Influenza vaccination is associated with lower risk of renal cell carcinoma among chronic kidney disease patients: a population-based cohort study

Abstract

Background Chronic kidney disease (CKD) patients possess a higher risk for renal cell carcinoma (RCC) possibly because of related underlying inflammation and immune dysregulation. In the current population-based cohort study, we evaluate the effects of influenza vaccination on RCC among CKD patients. Methods We analyzed the vaccinated and unvaccinated CKD patients (≥55 years old) identified from the Taiwan National Health Insurance Database. Propensity score matching was used to reduce the selection bias. Sub-group analyses based on comorbid conditions, dialysis status and vaccinated dosages were also conducted. Results The incidence of RCC reduced significantly in the vaccinated compared with unvaccinated group (unadjusted HR 0.50 (95% CI, 0.31, 0.81; p < 0.01) and adjusted HR 0.46 (95% CI, 0.28, 0.75; p < 0.01). Such protective effects of the influenza vaccination were noted significantly among those aged ≥ 75 (unadjusted HR 0.29 (95% CI, 0.12, 0.74; p < 0.01); adjusted HR 0.22 (95% CI, 0.08, 0.58; p < 0.01). A reverse association was noted between total number of vaccination and RCC events in both unadjusted and adjusted models. The Kaplan-Meier estimates of the RCC events showed a significantly higher free survival rates in the vaccinated as compared with the unvaccinated (log-rank p = 0.005). Conclusion This population-based cohort study found a significant inverse relationship between influenza vaccination and the risk of RCC in CKD patients and the protective effects were more prominent in the aged group > 75. A possible relation exists between total number of vaccination and RCC events. Future randomized clinical and basic studies will be needed to prove these findings and underlying pathophysiological mechanisms.

The potential association between influenza vaccination and lower incidence of renal cell carcinoma

“…In this issue of the Clinical Kidney Journal , Lin et al. report the intriguing finding that influenza vaccination in older adults with chronic kidney disease (CKD) is associated with a lower incidence of renal cell carcinoma (RCC) [ 1 ]. The retrospective propensity-matched study used an insurance claims database in Taiwan and studied 11 605 individuals over the age of 55 years with a coded diagnosis of CKD, in whom government-funded influenza vaccination is indicated.…”

“…Lin et al. report an eye-catching estimate of 54% lower hazards for incident RCC in individuals vaccinated against influenza versus those who are unvaccinated [adjusted hazard ratio (HR) 0.46, 95% confidence interval (CI) 0.28–0.75] [ 1 ]. What is especially intriguing is that Lin et al.…”