TY - JOUR
T1 - Risk of herpes zoster in CKD
T2 - A matched-cohort study based on administrative data
AU - Wu, Mei Yi
AU - Hsu, Yung Ho
AU - Su, Chien Ling
AU - Lin, Yuh Feng
AU - Lin, Hui Wen
N1 - Funding Information:
Support: This study is based in part on data from the NHI Research Database provided by the Bureau of NHI, Department of Health, and managed by National Health Research Institutes in Taiwan and supported by the National Science Council of Taiwan under grant NSC 100-2118-M-031–002 .
PY - 2012/10
Y1 - 2012/10
N2 - Background: Immune system dysregulation is associated with end-stage renal disease. Although decreased cellular immunity increases susceptibility to herpes zoster, the risk of herpes zoster in patients with earlier stages of chronic kidney disease (CKD) is unclear. Study Design: A matched-cohort study. Setting & Participants: Data from the Taiwan Longitudinal Health Insurance Database (LHID) for 2004-2006 were analyzed. The study cohort included patients 18 years or older given a diagnosis of CKD (excluding patients treated by dialysis or transplant) in 2004-2005 (n = 13,321). The comparison cohort (n = 66,605) included 5 randomly selected age- and sex-matched controls for each patient in the study cohort. Predictor: CKD. Incident cases of CKD were identified using the Taiwan LHID. CKD was ascertained from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Outcomes: Herpes zoster, ascertained from ICD-9-CM codes. All participants were followed up from the date of cohort entry until they developed herpes zoster or the end of 2006. Cox proportional hazard regressions were performed to compare the hazard rates of herpes zoster in the CKD cohort and the age- and sex-matched comparison cohort. Results: We identified 13,321 patients with a diagnosis of CKD who matched the inclusion criteria. 1,602 patients developed herpes zoster during the study period, of whom 353 were from the CKD cohort and 1,249 were from the comparison cohort. After adjusting for potential confounding factors, CKD was associated independently with greater risk of herpes zoster (HR, 1.60; 95% CI, 1.41-1.81). Limitations: Some patients with CKD or herpes zoster may have chosen not to seek medical care. Misclassification of CKD due to use of diagnostic codes also is a limitation. Conclusions: This population-based cohort study indicated that patients with CKD are at increased risk of herpes zoster compared with the general population.
AB - Background: Immune system dysregulation is associated with end-stage renal disease. Although decreased cellular immunity increases susceptibility to herpes zoster, the risk of herpes zoster in patients with earlier stages of chronic kidney disease (CKD) is unclear. Study Design: A matched-cohort study. Setting & Participants: Data from the Taiwan Longitudinal Health Insurance Database (LHID) for 2004-2006 were analyzed. The study cohort included patients 18 years or older given a diagnosis of CKD (excluding patients treated by dialysis or transplant) in 2004-2005 (n = 13,321). The comparison cohort (n = 66,605) included 5 randomly selected age- and sex-matched controls for each patient in the study cohort. Predictor: CKD. Incident cases of CKD were identified using the Taiwan LHID. CKD was ascertained from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Outcomes: Herpes zoster, ascertained from ICD-9-CM codes. All participants were followed up from the date of cohort entry until they developed herpes zoster or the end of 2006. Cox proportional hazard regressions were performed to compare the hazard rates of herpes zoster in the CKD cohort and the age- and sex-matched comparison cohort. Results: We identified 13,321 patients with a diagnosis of CKD who matched the inclusion criteria. 1,602 patients developed herpes zoster during the study period, of whom 353 were from the CKD cohort and 1,249 were from the comparison cohort. After adjusting for potential confounding factors, CKD was associated independently with greater risk of herpes zoster (HR, 1.60; 95% CI, 1.41-1.81). Limitations: Some patients with CKD or herpes zoster may have chosen not to seek medical care. Misclassification of CKD due to use of diagnostic codes also is a limitation. Conclusions: This population-based cohort study indicated that patients with CKD are at increased risk of herpes zoster compared with the general population.
KW - Herpes zoster
KW - chronic kidney disease
KW - epidemiology
KW - incidence
KW - risk factors
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U2 - 10.1053/j.ajkd.2012.03.018
DO - 10.1053/j.ajkd.2012.03.018
M3 - Article
C2 - 22575666
AN - SCOPUS:84866344658
SN - 0272-6386
VL - 60
SP - 548
EP - 552
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4
ER -