Appendix
to the manuscript entitled “Influenza vaccination in patients with end-stage renal disease: Systematic
review and assessment of quality of evidence related to vaccine efficacy, effectiveness and safety” by
Cornelius Remschmidt et al.
Appendix 1
Search strategy for the systematic review on influenza vaccine efficacy, effectiveness and safety in
patients with end-stage renal disease.
#1 “kidney”
#2 “dialysis”
#3 “renal”
#4 “nephr*”
#5 “hemodialysis”
#6 “haemodialysis”
#7 “uremia”
#8 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7
#9 “vacci*”
#10 “immuniz*”
#11 #9 OR #10
#12 “influenza”
#13 #8 AND #11 and #12
(restrictions: species: human)
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Appendix 2
List of excluded studies on influenza vaccine effectiveness and safety in patients with end-stage renal
disease (n=15):
No data of ESRD patients extractable (n=7)[1-8]
No control group (n=2)[9, 10]
No ESRD patients (n=1)[11]
Severity of kidney failure unclear (n=1)[12]
Kidney transplant patients only (n=1)[13]
Patients received two influenza doses (n=1)[14]
Implausible data of a congress abstract (n=1) [15]
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Appendix 3
Variables considered in the final adjusted analysis in the included studies reporting on influenza
vaccine effectiveness and safety in patients with end-stage renal disease (ESRD).
Study
Variables considered in the final adjusted analysis
Bond et al.
Age, race, sex, time on dialysis, modality (hemodialysis, continuous cyclic or
ambulatory peritoneal dialysis), diabetes as primary cause of ESRD,
comorbidities at dialysis initiation, and laboratory parameters.
Gilbertson et al.
Age, sex, race, ethnicity, ESRD network, length on time with ESRD, cause of
renal failure, Charlson comorbidity index, and severity of disease measure of
hospital days during the eight-month entry period.
McGrath et al.
Age, race, sex, cause of ESRD, vintage, adherence, hospital days, mobility aids,
ESRD network, comorbidities, and oxygen use.
Slinin et al.
Age, race, sex, smoking status, duration of dialysis, cause of ESRD, previous
transplantation, body mass index, laboratory parameters, and comorbidities.
Wang et al.
Age, sex, comorbidities, and calendar years.
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Appendix 4
Sensitivity analysis on adjusted effectiveness of influenza vaccination against (1) all-cause mortality
and (2) hospitalization due to influenza or pneumonia during influenza seasons in patients with endstage renal disease (ESRD).
(1) All-cause mortality: 1A. all studies; 1B. without patients on peritoneal dialysis (Gilbertson et al.);
1C. without patients with newly diagnosed ESRD (Wang et al.); 1D. without patients on peritoneal
dialysis or with newly diagnosed ESRD.
1A. All-cause mortality during influenza seasons, all studies.
1B. All-cause mortality during influenza seasons, without patients on peritoneal dialysis (Gilbertson
et al.).
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1C. All-cause mortality during influenza seasons, without patients with newly diagnosed ESRD (Wang
et al.).
1D. All-cause mortality during influenza seasons, without patients on peritoneal dialysis or with
newly diagnosed ESRD.
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(2) Hospitalization due to influenza or pneumonia: 2A. all studies; 2B. without patients on peritoneal
dialysis (Gilbertson et al.); 2C. without patients with newly diagnosed ESRD (Wang et al.); 2D. without
patients on peritoneal dialysis or with newly diagnosed ESRD.
2A. Hospitalization due to influenza or pneumonia during influenza seasons, all studies.
2B. Hospitalization due to influenza or pneumonia during influenza seasons, without patients on
peritoneal dialysis (Gilbertson et al.).
2C. Hospitalization due to influenza or pneumonia during influenza seasons, without patients with
newly diagnosed ESRD (Wang et al.).
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2D. Hospitalization due to influenza or pneumonia during influenza seasons, without patients on
peritoneal dialysis or with newly diagnosed ESRD.
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Excluded References
1.
Skull SA, Andrews RM, Byrnes GB, Campbell DA, Kelly HA, Brown GV, Nolan TM: Hospitalized
community-acquired pneumonia in the elderly: an Australian case-cohort study. Epidemiol
Infect 2009, 137:194-202.
