25 children without chronic diseases.

Results. The average frequency of positive IgG levels in children in group 1 with stage 3 CKD was found to m be only 33.3%, while in children with CKD stage 5 it was 52.8%. Positive IgG levels to BP in both groups were higher in children with non-immune-mediated pathology (Alport syndrome, congenital renal malformations, polycystic disease, etc.) compared to patients with primary steroid-resistant nephrotic syndrome. Positive levels of specific antibodies were detected in children in both groups in the period after vaccination up to 5 years of age — in 57.2% of children in group 1 and 55.1% in group 2.

Conclusion. Analysis of our sample shows about half of the patients (67.7% of patients with stage 3 CKD and 47% of children with stage 5 CKD) to have negative IgG to BP, which significantly increases the risk of infection in this cohort of patients and requires mandatory immunization in the pre-transplant period.

Contribution:
Matsneva I.Yu., Komarova O.V. — concept;
Matsneva I.Yu. Konyashin M.V., Kushtysev E.A., Dergacheva Yu.S. — collection and processing of material;
Matsneva I.Yu. — writing the text;
Trofimova A.G., Kurbatova O.V., Tsygin A.N. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 28, 2025
Accepted: November 27, 2025
Published: December 25, 2025

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