Abstract: SA-PO1104
The Association of the Influenza Vaccination with CKD Progression to ESKD in a High-Risk Patient Population
Session Information
- CKD Epidemiology, Risk Factors, Prevention - III
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Wilson, Clara, Montefiore Medical Center, Bronx, New York, United States
- Li, Jun, Montefiore Medical Center, Bronx, New York, United States
- Jobson, Crystal K., Montefiore Medical Center, Bronx, New York, United States
- Fisher, Molly, Montefiore Medical Center, Bronx, New York, United States
- Johns, Tanya S., Montefiore Medical Center, Bronx, New York, United States
- Melamed, Michal L., Montefiore Medical Center, Bronx, New York, United States
Background
Individuals with CKD who received influenza vaccination have lower risk of infection-related hospitalizations, cardiovascular events, and mortality compared to unvaccinated. However, the association between influenza vaccination status and risk of progression to ESKD has not been studied.
Methods
We describe a cohort of 4,020 adult patients with CKD stage 3b or 4 (eGFR < 45 mL/min/1.73 m2) identified through ATLAS and FluSurv-Net database from 9/2008 to 9/2010 (index dates) at risk for progression to ESKD. Primary exposure was receipt of influenza vaccine during the index period. Patient were followed to ESKD (primary outcome) or administratively censored at 12/31/2019. Multivariable Cox proportional hazards models were used to determine the association between influenza vaccination status and progression to ESKD.
Results
In this cohort, 46% were unvaccinated and 54% vaccinated. Vaccinated patients mean age was 71 years (SD 13.2), were predominantly Black (45.7%) and Hispanic (27.5%). Compared to unvaccinated patients, vaccinated patients were significantly older, more likely to be female, White or Hispanic, have higher baseline eGFR and comorbidities like hypertension, diabetes, congestive heart failure, peripheral vascular disease, malignancy, and neurologic disease (Table 1). In the unadjusted Cox model, risk of progression to ESKD in unvaccinated vs. vaccinated patients was 24% higher [HR 0.76 (95% CI: 0.67, 0.86)]. However, this risk attenuated [HR 0.92 (95% CI 0.81, 1.03)] after adjusting for age, sex, race/ethnicity, and comorbidities.
Conclusion
Influenza vaccination was associated with a lower risk of progression from CKD to ESKD; however, significance of risk reduction was attenuated by concomitant comorbidities and sociodemographic factors.