Post vaccination acute kidney injury and other renal complications after COVID-19 and influenza vaccination

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. COVID-19: Coronavirus disease 2019.

Figure 2 Proposed immunopathological mechanisms of influenza and coronavirus disease 2019 vaccine-associated kidney injury. This figure illustrates the potential mechanisms by which influenza and coronavirus disease 2019 vaccinations may be associated with kidney injury. The mechanisms are categorized into different pathways leading to acute kidney injury (AKI). The green pathway represents various proposed mechanisms underlying different forms of glomerulonephritis, including antineutrophil cytoplasmic antibody-associated vasculitis and pauci-immune glomerulonephritis, anti-glomerular basement membrane disease, and immune complex glomerulonephritis. The red pathway describes the proposed mechanisms for vascular-related causes of AKI, such as atypical haemolytic uremic syndrome, renal vein thrombosis, and renal thrombotic microangiopathy. The blue pathway describes the proposed mechanisms of podocytopathies, such as minimal change disease. The purple pathway describes the systemic causes related to AKI, such as rhabdomyolysis and pre-renal causes of AKI. This figure provides a comprehensive overview of how immune responses triggered by vaccinations may lead to kidney injury through both direct renal effects and systemic processes. AKI: Acute kidney injury; ANCA: Antineutrophil cytoplasmic antibody; Anti-GBM: Anti-glomerular basement membrane; DRESS: Drug reaction with eosinophilia and systemic symptoms; GBS: Guillain-Barré syndrome; IL-13: Interleukin-13; iTTP: Immune-mediated thrombotic thrombocytopenic purpura; MIS: Multisystem inflammatory syndrome; MOI: Multiorgan inflammation; TAFRO: Thrombocytopenia, anasarca, fever, reticulin myelofibrosis, renal dysfunction, and organomegaly; HLH: Haemophagocytic lymphohistiocytosis; COVID-19: Coronavirus disease 2019.