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Winter is flu time: Nephrologists call for flu vaccine – MEDIZIN ASPECTS

Flu is not safe. Most flu deaths occur in the elderly, warns the Robert Koch Institute (1). People over 60, especially those over 60, are at increased risk of developing a severe flu epidemic, complications such as pneumonia or heart failure, and cause the flu to die. In addition, the elderly often have several underlying diseases such as chronic cardiovascular disease, diabetes, liver and kidney disease. They are usually associated with a restricted immune system that can no longer be readily repelled by treacherous viruses. About 20 percent of patients older than 60 and chronic patients in Germany suffer from such severe flu that they need to be treated in a hospital (2).

This also applies to patients with chronic kidney disease, which is much more common than might be expected: there are about 9 million people in Germany with this disease (10.4 percent women and 11.8 percent men) – many without it . Dialysis is only a fraction of them – around 90,000 patients are regularly dialysed in Germany and 25,000 live with a donor kidney.

Even a slight restriction on kidney function affects the immune system and makes it susceptible to it. In addition, renal patients are often old and multimorbid. One study found that these were patients with the most complex clinical picture (3). Therefore, vaccination is already advised. Even patients with mild renal impairment have a significantly increased risk of pneumonia (4), and there is a significant increase in mortality associated with renal function. Influenza is a relevant cause of pneumonia or a precursor to other pathogens.

"The kidney function should be checked regularly, especially in the elderly, by a family doctor," says DGfN President, Prof. Dr. Honey. Andreas Kribben. "If there is a chronic kidney disease, we strongly recommend that you get the flu vaccine." Also, the Standing Committee on Vaccination (STIKO) recommends the flu vaccine to this group of patients. "It's just a small needle stick, but it provides great protection for patients," explains Prof. Kribben. Vaccination can be performed by a specialist or a specialist (nephrologist). The best time to do this is October or November. Costs are covered by health care providers.

The “Flu? Vaccination! ", Calls on the German Society for Nephrology (DGfN), together with the Federal Kidney Association eV, the German Kidney Foundation (DNS), the KfH Care Board for Kidney Dialysis and Transplantation eV, the nonprofit Foundation for Home Care Patients (PHV) and the Association of German Centers for kidney (DN) eV to remove the flu now in the fall.The educational campaign follows the posters and leaflets used by many nephrologists.The campaign motif depicts a 52-year-old "real" dialysis patient under wraps. – also due to influenza to which Regina E. calls other patients with chronic kidney disease (see text).

(2) Calendar Weekly Flu Report 14/2018, AGI Study Group, Robert Koch Institute. https: / / Wochenberichte.aspx
(3) Marcello Tonelli et al. Comparison of the complexity of patient lakes by different medical subspecialists in the universal health system. JAMA Netw Open. 2018, 1 (7): e184852. doi: 10.1001 / jamanetworkopen.2018.485
(4) Principles N, Esposito S; ESCMID vaccine study group. Influenza vaccination in end-stage renal disease patients. Expert Opinion on Saf 2015; 14 (8): 1249-58

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idw 2019/10