Acute interstitial nephritis following SARS-CoV-2 virus vaccination

A number of reports have de-scribed new onset or relapse of existing glo-merular disease after severe acute respira-tory syndrome coronavirus 2 (SARS-CoV-2) vaccination. More and more of these cases continue to emerge, and the European Med-icines Agency (EMA) has recently launched an in-depth investigation to ascertain the true frequency of such renal side effects. In comparison, acute interstitial nephritis after SARS-CoV-2 vaccination has only been de-scribed in 1 solitary case. Here, we describe a case of acute kidney injury due to biopsy-proven acute interstitial nephritis soon af-ter SARS-CoV-2 vaccination with the Astra-Zeneca vaccine. The patient responded well to steroids, although he required tempo-rary renal replacement therapy. A thorough medical history failed to elucidate any plau-sible explanation or trigger other than the preceding vaccination. We acknowledge the possibility that other factors could have trig-gered acute interstitial nephritis in the case described here. Similar uncertainty exists regarding glomerular disease reported in conjunction with SARS-CoV-2 vaccination. However, we note that acute interstitial nephritis associated with vaccination has been described before the pandemic, and we therefore feel that a link is possible. We suggest that nephrologists should be vigilant when they see cases of unexplained acute interstitial nephritis. A history of preceding SARS-CoV-2 vaccination should be explored, and cases should be reported within nation-al systems of pharmacovigilance.