Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan.
Division of Gastroenterology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Sci Rep. 2021 Mar 1;11(1):4847. doi: 10.1038/s41598-021-84285-8.
An influenza vaccination might reduce the risk of incident peripheral arterial occlusive disease (PAOD) in patients with chronic kidney disease (CKD), but supporting evidence is limited. This case-crossover study analyzed data from Taiwan's real-world National Health Insurance Research Database. This study included elderly (≥ 67 years old) patients with CKD having incident PAOD from January 1, 2006, to June 30, 2015. We defined 1 year before PAOD onset as the index date for the self-control group. A conditional logistic regression model was used to investigate exposure to an influenza vaccination for estimating the risk for incident PAOD following vaccination. In total, this study included 46,782 elderly patients with CKD having incident PAOD. The odds ratios for incident PAOD were 0.85 (95% confidence interval 0.77-0.94), 0.85 (0.79-0.92), 0.84 (0.79-0.90), and 0.85 (0.81-0.90) at 1, 2, 3, and 4 months after an influenza vaccination, respectively. We observed consistent results for the subgroups of patients with CKD and concomitant diabetes. However, we did not observe any beneficial effects of influenza vaccination in patients with advanced CKD or end-stage renal disease. This study demonstrated that influenza vaccination may be associated with a reduced risk of incident PAOD among patients with early-stage CKD.
流感疫苗接种可能降低慢性肾脏病(CKD)患者新发外周动脉闭塞性疾病(PAOD)的风险,但支持证据有限。这项病例交叉研究分析了来自台湾真实世界国家健康保险研究数据库的数据。本研究纳入了 2006 年 1 月 1 日至 2015 年 6 月 30 日新发 PAOD 的老年(≥67 岁)CKD 患者。我们将 PAOD 发病前 1 年定义为自身对照组的索引日期。采用条件逻辑回归模型来研究流感疫苗接种的暴露情况,以评估接种疫苗后新发 PAOD 的风险。本研究共纳入 46782 例新发 PAOD 的老年 CKD 患者。流感疫苗接种后 1、2、3 和 4 个月新发 PAOD 的比值比分别为 0.85(95%置信区间 0.77-0.94)、0.85(0.79-0.92)、0.84(0.79-0.90)和 0.85(0.81-0.90)。在 CKD 合并糖尿病患者亚组中观察到了一致的结果。然而,在晚期 CKD 或终末期肾病患者中,我们未观察到流感疫苗接种的有益效果。本研究表明,流感疫苗接种可能与早期 CKD 患者新发 PAOD 风险降低相关。