College of Medicine, and College of Public Health, China Medical University, Taichung, Taiwan.
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Int J Clin Pract. 2020 Oct;74(10):e13566. doi: 10.1111/ijcp.13566. Epub 2020 Jul 14.
BACKGROUND/OBJECTIVE: Patients on chronic dialysis are at risk of developing herpes zoster, but little systematic research focuses on the association between predialysis chronic kidney disease and herpes zoster. The objective of the study was to explore the association between predialysis chronic kidney disease and herpes zoster in Taiwan.
A nation-based retrospective cohort study was performed using the 2005-2012 database of the Taiwan National Health Insurance Program. There were 16 655 subjects aged 20-84 years with newly diagnosed predialysis chronic kidney disease as the study group and 33 310 randomly selected subjects without chronic kidney disease as the comparison group. Both groups were matched with sex, age, comorbidities and the year of the index date. The incidence rates of herpes zoster in both groups were calculated. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with predialysis chronic kidney disease.
The overall incidence rate of herpes zoster was 1.4-fold higher in the predialysis chronic kidney disease group than that in the non-chronic kidney disease group (8.76 vs 6.27 per 1000 person-years, 95% CI 1.27-1.54; P < .001). After controlling for co-variables, the adjusted HR of herpes zoster was 1.38 (95% CI 1.25-1.53; P < .001) for subjects with predialysis chronic kidney disease compared with non-chronic kidney disease subjects. The adjusted HR increased to 1.65 for subjects with predialysis chronic kidney disease and with any comorbidity (95% CI 1.42-1.92; P < .001).
Patients with predialysis chronic kidney disease correlate with approximately 1.4-fold increased hazard of developing herpes zoster.
背景/目的：慢性透析患者有发生带状疱疹的风险，但很少有系统研究关注透析前慢性肾脏病与带状疱疹之间的关系。本研究旨在探讨台湾地区透析前慢性肾脏病与带状疱疹之间的关系。
采用 2005-2012 年台湾全民健康保险计划数据库进行基于人群的回顾性队列研究。共有 16655 例年龄在 20-84 岁之间、新诊断为透析前慢性肾脏病的患者作为研究组，33310 例随机选择的无慢性肾脏病的患者作为对照组。两组均按性别、年龄、合并症和索引日期进行匹配。计算两组带状疱疹的发病率。采用多变量 Cox 比例风险回归模型估计与透析前慢性肾脏病相关的带状疱疹的风险比（HR）和 95%置信区间（CI）。
透析前慢性肾脏病组的带状疱疹总发生率比非慢性肾脏病组高 1.4 倍（8.76 比 6.27/1000 人年，95%CI 1.27-1.54；P<0.001）。在校正协变量后，与非慢性肾脏病患者相比，透析前慢性肾脏病患者发生带状疱疹的调整 HR 为 1.38（95%CI 1.25-1.53；P<0.001）。对于有透析前慢性肾脏病和任何合并症的患者，调整 HR 增加到 1.65（95%CI 1.42-1.92；P<0.001）。
透析前慢性肾脏病患者发生带状疱疹的风险约增加 1.4 倍。