2.
Wang CS, Wang ST, Lai CT, Lin LJ, Chou P: Impact of influenza vaccination on major causespecific mortality. Vaccine 2007, 25:1196-1203.
3.
Voordouw AC, Sturkenboom MC, Dieleman JP, Stijnen T, Smith DJ, van der Lei J, Stricker BH:
Annual revaccination against influenza and mortality risk in community-dwelling elderly
persons. JAMA 2004, 292:2089-2095.
4.
Sanchez Munoz-Torrero JF, Saponi Cortes JM, Ortiz Descante C, Ojeda Garcia Escribano I,
Sanchez Sanchez T, Perez Reyes F, Martin Ruiz C, Costo Campoamor A: [Utilization and
effectiveness of the flu vaccination in the prevention of the hospitalization induced by
cardiorespiratory decompensation in high-risk patients in Caceres]. Rev Clin Esp 2003,
203:363-367.
5.
Nichol KL, Wuorenma J, von Sternberg T: Benefits of influenza vaccination for low-,
intermediate-, and high-risk senior citizens. Arch Intern Med 1998, 158:1769-1776.
6.
Castilla J, Moran J, Martinez-Artola V, Reina G, Martinez-Baz I, Garcia Cenoz M, Alvarez N,
Irisarri F, Arriazu M, Elia F, Salcedo E: Effectiveness of trivalent seasonal and monovalent
influenza A(H1N1)2009 vaccines in population with major chronic conditions of Navarre,
Spain: 2010/11 mid-season analysis. Euro Surveill 2011, 16.
7.
Ritzwoller DP, Bridges CB, Shetterly S, Yamasaki K, Kolczak M, France EK: Effectiveness of the
2003-2004 influenza vaccine among children 6 months to 8 years of age, with 1 vs 2 doses.
Pediatrics 2005, 116:153-159.
8.
Yoshimoto T: [Studies on the prophylactic effect of influenza vaccine. Antibody response
and side reactions in patients under treatment by hemodialysis]. Nihon Ika Daigaku Zasshi
1985, 52:178-185.
9.
Krairittichai U, Chittaganpitch M: Efficacy of the trivalent influenza vaccination in Thai
patients with hemodialysis or kidney transplant compared with healthy volunteers. J Med
Assoc Thai 2013, 96 Suppl 3:S1-7.
10.
Wyzgal J, Brydak LB, Zygier D, Paczek L, Rowinski W, Grochowiecki T: Study on efficacy of
influenza vaccination in renal allograft recipients. Transplant Proc 2002, 34:572-575.
11.
Chan TC, Yap YH, Hung FN, Shea YF, Chu LW, Luk KH, Woo CY, Chan HW: The efficacy of
influenza vaccination is reduced in nursing home older adults with moderate to severe
renal impairment. J Am Med Dir Assoc 2013, 14:133-136.
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12.
Gasparini R, Amicizia D, Lai PL, Rossi S, Panatto D: Effectiveness of adjuvanted seasonal
influenza vaccines (Inflexal V (R) and Fluad (R) ) in preventing hospitalization for influenza
and pneumonia in the elderly: a matched case-control study. Hum Vaccin Immunother
2013, 9:144-152.
13.
Hurst FP, Lee JJ, Jindal RM, Agodoa LY, Abbott KC: Outcomes associated with influenza
vaccination in the first year after kidney transplantation. Clin J Am Soc Nephrol 2011,
6:1192-1197.
14.
Dogliani M, Fidelio T, Scalzo B, Iacono G, Deabate MC, Bagatella M, Saracco B: [Effectiveness
of influenza vaccination in patients undergoing regular dialysis treatments]. Minerva Urol
Nefrol 1997, 49:121-124.
15.
Trajceska L, Severova G, Dzekova P, Amitov D, Mladenovska D, Gelev S, Selim G, Sikole A:
Clinical effectiveness of vaccination against influenza in dialysis patients. Poster No 77.
ESAO (European Society for Artificial Organs) congress. Rostock, Germany, September 26th
– 29th, 2012. Available at: http://www.esao2012.org/index.php/programme/programmoverview/friday-0928/poster-session-2-p65-p83. Accessed on 1 June 2014. 2012.
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