Practical Guide to Vaccination in All Stages of CKD, Including Patients Treated by Dialysis or Kidney Transplantation
Practical Guide to Vaccination in All Stages of CKD, Including Patients Treated by Dialysis or Kidney Transplantation
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DOI：
10.1053/j.ajkd.2019.06.014
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发表时间：
2020-03-01
影响因子：
13.2
通讯作者：
Ghossein, Cybele
中科院分区：
文献类型：
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作者：
Krueger, Karen M.;Ison, Michael G.;Ghossein, Cybele
感染是慢性肾脏疾病（CKD）患者发病和死亡的主要原因，包括接受维持性透析或肾移植的患者。尽管这些人群对疫苗的反应受损，但由于免疫接种具有良好的安全性和这些患者的高感染率，免疫接种仍然是预防性保健的重要组成部分。大多数CKD患者的指南都着重于乙型肝炎、流感和肺炎球菌疫苗的重要性，以及与年龄相适应的免疫接种。需要更多的数据来确定这些免疫接种和其他免疫接种在该人群中的临床疗效，并确定最佳剂量和给药时间。研究表明，在透析或移植开始前进行免疫接种可能是有益的，因为早期CKD患者通常具有较高的血清转化率。由于肾病学家通常是CKD患者的初级保健医生，因此了解疫苗接种在该患者群体预防保健中的作用非常重要。
Infection is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD), including those receiving maintenance dialysis or with a kidney transplant. Although responses to vaccines are impaired in these populations, immunizations remain an important component of preventative care due to their favorable safety profiles and the high rate of infection in these patients. Most guidelines for patients with CKD focus on the importance of the hepatitis B, influenza, and pneumococcal vaccines in addition to age-appropriate immunizations. More data are needed to determine the clinical efficacy of these immunizations and others in this population and define optimal dosing and timing for administration. Studies have suggested that there may be a benefit to immunization before the onset of dialysis or transplantation because patients with early-stage CKD generally have higher rates of seroconversion. Because nephrologists often serve as primary care physicians for patients with CKD, it is important to understand the role of vaccinations in the preventive care of this patient population.