Vaccines Improve Survival in Dialysis Patients

Influenza and pneumococcal vaccination are associated with improved survival for patients receiving dialysis, concludes a report in the American Journal of Kidney Diseases.

The study included data from 903 of 1033 dialysis facilities in ESRD Networks 6, 11, and 15. The centers provided information on health status at the start of dialysis, receipt of influenza and pneumococcal vaccination, and mortality associated with the 2005–2006 influenza season. The analysis included data on 36,966 patients who had been receiving dialysis for at least 1 year as of the end of 2005. All-cause mortality was compared for vaccinated versus unvaccinated patients.

During the 2005–2006 season, 41.8 percent of patients were vaccinated against influenza and pneumococcal disease. Vaccinated patients were older, in worse health, more likely not to be black, and more likely to be receiving hemodialysis. The 1-year mortality was 17.1 percent overall, 15.9 percent for patients receiving both vaccinations, and 20.3 percent for those receiving neither vaccination. Mortality was even higher for patients who refused vaccination for “other reasons” or whose vaccination status was unknown.

Both vaccinations, alone and together, were associated with lower mortality. In adjusted models, the odds ratios for death were 0.71 for patients with influenza vaccination alone, 0.76 for those with pneumococcal vaccination alone, and 0.61 for those with both vaccinations. These patterns were supported on survival analysis.

Dialysis patients are a high-priority group for vaccination against influenza and other vaccine-preventable diseases. Because of their frequent interactions with health professionals, they have repeated opportunities for vaccinations and other preventive care.

This large analysis demonstrates “significant, strong, and independent” improvement in survival among dialysis patients who receive influenza and/or pneumococcal vaccination. The investigators conclude, “Every dialysis visit can be a preventive health opportunity for those not yet immunized.” [Bond TC, et al. Mortality of dialysis patients according to influenza and pneumococcal vaccination status. Am J Kidney Dis 2012; 60:959–965].

February 2013 (Vol. 5, Number 2)