Hepatitis B Vaccination Responders vs. Non-responders on Hemodialysis: Baseline Patient Characteristics

Abstract

Vaccination of Hemodialysis (HD) patients for the Hepatitis B virus is recommended. However, the rate of seroconversion at 30–75% is lower than that of the general population at 90 + %. In prior dialysis studies, younger patient age predicted seroconversion. Objective: To analyze baseline characteristics of HD patients with different vaccination responses. Method: A retrospective analysis of 2 distinct groups of HD patients: Group 1 (responders) seroconverted after 1 series of standard Hep B vaccination (40 mcg IM at 0,1,6 mos.), Group 2 (non-responders) failed to convert after 3 such series. All subjects were Hepatitis B & C Ab (-) at the start of HD. These two groups were compared in their age, sex, race, laboratory values, cause of renal failure, access type, nPCR, Kt/V at the initiation of HD to determine which factors may have predicted vaccination response. Results: 78 patients were identified as responders, 30 patients as non-responders. By univariate analysis, baseline lab tests did not differ for: WBC, albumin, phosphorous, calcium, intact PTH, ferritin, total iron, or HCT. The groups did not differ in racial mix or male:female ratio. Access type did not differ, averaging 60% catheter use at start of HD. Variable responder non-responder p Diabetes 29% 79% .040 Age (avg. ± SEM) 50 ± 1.8 57 ± 2.5 .041 Wt. (kg) 69 79 .023 The groups differed in average age, prevalence of diabetes and weight (Table). Responders had a significantly lower serum bicarbonate (20 meq/L vs. 23 meq/L, P = .040), though nPCR and Kt/V did not differ. Conclusion: HD patients who failed to responded to the Hep B vaccination after 3 series were older, more likely to be diabetics and weighed more than those who did respond after only 1 vaccination series. The responders were slightly more acidotic, though there were no differences in nPCR or serum albumin.