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Association between herpes zoster and end stage renal disease entrance in chronic kidney disease patients: a population-based cohort study

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Abstract

The association between herpes zoster (HZ) infection and subsequent risk of end stage renal disease (ESRD) in chronic kidney disease (CKD) patients is unknown. We aim to conduct a population-based cohort study to investigate the risks of developing ESRD after a HZ attack in CKD patients. From the Taiwan National Health Insurance Research Database, we identified 1,144 CKD patients who had HZ over the period 1997–2008 as HZ cohort. We selected 3,855 age- and sex–matched CKD patients without HZ as comparison cohort. All subjects were followed until the end of 2008 or censored. Cox-proportional hazard regression model was used to estimate the effects of HZ on ESRD risks. A total of 396 patients developed ESRD during the follow-up period, of which 108 subjects were from the HZ cohort and 288 from the comparison cohort. The log–rank test demonstrated that the HZ cohort had significantly higher risk of developing ESRD than the comparison cohort (P = 0.0071). The adjusted hazard ratio of subsequent ESRD in the HZ cohort was 1.36 (95 % CI 1.09–1.70) and the hazard ratio increased to 8.71 (95 % CI 5.23–14.5) if the HZ cohort was with concomitant diabetes and hypertension. CKD patients with HZ are at an increased risk of subsequent ESRD. CKD patients with HZ, diabetes, and hypertension have extremely high risk of developing ESRD.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Funding

This work was supported by the study projects (CMU102–BC–2) in China Medical University; the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center and for Excellence (DOH102–TD–B–111–004), Taiwan Ministry of Health and Welfare Cancer Research Center for Excellence (MOHW103–TD–B–111–03). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

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Authors and Affiliations

  1. Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    S.-Y. Lin & C.-H. Kao

  2. Division of Nephrology and Kidney Institute, College of Medicine, China Medical University Hospital and China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    S.-Y. Lin, J.-H. Liu, H.-C. Yeh, Y.-F. Yang & C.-C. Huang

  3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    C.-L. Lin, I.-J. Tsai, P.-C. Chen, F.-C. Sung & Y.-J. Chang

  4. Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA

    D. E. Morisky

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  1. S.-Y. Lin
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  2. J.-H. Liu
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  3. H.-C. Yeh
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  4. C.-L. Lin
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  5. I.-J. Tsai
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  7. F.-C. Sung
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  8. Y.-F. Yang
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  9. C.-C. Huang
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  10. D. E. Morisky
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  11. Y.-J. Chang
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  12. C.-H. Kao
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Correspondence to C.-H. Kao.

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Lin, SY., Liu, JH., Yeh, HC. et al. Association between herpes zoster and end stage renal disease entrance in chronic kidney disease patients: a population-based cohort study. Eur J Clin Microbiol Infect Dis 33, 1809–1815 (2014). https://doi.org/10.1007/s10096-014-2143-6

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  • DOI: https://doi.org/10.1007/s10096-014-2143-6

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