Hao Wen-Rui, Yang Tsung-Lin, Lai Yu-Hsin, Lin Kuan-Jie, Fang Yu-Ann, Chen Ming-Yao, Hsu Min-Huei, Chiu Chun-Chih, Yang Tsung-Yeh, Chen Chun-Chao, Liu Ju-Chi
Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
Taipei Heart Institute, Taipei Medical University, Taipei 110, Taiwan.
Vaccines (Basel). 2023 Jun 14;11(6):1098. doi: 10.3390/vaccines11061098.
Influenza vaccination could decrease the risk of major cardiac events in patients with hypertension. However, the vaccine's effects on decreasing the risk of chronic kidney disease (CKD) development in such patients remain unclear.
We retrospectively analysed the data of 37,117 patients with hypertension (≥55 years old) from the National Health Insurance Research Database during 1 January 2001 to 31 December 2012. After a 1:1 propensity score matching by the year of diagnosis, we divided the patients into vaccinated ( = 15,961) and unvaccinated groups ( = 21,156).
In vaccinated group, significantly higher prevalence of comorbidities such as diabetes, cerebrovascular disease, dyslipidemia, heart and liver disease were observed compared with unvaccinated group. After adjusting age, sex, comorbidities, medications (anti-hypertensive agents, metformin, aspirin and statin), level of urbanization and monthly incomes, significantly lower risk of CKD occurrence was observed among vaccinated patients in influenza season, non-influenza season and all season (Adjusted hazard ratio [aHR]: 0.39, 95% confidence level [C.I.]: 0.33-0.46; 0.38, 95% C.I.: 0.31-0.45; 0.38, 95% C.I.: 0.34-0.44, respectively). The risk of hemodialysis significantly decreased after vaccination (aHR: 0.40, 95% C.I.: 0.30-0.53; 0.42, 95% C.I.: 0.31-0.57; 0.41, 95% C.I.: 0.33-0.51, during influenza season, non-influenza season and all season). In sensitivity analysis, patients with different sex, elder and non-elder age, with or without comorbidities and with or without medications had significant decreased risk of CKD occurrence and underwent hemodialysis after vaccination. Moreover, the potential protective effect appeared to be dose-dependent.
Influenza vaccination decreases the risk of CKD among patients with hypertension and also decrease the risk of receiving renal replacement therapy. Its potential protective effects are dose-dependent and persist during both influenza and noninfluenza seasons.
流感疫苗接种可降低高血压患者发生重大心脏事件的风险。然而，该疫苗对降低此类患者慢性肾脏病（CKD）发生风险的作用仍不明确。
我们回顾性分析了2001年1月1日至2012年12月31日期间来自国民健康保险研究数据库的37117例高血压患者（≥55岁）的数据。按诊断年份进行1:1倾向评分匹配后，我们将患者分为接种组（n = 15961）和未接种组（n = 21156）。
与未接种组相比，接种组中糖尿病、脑血管疾病、血脂异常、心脏和肝脏疾病等合并症的患病率显著更高。在调整年龄、性别、合并症、药物（抗高血压药物、二甲双胍、阿司匹林和他汀类药物）、城市化水平和月收入后，在流感季节、非流感季节和全年，接种疫苗的患者发生CKD的风险均显著降低（调整后风险比[aHR]：0.39，95%置信区间[C.I.]：0.33 - 0.46；0.38，95% C.I.：0.31 - 0.45；0.38，95% C.I.：0.34 - 0.44）。接种疫苗后血液透析风险显著降低（流感季节、非流感季节和全年的aHR分别为：0.40，95% C.I.：0.30 - 0.53；0.42，95% C.I.：0.31 - 0.57；0.41，95% C.I.：0.33 - 0.51）。在敏感性分析中，不同性别、老年和非老年、有或无合并症以及有或无用药的患者接种疫苗后发生CKD的风险均显著降低且接受了血液透析。此外，潜在保护作用似乎呈剂量依赖性。
流感疫苗接种可降低高血压患者发生CKD的风险，也可降低接受肾脏替代治疗的风险。其潜在保护作用呈剂量依赖性，且在流感季节和非流感季节均持续存在。
Zotero 插件