Mrs Casey LIGHT1,2, A/ Prof KAREN HESLOP2, A/Prof HEMANT KULKARNI1
1Armadale Hospital, Perth/Armadale, Australia, 2Curtin University, Perth/Bentley, Australia
Biography:
Casey has over 40 years vast experience in Nephrology service including many pioneering establishments such as the first satellite unit in Perth (1982), outer-metropolitan satellite unit in Armadale (1998). In 2007, she became the first Renal Nurse Practitioner in Western Australia and as current practice.
Casey’s passion in continuously striving to improve the patients’ quality of life is reflected in many pilot studies, peer reviewed publications and awards. Multiple research outcomes were presented at national and international conferences and were used to compile improved clinical practice protocols. Her current research focus is on hepatitis B vaccination at early-stage CKD.
Aim:
To investigate the response rate and affecting factors of the hepatitis B vaccine in patients with stage 4 chronic kidney disease (CKD).
Background:
Hepatitis B vaccination remains a standard of care in the haemodialysis population. Poor response rate in the haemodialysis patient is noted however its impact in advanced CKD is not evaluated.
Method:
A prospective quantitative cohort study was conducted from July 2022 to Jan 2025 for patients with stage 4 chronic kidney disease (eGFR 15-29 ml/min/1.73m21.73M2). Stage 4 CKD patients attending the renal outpatient clinic with Hepatitis B surface Antibodies (HBsAb) <10 mIU/mL were recruited with written informed consent. These participants received 40mcg of H_B_VAX II® intramuscularly in the deltoid muscle at 0,1,6-month interval. The vaccine response was measured at six to eight weeks post vaccination. HBsAb >10 mIU/mL were deemed responsive to the vaccine. Response rate together with patient and clinical factors were analysed using the Statistical Package for Social Sciences (SPSS) version 29.0 for Windows.
Results:
99 (M=67, F=32) of the 106 patients (M=71, F=35) completed the six-month vaccination course; seven patients died with incomplete vaccination and excluded in the data analysis. 47.47% (n= 47) of the patients responded whilst 52.52% (n=52) did not (p=0.001). Patient factor such as age (p=0.001), clinical factors such as presence of cardiovascular disease (p=0.011), Vitamin D3 deficiency (p=0.028), Transferrin saturation levels (p=0.045), presence of multiple comorbidities (p=0.017) exerted negative effect on the vaccine response.
Conclusion:
This study showed the response rate in Stage 4 CKD also remains low (47.47%), emphasizing the importance of early vaccination. Recognizing the affecting factors could also play a role in individualizing the priority in the vaccination management strategy.
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