A comparison of herpes zoster incidence across the spectrum of chronic kidney disease, dialysis and transplantation.
BACKGROUND
The effect of different renal replacement therapies on the risk of developing herpes zoster in renal failure patients is unknown. We aimed to investigate the incidence of herpes zoster attack among renal failure patients who were receiving different dialysis modalities, renal transplantation (RT), or not receiving any of the above mentioned therapies yet.


METHODS
A retrospective cohort study of the national health insurance register database was conducted. This observational cohort study involved 79,581 study controls, 15,802 chronic kidney disease patients, 3,694 hemodialysis (HD) patients, 317 peritoneal dialysis (PD) patients, and 159 RT patients.


RESULTS
The RT group had the worst risk of herpes zoster (hazard ratio, HR, 8.46; 95% CI 5.85-12.2), followed by PD (HR 3.61; 95% CI 2.49-4.83) and HD (HR 1.35; 95% CI 1.18-1.55), compared with the comparison group (p < 0.0001). The RT group had also the highest risk of developing herpes zoster with complications among all groups (adjusted HR 15.3). The HRs of the PD group were higher than the HRs of the HD group in terms of herpes zoster or its complications (p < 0.0001 and p = 0.0002, respectively).


CONCLUSIONS
This study suggests that different treatment modalities are associated with different risks of herpes zoster attacks in renal failure patients. PD patients had higher risks than the HD group in terms of herpes zoster or its complications.
Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan, ROC.
Shih-Yi
SY
Lin
Jiung-Hsiun
JH
Liu
Cheng-Li
CL
Lin
I-Ju
IJ
Tsai
Pei-Chun
PC
Chen
Chi-Jung
CJ
Chung
Yao-Lung
YL
Liu
I-Kuan
IK
Wang
Hsin-Hung
HH
Lin
Chiu-Ching
CC
Huang
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan