End-stage renal disease (ESRD) contributes to the increasing prevalence of herpes zoster

Sato, Takahiko; Inoue, Tsutomu; Endo, Kei; Watanabe, Yusuke; Kikuta, Tomohiro; Tsuda, Masahiro; Arai, Jonde; Kobayashi, Kazuhiro; Ikeda, Naofumi; Ohno, Yoichi; Takenaka, Tsuneo; Suzuki, Hiromichi

doi:10.1093/ndtplus/sfp024

Cited by 12 publications

(15 citation statements)

References 7 publications

(6 reference statements)

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“…This immune incompetence involves various aspects, including defects in chemotaxis, phagocytosis, antigen presentation, antibody production, cytokine regulation, and most importantly, T-cell homeostasis [23,24]. Our finding that ESRD patients have a higher incidence of herpes zoster attacks and of herpes zoster complications than the general population is consistent with that of Sato et al [7]. Smetana et al [25 ]had noted that VZV was frequently reactivated in HD or PD patients.…”

Section: Discussionsupporting

confidence: 91%

“…Several studies have discovered that selective loss of circulating dendritic cell, naive T-cell, and CD4+ central memory cell counts are related to the loss of glomerular filtration rate [20,21]. In a retrospective study of 175 patients, Sato et al [7 ]demonstrated a higher incidence of herpes zoster in CKD stages 4 and 5 than in early-stage CKD patients. Our data might imply that the decline in renal functional status is associated with declining protection against VZV.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to aging, lymphoproliferative malignancies, receiving immunosuppressants, diabetes and human immunodeficiency virus disease also predispose patients to the reactivation of VZV [3,4,5,6]. Although patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) are being well recognized as immune-compromised groups, few studies have actually investigated the relationship between clinical herpes and renal dysfunction [7,8]. Sato et al [7 ]found that ESRD contributed to the herpes attack.…”

Section: Introductionmentioning

confidence: 99%

“…Although patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) are being well recognized as immune-compromised groups, few studies have actually investigated the relationship between clinical herpes and renal dysfunction [7,8]. Sato et al [7 ]found that ESRD contributed to the herpes attack. Wung et al [8 ]showed that renal dysfunction is a strong risk factor for herpes zoster in patients with Wegener’s granulomatosis.…”

Section: Introductionmentioning

confidence: 99%

“…Wung et al [8 ]showed that renal dysfunction is a strong risk factor for herpes zoster in patients with Wegener’s granulomatosis. These studies were limited by various factors: a small number of subjects, a cross-sectional design, short follow-up time or focusing only on a specific population [7,8]. Though Kuo et al [9 ]have shown that hemodialysis (HD) patients have a higher incidence of herpes than general populations, the epidemiology and complications of herpes zoster have not been investigated or compared among ESRD patients receiving HD, peritoneal dialysis (PD), or renal transplantation (RT).…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

Lin

Liu

Lin³

et al. 2012

Am J Nephrol

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Background: The effect of different renal replacement therapies on the risk of developing herpes zoster in renal failure patients is unknown. We aimed to investigate the incidence of herpes zoster attack among renal failure patients who were receiving different dialysis modalities, renal transplantation (RT), or not receiving any of the above mentioned therapies yet. Methods: A retrospective cohort study of the national health insurance register database was conducted. This observational cohort study involved 79,581 study controls, 15,802 chronic kidney disease patients, 3,694 hemodialysis (HD) patients, 317 peritoneal dialysis (PD) patients, and 159 RT patients. Results: The RT group had the worst risk of herpes zoster (hazard ratio, HR, 8.46; 95% CI 5.85–12.2), followed by PD (HR 3.61; 95% CI 2.49–4.83) and HD (HR 1.35; 95% CI 1.18–1.55), compared with the comparison group (p < 0.0001). The RT group had also the highest risk of developing herpes zoster with complications among all groups (adjusted HR 15.3). The HRs of the PD group were higher than the HRs of the HD group in terms of herpes zoster or its complications (p < 0.0001 and p = 0.0002, respectively). Conclusions: This study suggests that different treatment modalities are associated with different risks of herpes zoster attacks in renal failure patients. PD patients had higher risks than the HD group in terms of herpes zoster or its complications.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

Lin

Liu

Lin³

et al. 2012

Am J Nephrol

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Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

et al. 2022

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Background Multiple myeloma (MM) is known for its immune disturbance and patients suffering from MM are thus vulnerable to opportunistic infections, including herpes zoster (HZ). As HZ infection remarkably affects patients' quality of life and poses huge economic burdens on the health system, we aim to identify the risk factors of HZ infection and evaluate the effects of different dosages, types, and durations of anti‐HZ prophylaxis drugs to prevent HZ infection. Methods 551 MM patients at Taipei Veterans General Hospital in Taiwan between January 1, 2009 and August 31, 2021 were restrospectively analyzed. The patients' baseline characteristics were recorded. The primary endpoint of the study was the incidence of HZ infection among the studied patient population. Due to the lack of cost coverage from Taiwanese public health insurance on HZ prophylaxis drugs, the use of anti‐HZ drugs mainly depends on physicians' preferences and patients' choices. Results In our study, prophylaxis was given to 283 of the patients. In the multivariate analysis, we included non‐prophylaxis, age ≥ 60, corrected serum calcium ≥12 mg/dl, serum creatinine ≥2 mg/dl, serum β2‐microglobulin ≥5500 mg/L, autologous stem cell transplant (SCT), and allogeneic SCT for analysis. Our results demonstrated that the non‐prophylaxis group (HR: 2.37, 95% CI 1.57–3.57) and patients receiving autologous SCT (HR: 2.22, 95% CI 1.28–3.86) and allogeneic SCT (HR: 5.12, 95% CI 1.13–23.22) had higher risk of HZ infection. The difference in dosage and types of anti‐HZ drugs showed similar protective effects. In patients who stopped anti‐HZ prophylaxis before active cancer‐related treatment, a higher risk of getting HZ infection compared to the corresponding group was also observed (adjusted HR 3.09, 95% CI 1.35–7.07, p = 0.008). Conclusions We concluded that MM patients should receive HZ prophylaxis drugs while receiving active cancer‐related treatment. Patients receiving SCT are also at high risk of getting HZ infection, even under prophylaxis.

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Excessive ADAM17 activation occurs in uremic patients and may contribute to their immunocompromised status

Yashiro

Ohya

Mima

et al. 2020

Immunity Inflam & Disease

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Introduction: We previously reported that fibroblast growth factor 23 (FGF23)-klotho signaling plays a role in B cell immunity. Despite high serum levels of FGF23, a decline in immunity is frequently observed in patients on hemodialysis (HD); thus, abnormalities in the FGF23-klotho signaling pathway in immune cells may occur in these patients. Methods: We analyzed the number of klotho-positive cells in peripheral blood mononuclear cells from 10 male and 6 female patients on HD and 5 healthy male subjects using flow cytometry. We analyzed the abundance of cleaved klotho protein in the murine B cell line, A20, and in the serum of HD patients and healthy subjects (HS) using flow cytometry and Western blotting. The serum level of A disintegrin and metalloprotease 17 (ADAM17) was measured in HD patients and HS using enzyme-linked immunosorbent assay. Results: The number of klotho-positive B cells was reduced in HD patients. Serum ADAM17 was responsible for the reduction in klotho, as a specific ADAM17 inhibitor reversed this change. The total serum levels of ADAM17 were similar in HD patients and HS; however, activated ADAM17 was increased in the serum of HD patients. Conclusions: We concluded that abnormal ADAM17 activation could contribute to the immunocompromised status in patients on HD, in line with the reported role of ADAM17 as an anti-inflammatory and immunosuppressive factor.

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End-stage renal disease (ESRD) contributes to the increasing prevalence of herpes zoster

Cited by 12 publications

References 7 publications

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

A Comparison of Herpes Zoster Incidence across the Spectrum of Chronic Kidney Disease, Dialysis and Transplantation

Herpes zoster prophylaxis: Essential for treating newly diagnosed multiple myeloma patients

Excessive ADAM17 activation occurs in uremic patients and may contribute to their immunocompromised status

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