Risk of herpes zoster among patients with predialysis chronic kidney disease in a cohort study in Taiwan.

ABSTRACT

BACKGROUND/OBJECTIVE: Patients on chronic dialysis are at risk of developing herpes zoster, but little systematic research focuses on the association between predialysis chronic kidney disease and herpes zoster. The objective of the study was to explore the association between predialysis chronic kidney disease and herpes zoster in Taiwan. METHODS: A nation-based retrospective cohort study was performed using the 2005-2012 database of the Taiwan National Health Insurance Program. There were 16 655 subjects aged 20-84 years with newly diagnosed predialysis chronic kidney disease as the study group and 33 310 randomly selected subjects without chronic kidney disease as the comparison group. Both groups were matched with sex, age, comorbidities and the year of the index date. The incidence rates of herpes zoster in both groups were calculated. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with predialysis chronic kidney disease. RESULTS: The overall incidence rate of herpes zoster was 1.4-fold higher in the predialysis chronic kidney disease group than that in the non-chronic kidney disease group (8.76 vs 6.27 per 1000 person-years, 95% CI 1.27-1.54; P < .001). After controlling for co-variables, the adjusted HR of herpes zoster was 1.38 (95% CI 1.25-1.53; P < .001) for subjects with predialysis chronic kidney disease compared with non-chronic kidney disease subjects. The adjusted HR increased to 1.65 for subjects with predialysis chronic kidney disease and with any comorbidity (95% CI 1.42-1.92; P < .001). CONCLUSIONS: Patients with predialysis chronic kidney disease correlate with approximately 1.4-fold increased hazard of developing herpes zoster.