Impfungen bei Kindern mit chronischer Nierenerkrankung

Zusammenfassung

Chronische Nierenerkrankungen und der Zustand nach Nierentransplantation gehen u. a. mit vermehrter Infektionsneigung einher. Betroffene Kinder und Jugendliche sollten daher alle empfohlenen Impfungen (Standardund Indikationsimpfung) in normaler Dosis zeitgerecht erhalten. Idealerweise ist der Impfstatus bereits vor der geplanten Nierentransplantation oder immunsuppressiven Therapie komplett. Wenn nicht, können bestimmte Impfungen vorgezogen werden. Nach der Nierentransplantation bzw. unter dauerhafter immunsuppressiver Behandlung können Totimpfstoffe gefahrlos verabreicht werden. Da die Impfantwort gegenüber einzelnen Impfstoffen reduziert sein kann, sind Antikörperbestimmungen und bei nicht ausreichender Impfantwort Boosterimpfungen sinnvoll. Unter immunsuppressiver Therapie sind Lebendimpfungen (z. B. Rotavirus- Impfung) meist kontraindiziert. Zum zusätzlichen indirekten Schutz sollten enge Kontaktpersonen komplett immunisiert werden, einschließlich der jährlichen inaktivierten Grippeschutzimpfung.

Summary

Children and adolescents with chronic kidney disease (CKD) and after kidney transplantation are at increased risk for vaccine-preventable infectious diseases. Before immune suppressive treatment and/or kidney transplantation paediatric CKD patients should receive all of the vaccines in normal dosage currently recommended for healthy children and adolescents, Under immunosuppressive therapy all inactivated vaccines can be given. It should be noted that patients may have a reduced response to and reduced duration of antibody protection after immunization. In accordance, measurement of antibody titers and booster vaccinations may be necessary. Nephrology patients under immunosuppressive medication should not receive live-viral vaccines (i. e. rotavirus vaccine, MMR, VZV, LAIV). Household contact persons should receive all routinely recommended vaccinations including annual inactivated influenza vaccination.

Schlüsselwörter

Impfung - chronische Nierenerkrankung - Nieren transplantation - Immunsuppression

Keywords

Vaccination - chronic kidney disease - kidney transplantation - immunosuppression

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