Association between influenza vaccination and the reduced risk of acute kidney injury among older people

A nested case-control study

Chia Hsiang Shih, Yi Jung Lee, Pei Wen Chao, Shu Chen Kuo, Shuo Ming Ou, Hung Meng Huang, Yung Tai Chen

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: The objective of this study is to determine whether vaccination against influenza is associated with a reduced risk of acute kidney injury (AKI) in a nationwide cohort of adults aged ≥65 years. Methods: We investigated a total of 13,270 patients aged ≥65 years who were hospitalized for AKI between 2000 and 2013 from Taiwan's National Health Insurance Research Database. Each AKI case was matched with one control subject according to duration of follow-up, age, sex, monthly income, urbanization level, and baseline comorbidities. Odds ratios (ORs) for AKI associated with exposure to the influenza vaccine in the previous year were calculated in a nested case-control analysis. Results: Influenza vaccination in the previous year was associated with a lower risk of AKI (adjusted OR 0.67, 95% confidence interval [CI] 0.63–0.72). Compared with a reference group of unvaccinated individuals with no influenza infection, vaccination with no influenza infection was associated with a lower risk of AKI (adjusted OR 0.68, 95% CI 0.64–0.73). Lack of vaccination and presence of influenza infection was associated with a higher risk of AKI (adjusted OR 1.78, 95% CI 1.57–2.01), whereas the risk of AKI was insignificant in vaccinated patients who developed influenza (adjusted OR 1.01, 95% CI 0.69–1.18). Conclusions: The risk of AKI was 37% lower among older people who received vaccination against influenza in a real-world setting. Further work is required to clarify causality.

Original languageEnglish
Pages (from-to)65-69
Number of pages5
JournalEuropean Journal of Internal Medicine
Volume54
DOIs
Publication statusPublished - Aug 1 2018

Fingerprint

Acute Kidney Injury
Human Influenza
Case-Control Studies
Vaccination
Odds Ratio
Confidence Intervals
Infection
Urbanization
Influenza Vaccines
National Health Programs
Taiwan
Causality
Comorbidity
Databases
Research

Keywords

  • Epidemiology
  • Influenza vaccine, acute kidney injury, older people
  • Nested case-control study

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Association between influenza vaccination and the reduced risk of acute kidney injury among older people : A nested case-control study. / Shih, Chia Hsiang; Lee, Yi Jung; Chao, Pei Wen; Kuo, Shu Chen; Ou, Shuo Ming; Huang, Hung Meng; Chen, Yung Tai.

In: European Journal of Internal Medicine, Vol. 54, 01.08.2018, p. 65-69.

Research output: Contribution to journalArticle

Shih, Chia Hsiang ; Lee, Yi Jung ; Chao, Pei Wen ; Kuo, Shu Chen ; Ou, Shuo Ming ; Huang, Hung Meng ; Chen, Yung Tai. / Association between influenza vaccination and the reduced risk of acute kidney injury among older people : A nested case-control study. In: European Journal of Internal Medicine. 2018 ; Vol. 54. pp. 65-69.
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abstract = "Objective: The objective of this study is to determine whether vaccination against influenza is associated with a reduced risk of acute kidney injury (AKI) in a nationwide cohort of adults aged ≥65 years. Methods: We investigated a total of 13,270 patients aged ≥65 years who were hospitalized for AKI between 2000 and 2013 from Taiwan's National Health Insurance Research Database. Each AKI case was matched with one control subject according to duration of follow-up, age, sex, monthly income, urbanization level, and baseline comorbidities. Odds ratios (ORs) for AKI associated with exposure to the influenza vaccine in the previous year were calculated in a nested case-control analysis. Results: Influenza vaccination in the previous year was associated with a lower risk of AKI (adjusted OR 0.67, 95{\%} confidence interval [CI] 0.63–0.72). Compared with a reference group of unvaccinated individuals with no influenza infection, vaccination with no influenza infection was associated with a lower risk of AKI (adjusted OR 0.68, 95{\%} CI 0.64–0.73). Lack of vaccination and presence of influenza infection was associated with a higher risk of AKI (adjusted OR 1.78, 95{\%} CI 1.57–2.01), whereas the risk of AKI was insignificant in vaccinated patients who developed influenza (adjusted OR 1.01, 95{\%} CI 0.69–1.18). Conclusions: The risk of AKI was 37{\%} lower among older people who received vaccination against influenza in a real-world setting. Further work is required to clarify causality.",
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AB - Objective: The objective of this study is to determine whether vaccination against influenza is associated with a reduced risk of acute kidney injury (AKI) in a nationwide cohort of adults aged ≥65 years. Methods: We investigated a total of 13,270 patients aged ≥65 years who were hospitalized for AKI between 2000 and 2013 from Taiwan's National Health Insurance Research Database. Each AKI case was matched with one control subject according to duration of follow-up, age, sex, monthly income, urbanization level, and baseline comorbidities. Odds ratios (ORs) for AKI associated with exposure to the influenza vaccine in the previous year were calculated in a nested case-control analysis. Results: Influenza vaccination in the previous year was associated with a lower risk of AKI (adjusted OR 0.67, 95% confidence interval [CI] 0.63–0.72). Compared with a reference group of unvaccinated individuals with no influenza infection, vaccination with no influenza infection was associated with a lower risk of AKI (adjusted OR 0.68, 95% CI 0.64–0.73). Lack of vaccination and presence of influenza infection was associated with a higher risk of AKI (adjusted OR 1.78, 95% CI 1.57–2.01), whereas the risk of AKI was insignificant in vaccinated patients who developed influenza (adjusted OR 1.01, 95% CI 0.69–1.18). Conclusions: The risk of AKI was 37% lower among older people who received vaccination against influenza in a real-world setting. Further work is required to clarify causality.

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