|
Title Influenza and Pneumococcal Vaccination Among Individuals with Biopsy-Proven Medical Diseases of the Kidney |
|
Type Poster Presentation |
|
Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
|
Topic Chronic Kidney Disease: Glomerular, Tubulointerstitial and Inherited Kidney disorders |
|
Main Author Jackie Sim1 |
|
Presenting Author Jackie Sim1 |
|
Co-Author Irene Mok2 Jason Choo2 Nicholas Yoon1 Yok Mooi Chin2 Wei Ling Teng2 Cynthia Ciwei Lim2 |
|
Department / Institution / Country Yong Loo Lin School of Medicine / National University of Singapore / Singapore1 Department of Renal Medicine / Singapore General Hospital / Singapore2 |
|
Abstract Content: Introduction, Method, Result, Conclusion Introduction: Respiratory infections are frequent and associated with increased morbidity and hospitalization among patients with chronic kidney disease and glomerulonephritis. Vaccination against influenza and pneumococcal infections are available and should be encouraged but the uptake among local physicians and patients is not known. We aimed to evaluate the prevalence of these vaccinations among individuals with biopsy-proven glomerulonephritis and chronic kidney disease. Methods: The Singapore General Hospital Native Kidney Biopsy Registry, a clinical audit database started in November 2015, was reviewed for clinical presentation, histological diagnosis and vaccination history of 398 consecutive patients who had kidney biopsies performed between June 2016 and June 2018. Results: Median age was 53.4 (IQR 39.3, 64.2) years and the majority were female (57.3%) and Chinese (72.6%; Malay 16.8%, Indian 5.5% and other ethnicities 4.8%). At presentation, 142 (35.7%) had diabetes, 132 (33.2%) had nephrotic syndrome and median serum creatinine was 111 (67, 196) µmol/L. Immunosuppression was initiated within 6 months in 185 individuals diagnosed with lupus nephritis (36.8%), minimal change nephropathy (15.7%), IgA nephropathy (15.7%), membranous nephropathy (9.7%) and ANCA-associated vasculitis (2.7%). Pre-biopsy, 29 individuals (7.3%) already had influenza vaccination and none had pneumococcal vaccination. Post-biopsy, influenza and pneumococcal vaccinations were administered to 110 (27.6%) and 81 adults (20.3%) respectively. Patients who received immunosuppression were more likely to have vaccinations against influenza (35.7% vs. 21.9%, p=0.001) and pneumococcus (24.9% vs. 17.4%, p=0.05). Conclusion: Patients treated with immunosuppressant were more likely to receive influenza vaccination but vaccination rates for both influenza and pneumococcus were low. As these are important preventive measures against respiratory infections among at-risk patients, future studies should evaluate barriers to vaccinations among individuals treated with immunosuppressant for glomerulonephritis and chronic kidney disease. |