For US Healthcare Professionals
For US HCPs
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Understanding the risk and impact of shingles and RSV on your patients with CKD
Chronic kidney disease has been associated with an increased risk of shingles.1 Chronic kidney disease can be associated with hospitalizations with RSV.2
In 2025, it is estimated that 5.6 million individuals aged ≥50 years have renal disease.3*†
- *
Estimated number of adults aged ≥50 years with select comorbidities are based on prevalence estimates obtained from a retrospective, cross-sectional analysis of pooled 2011-2020 data from the National Health and Nutrition Examination Survey (NHANES) on self-reports of diagnoses by an HCP. The study included 26,280 adults aged ≥20 years, with population weights provided by NHANES used to subsequently extrapolate findings to the entire 2020 US non-institutionalized adult population. Prevalence estimates of comorbidities were then extrapolated to 2025 population estimates obtained from the US Census Bureau.3
- †
Renal disease described as weak or failing kidneys not including kidney stones, bladder infections, or incontinence in NHANES questionnaire.3
- CKD=chronic kidney disease; HCP=healthcare professional; RSV=respiratory syncytial virus.
CKD and the risk of shingles
Patients aged ≥50 years are at increased risk of shingles.4 Chronic kidney disease has been associated with an increased risk of shingles.1
The risk of shingles sharply increases starting at age 50 and continues to increase with age.4 In addition to age, chronic kidney disease has been identified as an additional risk factor.1
PATIENTS WITH CKD HAD A
29
%
INCREASED RISK OF SHINGLES COMPARED WITH PATIENTS WITHOUT CKD1‡
- 18 studies, pooled effect estimate: RR: 1.29 (95% CI, 1.10, 1.51)1
‡Data from a meta-analysis assessing risk factors for HZ. The analysis included a total study population of 198,751,846 individuals, with 3,768,691 HZ cases across 88 studies (68 cohort and 20 case-control studies) from 1966 to 2019. The populations in these studies ranged from people aged 3 months to 104 years. Eighteen risk factors were identified in the meta-analysis. Limitations included the following: most studies were observational and had a higher likelihood of bias; the majority of studies used administrative data, which is subject to miscoding, errors, and variation between practitioners; finally, heterogeneity was high across studies.1
PATIENTS WITH CKD WHO HAD SHINGLES WERE AT INCREASED RISK OF DEVELOPING
ESRD
In a retrospective study of Taiwanese patients with CKD, a shingles episode was associated with an increased risk of developing ESRD.5§
- aHR: 1.36 (95% CI, 1.09, 1.70)5
§Data from a retrospective study using claims from the Taiwan National Health Insurance (NHI) Research Database over the period of 1997-2008 assessing the risk of end-stage renal disease (ESRD) after an HZ episode in patients with CKD. Patients with CKD aged ≥18 years with an HZ diagnosis (n=1144) were matched based on age and sex to patients with CKD without an HZ diagnosis (n=3855). Patients were followed until the occurrence of ESRD, withdrawal from NHI, death, or December 31, 2008, whichever came first. During the follow-up period, there were 108 patients in the HZ cohort who developed ESRD vs 288 patients in the non-HZ cohort. The hazard ratio was adjusted for age, sex, and comorbidities. Important limitations: patients were not matched based on baseline renal function or stage of CKD, and confounding variables including smoking, family history of renal disease, and obesity, all of which are associated with the development of ESRD, were not available in the NHI database. The study was also conducted in a racially homogenous population that differs from the US population.5
aHR=adjusted hazard ratio; CI=confidence interval; ESRD=end-stage renal disease; HZ=herpes zoster; RR=relative risk.
CKD and the risk of RSV
Chronic kidney disease has been associated with hospitalizations with RSV.2
PATIENTS WITH A KIDNEY DISORDER ACCOUNTED FOR
29.3
OF INDIVIDUALS AGED ≥60 YEARS HOSPITALIZED WITH RSV2¶
- (95% CI, 26.3, 32.5)2
¶Data from a population-based hospitalization surveillance system (RSV-NET), which examined characteristics (eg, age, underlying medical conditions, and clinical outcomes) of 3218 adults aged ≥60 years hospitalized with laboratory confirmed RSV infection between July 2022-June 2023. Underlying medical conditions and severe outcomes of those hospitalized were assessed and described from a random sample of 1634 adults hospitalized during October 2022-April 2023.2
RSV-NET=Respiratory Syncytial Virus Hospitalization Surveillance Network.
Are you familiar with shingles and RSV preventive care options for your patients with CKD?
References
Marra F, Parhar K, Huang B, Vadlamudi N. Risk factors for herpes zoster infection: a meta-analysis. Open Forum Infect Dis. 2020;7(1):1-8.
Havers FP, Whitaker M, Melgar M, et al. Characteristics and outcomes among adults aged ≥60 years hospitalized with laboratory-confirmed respiratory syncytial virus — RSV-NET, 12 states, July 2022–June 2023. MMWR. 2023;72(40):1075-1082.
Data on file, GSK.
Shingles (herpes zoster). Clinical overview of shingles (herpes zoster). Centers for Disease Control and Prevention. Reviewed June 27, 2024. Accessed August 15, 2025.
Lin SY, Liu JH, Yeh HC, et al. Association between herpes zoster and end stage renal disease entrance in chronic kidney disease patients: a population-based cohort study. Eur J Clin Microbiol Infect Dis. 2014;33(10):1809-1815.