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Journal Article Epublish 3 citations

PubMed: 37915887 DOI: 10.1093/ckj/sfad110

Influenza vaccination is associated with lower risk of renal cell carcinoma among chronic kidney disease patients: a population-based cohort study.

Clin Kidney J 16(11):1936-1946

Authors: Chia-Wei Lin, Jing-Quan Zheng, Kai-Yi Tzou, Yu-Ann Fang, Wei-Tang Kao, Hsin-Ting Lin, Ju-Chi Liu, Yu-Han Huang, Yuh-Feng Lin, Kuo-Cheng Lu, Shao-Wei Dong, Cai-Mei Zheng, Chia-Chang Wu

Affiliations

  • Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
  • Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
  • Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Taipei Medical University Research Centre of Urology and Kidney, Taipei Medical University, Taipei, Taiwan.
  • Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan. Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
  • Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
  • Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.
  • Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
  • Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
  • Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.

Abstract

Background

Chronic kidney disease (CKD) patients possess a higher risk for renal cell carcinoma (RCC) possibly because of related underlying inflammation and immune dysregulation. In the current population-based cohort study, we evaluate the effects of influenza vaccination on RCC among CKD patients.

Methods

We analysed the vaccinated and unvaccinated CKD patients (≥55 years of age) identified from the Taiwan National Health Insurance Database. Propensity score matching was used to reduce the selection bias. Subgroup analyses based on comorbid conditions, dialysis status and vaccinated dosages were also conducted.

Results

The incidence of RCC decreased significantly in the vaccinated compared with unvaccinated group {unadjusted hazard ratio [HR] 0.50 [95% confidence interval (CI) 0.31-0.81],  < .01; adjusted HR 0.46 [95% CI 0.28-0.75],  < .01}. Such protective effects of influenza vaccination were noted significantly among those ≥75 years of age [unadjusted HR 0.29 (95% CI 0.12-0.74),  < .01; adjusted HR 0.22 (95% CI 0.08-0.58),  < .01]. A reverse association was noted between the total number of vaccinations and RCC events in both unadjusted and adjusted models. The Kaplan-Meier estimates of the RCC events showed significantly higher free survival rates in the vaccinated as compared with the unvaccinated patients (logrank  = .005).

Conclusion

This population-based cohort study found a significant inverse relationship between influenza vaccination and the risk of RCC in CKD patients and the protective effects were more prominent in patients >75 years of age. A possible relation exists between the total number of vaccinations and RCC events. Future randomized clinical and basic studies will be needed to prove these findings and underlying pathophysiological mechanisms.

MeSH

Kidney Diseases, Cells, Vaccines, Cohort Studies, Kidney, Carcinoma, Renal Cell, Vaccination, Influenza, Human