Recommendations1,2 that patients with chronic renal disease should be given influenza vaccine annually are based on three premises: (1) patients with renal failure have a higher than normal mortality following influenza infection; (2) influenza vaccine may reduce morbidity and mortality in these patients; (3) the vaccine does not cause a substantial reduction in their renal function nor does it increase the risk of organ rejection in patients with renal allografts.
The first premise is supported by the observations of Eickhoff et al,3 who found that during the Asian influenza epidemic of 1957, more deaths from chronic nephritis or cardiovascular renal disease were reported than were expected from projections based on mortality in preceding years. There is also some suggestion of increased risk of renal allograft rejection following influenza A or B infection.4,5 The mechanisms by which influenza infection may cause increased mortality and the precise degree of risk
Noble GR. Influenza Vaccine in Renal Disease. JAMA. 1978;239(24):2592–2593. doi:10.1001/jama.1978.03280510076026
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