tailieunhanh - Guidelines for Vaccinating Kidney Dialysis Patients and Patients with Chronic Kidney Disease

Strategic Approach: 1) Identify genetic risk factors for neurocognitive and psychiatric illnesses through high throughput genotyping, proteomics or next generation sequencing platforms, 2) leverage Canada's unique populations and cohorts for the genetic analysis, 3) develop new phenotyping modalities to stratify populations for analysis. Global Context: All neurocognitive and psychiatric disorders of childhood seen in Canada occur worldwide. In autism, mental retardation, and other diseases, it is becoming clear that rare genomic variants account for a significant proportion of illness. Currently about 10% of autism cases can be accounted for by rare and frequently de novo CNV’s. This proportion. | Guidelines for Vaccinating Kidney Dialysis Patients and Patients with Chronic Kidney Diseas summarized from Recommendations of the Advisory Committee on Immunization Practices ACIP June 2006 This summary is not meant to apply to kidney patients who are recently post-transplant. These patients are considered more significantly immunosuppressed than those who have only chronic kidney disease with or without dialysis. Vaccination of Renal Dialysis Patients and Patients with Chronic Renal Disease Patients with renal failure have an increased risk of infection with a variety of pathogens particularly pneumococcus and hepatitis B. The efficacy of pneumococcal vaccination for some of these patients including those on dialysis may be considerably lower than for immunocompetent patients their antibody levels may be lower and they may require repeat vaccination or an increased dose of vaccine. Because secondary antibody responses are less affected than primary antibody responses immunization strategies should be formulated early in the course of progressive renal disease. This approach is particularly important if transplantation and chronic immunosuppressive therapy are being considered. Nephrotic syndrome is the renal disease most clearly associated with an increased risk for pneumococcal infection. 1 Vaccine Recommended May Use if Otherwise Indicated Contraindicated Anthrax X DTaP Tdap Td X Hib X Hepatitis A X Hepatitis B X see p. 2 Influenza TIV X see p. 3 Influenza LAIV X see p. 4 Japanese Encephalitis X MMR X Meningococcal X Pneumococcal X see p. 4 Polio IPV X Rabies X Rotavirus X Smallpox X Typhoid X Varicella X Yellow Fever X No specific ACIP recommendation for this vaccine exists for renal dialysis patients and patients with chronic renal disease. Children with primary immunodeficiency disorders and both children and adults who have received hematopoietic hepatic or renal transplants are at risk for severe or prolonged rotavirus gastroenteritis and can shed .