Abstract
BackgroundEnd stage renal disease (ESRD) is on the rise globally. Varicella infection among adult patients with ESRD has been reported to lead to multiple complications and even death. While varicella vaccination has been recommended in paediatric renal patients; recommendation on varicella vaccination among adult patients with ESRD remained sparse. This review is aimed at evaluating the impact of varicella infection among adult patients with ESRD and make a recommendation for vaccination.MethodsThree databases (PubMed, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched in April 2018 with keywords ‘varicella, chronic kidney failure, chronic kidney disease, renal replacement therapy, kidney transplantation, end stage renal disease, end stage renal failure, chicken pox, vaccine, vaccination and complications’.Results29 articles were selected for review. The studies were mainly case reports, and they included measured outcomes: prevalence of seronegativity, impact (morbidity, length of stay, and mortality) of varicella among patients with ESRD, seroconversion rates and safety of varicella vaccination. The prevalence of seronegativity among varicella-infected ESRD adults was found to be at 42 to 100%. Nineteen deaths were reported. At least 54 patients have had complications from varicella infection. Seroconversion rate post vaccination was found to be around 64–94%.ConclusionVaricella is associated with significant morbidity and mortality rates in adult patients with ESRD. Varicella vaccination should be considered for the vulnerable, seronegative patients.
Highlights
End stage renal disease (ESRD) is on the rise globally
The mortality rate from pulmonary infections was 14 to 16-fold higher in dialysis patients and about two-fold higher in renal transplant recipients compared to general population [6]
This review is aimed at identifying the prevalence of seronegativity among patients with ESRD, evaluating the impact of varicella infection to adult patients with ESRD, and synthesizing current recommendations on varicella-zoster virus (VZV) vaccination
Summary
End stage renal disease (ESRD) is on the rise globally. Varicella infection among adult patients with ESRD has been reported to lead to multiple complications and even death. This review is aimed at evaluating the impact of varicella infection among adult patients with ESRD and make a recommendation for vaccination. End stage renal disease (ESRD) is a prevalent chronic condition in many countries. The lifetime risk for an individual to develop chronic kidney disease (CKD) is high, with more than half the adults aged 30–64 years in the United States likely to develop CKD [2]. Fehr et al.’s literature review on cases of disseminated varicella infection in adult renal allograft recipients, showed an overall mortality of 34% [5].
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