Factors affecting inadequate response to HBV vaccine in hemodialysis patients: northeast anatolia survey with six hemodialysis centers

  • Halil İbrahim ErdoğduEmail author
  • Eray Atalay
  • Gül Gürsoy
  • Başol Canbakan
  • Serkan Aktürk
  • Canan Yazıcı
  • Orhan Yücel
  • Sinan Mersin
  • Sengül Üçer
  • Özgür Merhametsiz
  • Can Öner
  • Merve Erat
Original article



In hemodialysis patients Hepatitis B virus (HBV) infection is one of the problems. Because of HBV vaccine response is lower than in the general population, in this study it is aimed to determine the factors that may cause inadequate HBV vaccine response in hemodialysis patients.


In study, HBsAg, anti-HBs, anti-HBc IgG data belonging to 278 patients were obtained from file and computer records. It was seen that seronegative cases had been given recombinant HBV vaccine. Anti-HBs titers were monitored 1 month after vaccination was completed. According to this, the patients are divided into two groups. Those with anti-HBs < 10 IU/mL were identified as non-responders and with anti-HBs ≥ 10 IU/mL as responders. Factors such as age, serum albumin and urea reduction rate which may affect inadequate response to HBV vaccine were evaluated. As statistical examination, Chi-square test was used for the analysis of the data determined by counting, and logistic regression was used for statistically significant independent variables in chi-square test. p value of < 0.05 was considered statistically significant (Confidence interval: 95%).


Out of 278 patients, according to exclusion criteria 81 patients were excluded. 13.2%(26/197) of HBV vaccinated patients had insufficient response. The inadequate response rate to HBV vaccination was found to be higher in patients with age ≥ 65 (p = 0.039), serum albumin < 3.5 g/dL (p = 0.024) and urea reduction rate ≤ 65 (p = 0.028). No statistically significant relationship was found between inadequate response to HBV vaccine and anti-HCV positivity, presence of diabetes mellitus, anemia status, vitamin D therapy and vascular access pathway variability.


We conclude that relatively high patient age, low albumin level and insufficient urea reduction rate may cause inadequate HBV vaccine response. Taking these factors into consideration may provide a useful insight for an adequate response to vaccination.


Hepatitis B vaccines Hemodialysis Humoral immune response Hemodialysis adequacy 



We would also thank to Associate Professor Dr. Binali Catak, from the Department of Public Health for his contribution.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Ethics Committee for Clinical Research, Faculty of Medicine, Kafkas University, Kars, Turkey. Our study was conducted according to the declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Halil İbrahim Erdoğdu
    • 1
    Email author
  • Eray Atalay
    • 1
  • Gül Gürsoy
    • 2
  • Başol Canbakan
    • 3
  • Serkan Aktürk
    • 4
  • Canan Yazıcı
    • 5
  • Orhan Yücel
    • 4
  • Sinan Mersin
    • 6
  • Sengül Üçer
    • 7
  • Özgür Merhametsiz
    • 8
  • Can Öner
    • 9
  • Merve Erat
    • 1
  1. 1.Department of Internal MedicineHealth Research Center, Kafkas UniversityKarsTurkey
  2. 2.Department of Internal Medicine and EndocrinologyKafkas UniversityKarsTurkey
  3. 3.Department of Internal Medicine and NeprologyKafkas UniversityKarsTurkey
  4. 4.Department of Hemodialysis and NephrologyKars Harakani State HospitalKarsTurkey
  5. 5.Departement of Internal MedicineArdahan State HospitalArdahanTurkey
  6. 6.Department of Internal MedicineKartal Lütfi Kırdar Education and Research HospitalIstanbulTurkey
  7. 7.Department of Clinical Microbiology and Infectious diseasesKafkas UniversityKarsTurkey
  8. 8.Department of Hemodialysis and NephrologyIğdır State HospitalIğdırTurkey
  9. 9.Department of Family MedicineKartal Lütfi Kırdar Education and Research HospitalIstanbulTurkey

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