Chia-Ter Chao1, Chun-Fu Lai, Jenq-Wen Huang. 1. Renal Division, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Abstract
OBJECTIVE: Herpes zoster (HZ) reactivation is common in immunocompromised patients. Advanced renal failure is also reportedly associated with impairment of cellular immunity. There is not any study yet assessing risk factors of HZ reactivation in hemodialysis patients. METHODS: All patients undergoing maintenance hemodialysis for more than 3 months and who developed HZ between 2000/01/01 and 2009/12/31 in a tertiary referral medical center were identified, and matched 1:1 to hemodialysis patients without HZ by age and gender. Multivariate-adjusted conditional logistic regression model was constructed to determine possible risk factors. RESULTS: Out of a total of 126 maintenance hemodialysis patients (65.3% female), 63 belonged to the HZ reactivation group and 63 to the age/sex matched control patients. Conditional logistic regression model linked corticosteroid use with heightened risk (odds ratio [OR] 20.2, 95% confidence interval [CI] 3.5-125.6; p=0.002), while iron therapy and 1α-hydroxylated vitamin D were associated with significantly lower likelihood of developing HZ (OR 0.12, 95%CI 0.0-0.6; p=0.01, and OR 0.06, 95% CI 0.0-0.4; p=0.005 respectively). CONCLUSIONS: Use of iron preparations and 1α-hydroxylated vitamin D is potentially associated with less risk of developing HZ reactivation in maintenance hemodialysis patients.
OBJECTIVE: Herpes zoster (HZ) reactivation is common in immunocompromised patients. Advanced renal failure is also reportedly associated with impairment of cellular immunity. There is not any study yet assessing risk factors of HZ reactivation in hemodialysis patients. METHODS: All patients undergoing maintenance hemodialysis for more than 3 months and who developed HZ between 2000/01/01 and 2009/12/31 in a tertiary referral medical center were identified, and matched 1:1 to hemodialysis patients without HZ by age and gender. Multivariate-adjusted conditional logistic regression model was constructed to determine possible risk factors. RESULTS: Out of a total of 126 maintenance hemodialysis patients (65.3% female), 63 belonged to the HZ reactivation group and 63 to the age/sex matched control patients. Conditional logistic regression model linked corticosteroid use with heightened risk (odds ratio [OR] 20.2, 95% confidence interval [CI] 3.5-125.6; p=0.002), while iron therapy and 1α-hydroxylated vitamin D were associated with significantly lower likelihood of developing HZ (OR 0.12, 95%CI 0.0-0.6; p=0.01, and OR 0.06, 95% CI 0.0-0.4; p=0.005 respectively). CONCLUSIONS: Use of iron preparations and 1α-hydroxylated vitamin D is potentially associated with less risk of developing HZ reactivation in maintenance hemodialysis patients.