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Preventive medicine · Dec 2023
Multicenter Study23-valent pneumococcal polysaccharide vaccine and the risk of renal progression in older patients with chronic kidney disease.
- Po-Ya Chang, Chun-Ji Lin, Hao-Cheng Chen, Hueng-Chuen Fan, and Hsuchung Kuo.
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan. Electronic address: pychang@ntunhs.edu.tw.
- Prev Med. 2023 Dec 1; 177: 107753107753.
BackgroundThe 23-valent pneumococcal polysaccharide vaccine (PPSV23) ensures favorable outcomes and reduces the risk of cardiac events in patients on dialysis. However, the effect of PPSV23 vaccination on renal function remains unknown, particularly in patients with chronic kidney disease (CKD). Therefore, we investigated the association between PPSV23 efficacy and renal progression in older patients (age ≥ 75 years) with CKD.MethodsThis multicenter, longitudinal cohort study was conducted using data (2008-2016) from the Epidemiology and Risk Factors Surveillance of CKD database. This database was associated with Taiwan's National Health Insurance Research Database (for period: 2008-2019). A total of 1195 older patients with CKD were recruited from 14 hospitals and communities across Taiwan. Renal progression was defined as a > 25% reduction in estimated glomerular filtration rate from the baseline value.ResultsA significant reduction in the risk of renal progression was observed in patients who had received PPSV23 (adjusted hazard ratio [HR]: 0.57; 95% confidence interval [CI]: 0.35-0.91). However, when stratified by CKD stage, this significant reduction was observed in patients with early-stage CKD but not in those with late-stage CKD. Furthermore, a significant reduction in the risk of renal progression was noted in male patients and those with hypertension.ConclusionOur findings support the protective effect of PPSV23 against renal deterioration in older patients with CKD.Copyright © 2023. Published by Elsevier Inc.
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