Giornale di Clinica Nefrologia e Dialisi · Published 2025-12-31 · DOI 10.33393/gcnd.2025.3666
Introduction: Herpes zoster (HZ), also known as shingles, is caused by the reactivation of the varicella-zoster virus (VZV) and presents a higher risk of complications in patients with advanced chronic kidney disease (CKD) and those undergoing dialysis. Discussion: CKD patients are particularly vulnerable due to uremia-induced immunodeficiency and additional factors such as diabetes, malnutrition, and the use of immunosuppressive drugs. The cell-mediated immune response, which is essential for controlling VZV, is compromised in these individuals. Although they respond less effectively to traditional vaccines, recombinant adjuvanted vaccines have revolutionized HZ prevention, offering protection even in immunocompromised settings. Observational studies have shown a higher incidence of HZ and more severe complications in patients with advanced CKD and on dialysis, with the risk of postherpetic neuralgia nearly doubled compared to healthy individuals. The recombinant adjuvanted vaccine has demonstrated a good tolerability profile and an efficacy greater than 90%, recommended by KDIGO and CDC/ACIP guidelines for immunocompromised patients. Conclusion: Vaccination should be an integral part of the preventive strategy in nephropathic patients, on par with those against influenza, hepatitis B, and pneumococcus, to reduce the burden of disease and improve clinical outcomes.
Abstract from DOAJ. Public domain (CC0 1.0).
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