Abstract
Background: Infections caused by Streptococcus pneumoniae was a major cause of morbidities and mortalities in the immunocompromised patients including those with chronic renal failure (CRF). The efficacy of PPV23 in patients with CRF under maintenance hemodialysis was analyzed.
Methods: Patients with CRF under maintenance hemodialysis aged greater then 50 years in Taiwan Taoyuag CGMH received their PPV23 vaccinations voluntarily in January 2009. The risks of pneumonia, AMI, cerebrovascular events and mortality in CRF patients with and without PPV23 during the period of January 2009 to December 2013 were analyzed.
Results: 545 patients were included in this study, 168 (30.8%) of them were PPV23 vaccinated. Multivariate regression analysis demonstrated that age, diabetes, ischemic heart disease and malignancies were independent factors for increased risk of death. Age, diabetes, COPD, heart failure and malignancies were associated with higher risks for development of pneumonia. Diabetes and history of ischemic heart disease were independent factors for higher risk of AMI. The only risk factor for cerebrovascular events was diabetes. PPV23 vaccination had no effect on death, pneumonia, AMI or cerebrovascular events in the 5-years follow-up period, with ORs of 0.691 (95%CI: 0.460-1.039, p=0.075) for all-cause death, 0.981 (95%CI: 0.654-1.471, p=0.927) for pneumonia, 0.610 (95%CI: 0.343-1.085, p=0.092) for AMI, and 0.745 (95%CI: 0.333-1.670, p=0.476) for cerebrovascular events.
Conclusions: PPV23 vaccination had no protective effects on all-cause death, pneumonia, the development of AMI or cerebrovascular events in CRF patient under maintenance hemodialysis.
- Copyright ©the authors 2016
