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Seasonal influenza vaccination is associated with reduced morbidity and mortality in peritoneal dialysis patients.

Abstract

BACKGROUND

Studies on the effectiveness of seasonal influenza vaccination in peritoneal dialysis (PD) patients are limited. The aim of the present study is to evaluate the effectiveness of seasonal influenza vaccination in reducing morbidity and mortality in incident end-stage renal disease patients on PD.

METHODS

From Taiwan's National Health Insurance Research Database, we identified 2089 incident PD patients with seasonal influenza vaccination and 2089 propensity score matched incident PD patients without the vaccination during 1998-2010. Each study subject was followed up to measure the 12-month incident cardiovascular and infectious diseases, and deaths. The effects of multi-year vaccinations were also estimated.

RESULTS

Compared with the non-vaccinated cohort, the vaccinated cohort had a lower hospitalization rate (68.5 versus 80.2 per 100 person-years) with an adjusted hazard ratio (aHR) of 0.85 [95% confidence interval (CI) = 0.78-0.92]. Hazards of hospitalization were significantly reduced for sepsis (aHR = 0.79, 95% CI = 0.65-0.96), heart disease (aHR = 0.74, 95% CI = 0.63-0.89) and intensive care (aHR = 0.85, 95% CI = 0.73-0.99). In addition, hazards of peritonitis (aHR = 0.84, 95% CI = 0.73-0.97) and overall mortality (aHR = 0.66, 95% CI = 0.55-0.78) were also reduced. The aHR of mortality was reduced much further to 0.28 (95% CI = 0.22-0.35) for those with multiple-year vaccinations.

CONCLUSIONS

Seasonal influenza vaccination for PD patients is associated with significant reduction in morbidities and a 34% reduction in mortality. Multi-year vaccinations could reduce the death hazard further to 72%.

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  • Authors+Show Affiliations

    ,

    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.

    ,

    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan College of Medicine, China Medical University, Taichung, Taiwan.

    ,

    Division of Infection, China Medical University Hospital, Taichung, Taiwan.

    ,

    Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.

    ,

    Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.

    ,

    Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan Chang Gung University College of Medicine, Taoyuan, Taiwan.

    ,

    Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.

    ,

    Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.

    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan Department of Health Services Administration, China Medical University, Taichung, Taiwan.

    Source

    MeSH

    Aged
    Female
    Humans
    Influenza A virus
    Influenza Vaccines
    Influenza, Human
    Kidney Failure, Chronic
    Male
    Middle Aged
    Morbidity
    Peritoneal Dialysis
    Propensity Score
    Proportional Hazards Models
    Retrospective Studies
    Seasons
    Survival Rate
    Taiwan
    Vaccination

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26453199

    Citation

    Wang, I-Kuan, et al. "Seasonal Influenza Vaccination Is Associated With Reduced Morbidity and Mortality in Peritoneal Dialysis Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 31, no. 2, 2016, pp. 269-74.
    Wang IK, Lin CL, Lin PC, et al. Seasonal influenza vaccination is associated with reduced morbidity and mortality in peritoneal dialysis patients. Nephrol Dial Transplant. 2016;31(2):269-74.
    Wang, I. K., Lin, C. L., Lin, P. C., Chang, S. N., Chou, C. Y., Yen, T. H., ... Sung, F. C. (2016). Seasonal influenza vaccination is associated with reduced morbidity and mortality in peritoneal dialysis patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 31(2), pp. 269-74. doi:10.1093/ndt/gfv360.
    Wang IK, et al. Seasonal Influenza Vaccination Is Associated With Reduced Morbidity and Mortality in Peritoneal Dialysis Patients. Nephrol Dial Transplant. 2016;31(2):269-74. PubMed PMID: 26453199.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Seasonal influenza vaccination is associated with reduced morbidity and mortality in peritoneal dialysis patients. AU - Wang,I-Kuan, AU - Lin,Cheng-Li, AU - Lin,Po-Chang, AU - Chang,Shih-Ni, AU - Chou,Che-Yi, AU - Yen,Tzung-Hai, AU - Chang,Chiz-Tzung, AU - Huang,Chiu-Ching, AU - Sung,Fung-Chang, Y1 - 2015/10/08/ PY - 2015/05/23/received PY - 2015/09/13/accepted PY - 2015/10/11/entrez PY - 2015/10/11/pubmed PY - 2016/10/19/medline KW - end-stage renal disease KW - influenza vaccination KW - morbidity KW - mortality KW - peritoneal dialysis SP - 269 EP - 74 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 31 IS - 2 N2 - BACKGROUND: Studies on the effectiveness of seasonal influenza vaccination in peritoneal dialysis (PD) patients are limited. The aim of the present study is to evaluate the effectiveness of seasonal influenza vaccination in reducing morbidity and mortality in incident end-stage renal disease patients on PD. METHODS: From Taiwan's National Health Insurance Research Database, we identified 2089 incident PD patients with seasonal influenza vaccination and 2089 propensity score matched incident PD patients without the vaccination during 1998-2010. Each study subject was followed up to measure the 12-month incident cardiovascular and infectious diseases, and deaths. The effects of multi-year vaccinations were also estimated. RESULTS: Compared with the non-vaccinated cohort, the vaccinated cohort had a lower hospitalization rate (68.5 versus 80.2 per 100 person-years) with an adjusted hazard ratio (aHR) of 0.85 [95% confidence interval (CI) = 0.78-0.92]. Hazards of hospitalization were significantly reduced for sepsis (aHR = 0.79, 95% CI = 0.65-0.96), heart disease (aHR = 0.74, 95% CI = 0.63-0.89) and intensive care (aHR = 0.85, 95% CI = 0.73-0.99). In addition, hazards of peritonitis (aHR = 0.84, 95% CI = 0.73-0.97) and overall mortality (aHR = 0.66, 95% CI = 0.55-0.78) were also reduced. The aHR of mortality was reduced much further to 0.28 (95% CI = 0.22-0.35) for those with multiple-year vaccinations. CONCLUSIONS: Seasonal influenza vaccination for PD patients is associated with significant reduction in morbidities and a 34% reduction in mortality. Multi-year vaccinations could reduce the death hazard further to 72%. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/26453199/Seasonal_influenza_vaccination_is_associated_with_reduced_morbidity_and_mortality_in_peritoneal_dialysis_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfv360 DB - PRIME DP - Unbound Medicine ER -