Original InvestigationDialysisRisk of Herpes Zoster in Patients Treated With Long-term Hemodialysis: A Matched Cohort Study
Section snippets
Data Source
The National Health Insurance (NHI) program, which provides compulsory universal health insurance, was implemented in Taiwan on March 1, 1995. Under the NHI, 98% of the island's population receives all forms of health care services, including outpatient services, inpatient care, Chinese medicine, dental care, childbirth, physical therapy, preventive health care, home care, and rehabilitation for chronic mental illness. In cooperation with the Bureau of NHI, the National Health Research
Results
There were 843 patients in our hemodialysis cohort who were compared with 3,372 selected matched controls. Table 1 lists the distribution of demographic characteristics and selected medical conditions of study participants. Patients treated with long-term hemodialysis therapy had a significant higher rate of diabetes. There was no significant difference in the distribution of SLE, breast cancer, liver cancer, and lymphoma/leukemia between these 2 cohorts.
Table 2 lists the distribution of herpes
Discussion
In this population-based cohort study, after adjusting for potential confounders, we found that patients treated with long-term hemodialysis were 1.98 times more likely than the general population to experience herpes zoster during the 6-year follow-up period (HR, 1.98; 95% CI, 1.72-2.27). To our knowledge, this study is the first cohort study to investigate the risk of herpes zoster in patients treated with long-term hemodialysis.
Patients of older age or who are immunocompromised, have
Acknowledgements
This study is based in part on data from the NHI Research Database provided by the Bureau of NHI, Department of Health, and managed by NHRIs. The interpretation and conclusions contained herein do not represent those of the Bureau of NHI, Department of Health, or NHRIs.
Support: This study was supported in part by a grant from the National Science Council, Executive Yuan, Taiwan (NSC-97-2314-B-037-006-MY3).
Financial Disclosure: The authors declare that they have no other relevant financial
References (46)
- et al.
Epidemiologic features of CKD in Taiwan
Am J Kidney Dis
(2007) - et al.
All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462293 adults in Taiwan
Lancet
(2008) Varicella zoster virus vasculopathy and disseminated encephalomyelitis
J Neurol Sci
(2002)- et al.
Evidence for high risk of cerebral hemorrhage in chronic dialysis patients
Kidney Int
(1993) - et al.
Incidence, outcome, and risk factors of cerebrovascular events in patients undergoing maintenance hemodialysis
Am J Kidney Dis
(1998) - et al.
Elevated risk of stroke among patients with end-stage renal disease
Kidney Int
(2003) - et al.
Stroke in patients on maintenance hemodialysis: a 22-year single-center study
Am J Kidney Dis
(2005) - et al.
Cerebrovascular disease incidence, characteristics, and outcomes in patients initiating dialysis: the Choice for Healthy Outcomes in Caring for ESRD (CHOICE) Study
Am J Kidney Dis
(2009) - et al.
Herpes zoster associated encephalitis in dialysis patients
J Infect
(1991) - et al.
Vasculitic, hypoxic-ischemic leukoencephalopathy
Clin Neurol Neurosurg
(1994)
What does epidemiology tell us about risk factors for herpes zoster?
Lancet Infect Dis
Uremia impairs monocytes and monocyte-derived dendritic cell function in hemodialysis patients
Kidney Int
Maintenance dialysis population dynamics: current trends and long-term implications
J Am Soc Nephrol
USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States
Am J Kidney Dis
Epidemiological features and costs of herpes zoster in Taiwan: a national study 2000 to 2006
Acta Derm Venereol
Clinical and molecular pathogenesis of varicella virus infection
Viral Immunol
Neurologic complications of the reactivation of varicella-zoster virus
N Engl J Med
Granulomatous angiitis of the nervous system in cases of herpes zoster and lymphosarcoma
Neurology
Varicella-zoster virus infections of the nervous system: clinical and pathologic correlates
Arch Pathol Lab Med
Aspects of immune dysfunction in end-stage renal disease
Clin J Am Soc Nephrol
Inflammation in atherosclerosis
Nature
Risk of myocardial infarction and stroke after acute infection or vaccination
N Engl J Med
Chronic infections and the risk of carotid atherosclerosis: prospective results from a large population study
Circulation
Cited by (42)
How far is vitamin D implicated in cutaneous infections
2022, Clinics in DermatologyCitation Excerpt :The impact of herpes zoster (HZ) on patients’ quality of life and the introduction of zoster vaccination for HZ prevention,46 raised the awareness of the importance of HZ prophylaxis and possible adjuvants to enhance treatment and vaccination efficacy.47 A potential adjunctive measure is vitamin D, which may lower the incidence of HZ.48-50 Primary varicella zoster virus (VZV) infection is followed by immunity and a state of viral latency, which if switched towards viral reactivation, leads to HZ.47
Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study
2021, American Journal of the Medical SciencesCitation Excerpt :These infections were selected because the defective epidermal barrier seen in psoriasis might be expected to put these patients at greater risk of seven of the infectious complications examined: bacteremia, septicemia, SIRS, cellulitis, conjunctivitis, fungemia, and onychomycosis. Herpes zoster was also chosen as an outcome because both kidney failure and psoriasis are reported to increase the risk of Herpes zoster infection, and we wished to determine whether psoriasis enhances susceptibility to this infection in ESRD patients.35,36 Finally, there is some thought that psoriasis may be associated with pericarditis,37 with occasional case reports of psoriasis patients on biologic treatment presenting with pericarditis.38,39
Limited skin lesions in a haemodialysis patient
2020, European Journal of Internal MedicineRisk Factors for Herpes Zoster: A Systematic Review and Meta-analysis
2017, Mayo Clinic Proceedings
Originally published online December 19, 2011.