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- OpenAccess
Influenza Vaccination in Patients With Chronic Kidney Disease and End-Stage Renal Disease After Dialysis: A Population Based Case-Control Study
摘要
BACKGROUND: Influenza is a serious illness that causes significant mortality in high-risk patients. The purpose of this study was to investigate the effectiveness of the influenza vaccine in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. This study compared the influenza-related death in CKD and ESRD patients between the cohort with and without influenza vaccination. METHODS: We conducted a population-based case-control study by using the Longitudinal Health Insurance Database to evaluate the protective effect in CKD and ESRD patients. The case group consisted of all CKD patients ≥ 65 years of age who died from influenza-related hospitalizations from 2006 to 2013. The 503 cases and 1106 controls were well matched for age, sex, and ESRD. The vaccine cohort to the non-vaccine cohort odds ratio (OR) of mortality was measured. RESULTS: The case-cohort had a significant lower influenza vaccination frequency and lower vaccination rate in the current vaccine season compared to control cohort (2.42 ± 1.96 vs. 2.71 ± 2.05, P = 0.0091; 30.82% vs. 39.46%, P = 0.001). In all recruited patients, the vaccine cohort had lower risks than the non-vaccine cohort for mortality (OR, 0.67; 95% confidence interval [CI], 0.53-0.84). After controlling the confounding variables, the multivariate analysis revealed the vaccine cohort had an overall adjusted OR of 0.64 (95% CI, 0.50-0.82) for mortality. Notably, our results suggested that the repeated vaccination group (repeat vaccination each year) had lower risks for mortality compared to the non-repeated group (OR, 0.92; 95% CI, 0.87-0.97). Following all recruited CKD patients were divided into non-ESRD and ESRD groups. In non-ESRD groups, the adjusted OR of 0.58 (95% CI, 0.44-0.77) for mortality showed a protective association for patients with vaccination. A similar trend was observed in the ESRD group without reaching statistical significance. CONCLUSION: Influenza vaccine is a positive association with a reduction of influenza-related death risk in patients with CKD and ESRD.
延伸閱讀
- 麥秀琴（2016）。Investigation of Associated Factors and Resource Utilization of Delayed Hemodialysis in End-Stage Renal Disease Patients〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-1408201602430600
- Hung, S. C., Liu, J. S., Kuo, K. L., Peng, C. H., Wu, C. H., Wang, Y. C., Hsu, C. C., & Tarng, D. C. (2016). Association between Diuretic Use and the Risk of Chronic Dialysis and Death in Patients with Advanced Chronic Kidney Disease. Acta Nephrologica, 30(2), 70-78. https://doi.org/10.6221/AN.2016029
- 郭碧蓮（2012）。Investigation of Outcomes of annual influenza vaccination on chronic obstruction pulmonary disease patients comorbid with ischemic heart disease〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2012.00238
- Chen, H. C., Lai, Y. H., Tsai, C. Y., Shin, S. J., & Tsai, J. H. (1991). Continuous Ambulatory Peritoneal Dialysis in Diabetic Patients with End-Stage Renal Disease: Experience with Intraperitoneal Insulin Therapy. The Kaohsiung Journal of Medical Sciences, 7(2), 56-61. https://doi.org/10.6452/KJMS.199102.0056
- Cho, S. L., Chen, P. M., Lai, T. S., Chen, P. Y., Chang, F. C., Chen, Y. T., Chiang, W. C., Lin, S. L., & Chen, Y. M. (2020). The Impact of Initial and Subsequent Blood Pressure Control on Renal Outcome in Moderate to Severe Chronic Kidney Disease Patients. Acta Nephrologica, 34(3), 127-135. https://doi.org/10.6221/AN.202009_34(3).0004