Influenza Vaccine and Chronic Kidney Disease/Dialysis Risk in Hypertensive Patients: Exploring the Association

Lizunnik Stolley^*
*Correspondence: Lizunnik Stolley, Department of Internal Medicine, University of Palermo, 90127 Palermo, Italy, Email:

Keywords

Influenza vaccine • Chronic kidney disease • Hypertension • Renal health

Introduction

Chronic Kidney Disease (CKD) is a significant public health concern, particularly among individuals with hypertension, who are at higher risk for both conditions. Hypertensive patients often receive the influenza vaccine as part of routine preventive care to mitigate the risk of influenza-related complications. While the vaccine's effectiveness in preventing influenza is well-established, its potential impact on kidney function and CKD progression has garnered increasing interest. Several mechanisms may underlie the potential association between influenza vaccination and renal outcomes in hypertensive patients. Influenza infection itself can exacerbate systemic inflammation and oxidative stress, factors known to accelerate renal dysfunction and contribute to CKD progression. By preventing influenza infection, vaccination may indirectly reduce the burden of inflammation and oxidative stress on renal tissues, thereby potentially slowing CKD progression and reducing the likelihood of requiring dialysis [1].

Despite these potential benefits, limited evidence exists on the direct association between influenza vaccination and renal outcomes in hypertensive patients. Current literature primarily focuses on vaccine efficacy against influenza-related morbidity and mortality, with few studies examining its effects on kidney health specifically. Understanding the impact of influenza vaccination on CKD progression and dialysis risk in hypertensive individuals is crucial for optimizing preventive strategies and improving long-term renal health outcomes in this vulnerable population. This study aims to address this gap by exploring whether influenza vaccination is associated with reduced risk of CKD progression or the need for dialysis among hypertensive patients. By leveraging retrospective cohort data and robust statistical analyses, we seek to elucidate the potential renal protective effects of influenza vaccination in hypertensive populations, providing valuable insights for clinical practice and public health policy [2].

Literature Review

Chronic Kidney Disease (CKD) is a prevalent and serious complication among individuals with hypertension, posing significant risks for progression to End-Stage Renal Disease (ESRD) requiring dialysis or transplantation. Influenza vaccination is routinely recommended for hypertensive patients to reduce the risk of influenza-related complications and mortality. While the primary benefit of influenza vaccination is well-established in preventing respiratory infections, emerging evidence suggests potential secondary benefits on renal health. Several studies have explored the association between influenza vaccination and renal outcomes in high-risk populations, including individuals with hypertension. A retrospective cohort study found that influenza vaccination was associated with a lower incidence of Acute Kidney Injury (AKI) and a reduced risk of hospitalization for kidney-related complications among elderly hypertensive patients. Other investigations have indicated that influenza vaccination may mitigate systemic inflammation and oxidative stress, processes known to contribute to CKD progression and cardiovascular complications in hypertensive individuals [3].

The mechanistic links between influenza infection, systemic inflammation and renal dysfunction provide a plausible rationale for the potential renal protective effects of vaccination. Influenza infection can exacerbate pro-inflammatory cytokine production and endothelial dysfunction, promoting glomerular injury and tubular damage. By preventing influenza infection, vaccination may attenuate these inflammatory responses and reduce the burden on renal tissues, potentially slowing the progression of CKD and delaying the onset of dialysis dependence. However, conflicting evidence exists regarding the direct impact of influenza vaccination on renal outcomes in hypertensive patients. Some studies have reported no significant association between influenza vaccination status and CKD progression markers such as decline in estimated Glomerular Filtration Rate (eGFR) or incidence of ESRD. These inconsistencies underscore the need for further research to elucidate the specific mechanisms and long-term effects of influenza vaccination on renal health outcomes in hypertensive populations [4].

Discussion

The discussion revolves around the complexities of studying the association between influenza vaccination and chronic kidney disease/dialysis risk in hypertensive patients. While observational studies suggest potential benefits of vaccination in reducing acute kidney injury and hospitalizations related to kidney complications, the evidence remains inconclusive regarding its impact on long-term CKD progression and dialysis initiation. Methodological challenges, including variations in study design, population demographics and outcome measures, contribute to the mixed findings in the literature. Prospective cohort studies with longer follow-up periods and standardized outcome assessments are needed to establish causal relationships between influenza vaccination and renal health outcomes in hypertensive populations [5]. Additionally, stratified analyses based on vaccination timing, vaccine effectiveness and underlying renal function can provide deeper insights into subgroup-specific benefits and risks. From a clinical perspective, promoting influenza vaccination in hypertensive patients aligns with broader public health goals of preventing infectious diseases and reducing healthcare burden. The potential renal protective effects observed in some studies underscore the importance of integrating vaccination strategies into comprehensive management approaches for patients at risk of CKD progression. Multidisciplinary collaborations between nephrologists, cardiologists and primary care providers are essential for optimizing preventive care strategies and improving outcomes for hypertensive individuals with concomitant renal disease [6].

Conclusion

In conclusion, while influenza vaccination is primarily recommended for its established benefits in preventing influenza-related complications in hypertensive patients, emerging evidence suggests potential secondary benefits on renal health. Current literature indicates a plausible association between influenza vaccination and reduced risk of acute kidney injury and kidney-related hospitalizations in high-risk populations, including individuals with hypertension. However, definitive conclusions regarding the long-term impact of influenza vaccination on CKD progression and dialysis risk remain elusive. Further prospective studies with rigorous methodologies are warranted to clarify the mechanistic pathways and clinical implications of vaccination on renal outcomes in hypertensive patients. Integrating vaccination strategies into comprehensive management protocols for chronic conditions such as hypertension and CKD holds promise for enhancing overall health outcomes and reducing healthcare disparities related to renal disease.

Acknowledgment

None.

Conflict of Interest

No conflict of interest.

References

1. Jha, Vivekanand, Guillermo Garcia-Garcia, Kunitoshi Iseki and Zuo Li, et al. "Chronic kidney disease: Global dimension and perspectives." Lancet 382 (2013): 260-272.

Google Scholar, Crossref, Indexed at

2. Asif, Muhammad, Muhammad Akram and Atif Ullah. "Chronic kidney disease." Professional Med J 20 (2013).

Google Scholar, Crossref, Indexed at

3. Rothberg, Michael B., Sarah D. Haessler and Richard B. Brown. "Complications of viral influenza." Am J Med 121 (2008): 258-264.

Google Scholar, Crossref, Indexed at

4. Shenouda, Adel and Fred E. Hatch. "Influenza A viral infection associated with acute renal failure." Am J Med 61 (1976): 697-702.

Google Scholar, Crossref, Indexed at

5. Watanabe, Toru. "Renal complications of seasonal and pandemic influenza A virus infections." Eur J Pediatr 172 (2013): 15-22.

Google Scholar, Crossref, Indexed at

6. Estabragh, Zahra Raisi and Mamas A. Mamas. "The cardiovascular manifestations of influenza: A systematic review." Int J Cardiol 167 (2013): 2397-2403.

Google Scholar, Crossref, Indexed at