慢性肾病（CKD）患者患肾细胞癌（RCC）的风险较高，可能是由于相关的潜在炎症和免疫失调。在当前基于人群的队列研究中，我们评估了流感疫苗接种对 CKD 患者中 RCC 的影响。我们分析了从台湾国民健康保险数据库中确定的接种疫苗和未接种疫苗的 CKD 患者（≥55 岁）。倾向评分匹配用于减少选择偏差。还进行了基于合并症、透析状态和疫苗剂量的亚组分析。与未接种疫苗组相比，接种疫苗组的 RCC 发病率显着降低{未调整的风险比 [HR] 0.50 [95% 置信区间 (CI) 0.31-0.81]， P < .01；调整后 HR 0.46 [95% CI 0.28-0.75]，P < .01}。流感疫苗的这种保护作用在 75 岁以上的人群中显着 [未经调整的 HR 0.29 (95% CI 0.12-0.74)，P < .01；调整后 HR 0.22 (95% CI 0.08-0.58)，P < .01]。在未调整和调整的模型中，疫苗接种总数与 RCC 事件之间存在反向关联。 Kaplan-Meier 对 RCC 事件的估计显示，与未接种疫苗的患者相比，接种疫苗的患者的自由生存率显着更高 (logrank P = .005)。 这项基于人群的队列研究发现，流感疫苗接种与患流感的风险之间存在显着的负相关关系。 CKD 患者中的 RCC 和 75 岁以上患者的保护作用更为突出。疫苗接种总数与 RCC 事件之间可能存在关联。未来需要进行随机临床和基础研究来证明这些发现和潜在的病理生理学机制。© 作者 2023。由牛津大学出版社代表 ERA 出版。

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.We analysed the vaccinated and unvaccinated CKD patients (≥55 years of age) identified from the Taiwan National Health Insurance Database. Propensity score matching was used to reduce the selection bias. Subgroup analyses based on comorbid conditions, dialysis status and vaccinated dosages were also conducted.The incidence of RCC decreased significantly in the vaccinated compared with unvaccinated group {unadjusted hazard ratio [HR] 0.50 [95% confidence interval (CI) 0.31-0.81], P < .01; adjusted HR 0.46 [95% CI 0.28-0.75], P < .01}. Such protective effects of influenza vaccination were noted significantly among those ≥75 years of age [unadjusted HR 0.29 (95% CI 0.12-0.74), P < .01; adjusted HR 0.22 (95% CI 0.08-0.58), P < .01]. A reverse association was noted between the total number of vaccinations and RCC events in both unadjusted and adjusted models. The Kaplan-Meier estimates of the RCC events showed significantly higher free survival rates in the vaccinated as compared with the unvaccinated patients (logrank P = .005).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 patients >75 years of age. A possible relation exists between the total number of vaccinations and RCC events. Future randomized clinical and basic studies will be needed to prove these findings and underlying pathophysiological mechanisms.© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.