title: Association of response to hepatitis B vaccination and survival in dialysis patients.
abstract: BACKGROUND
  The status of immunocompromised patients is well recognized in end stage renal disease (ESRD). As described recently, this acquired immune dysfunction in the uremic milieu may be one of the main pathogenic factors for mortality in ESRD. The aim of this study was to determine the relationship between the immune response following a hepatitis B vaccination (HBV vaccination) and the survival of maintenance dialysis patients.
  
  
  METHODS
  A total of 156 patients (103 on hemodialysis and 53 on continuous ambulatory peritoneal dialysis) were recruited. After receiving a full dose of the HBV vaccination, all patients were followed up for to 5 years to evaluate the association of patient survival, cause of mortality, and immune response.
  
  
  RESULTS
  The response rate to the hepatitis B vaccination was 70.5%. There was no significant association between the immune response and the 5-year survival rate (p =0.600) or between the post-vaccination anti-HBs titers and the 5-year survival rate (p = 0.201). The logistic prediction model with the coefficient as non-response following HBV vaccination, diabetes mellitus, old age, and low albumin level could significantly predict infection-cause mortality (sensitivity = 0.842, specificity = 0.937).
  
  
  CONCLUSIONS
  There was no significant association between the immune response to HBV vaccination and the 5-year survival rate. However, non-response following HBV vaccination might be associated with infection-cause mortality in dialysis patients.
authors.affiliation: Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.forename: Jiung-Hsiun
authors.initials: JH
authors.lastname: Liu
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Wang
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Chen-An
authors.initials: CA
authors.lastname: Tsai
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Liu
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Chiz-Chung
authors.initials: CC
authors.lastname: Chang
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D015984:Causality; D015897:Comorbidity; D005260:Female; D017325:Hepatitis B Vaccines / Q000276:immunology* / Q000627:therapeutic use*; D006801:Humans; D007154:Immune System Diseases / Q000401:mortality*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000401:mortality*; D051436:Renal Insufficiency, Chronic / Q000401:mortality* / Q000534:rehabilitation*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014611:Vaccination / Q000401:mortality*
chemical_list: D017325:Hepatitis B Vaccines