Herpes Zoster (Shingles) is a painful skin rash that usually appears in a band, a strip, or a small area on one side of the face or body. Anyone who has had Chicken Pox can get Shingles. The virus is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines or all the above such as Chronic Kidney Disease (CKD) patients. In fact Shingles affects an estimated one million people in the United States each year, and a study of CKD patients concluded that those with End Stage Renal Disease (ESRD) may be at risk to the increased prevalence of the condition.
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Symptoms happen in stages, starting with a headache or light sensitivity. You may also feel like you have the flu but not have a fever. Later, you will likely feel itching, tingling, or pain in a certain area. That is where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash, and some do not get a rash at all. It is possible that you could also feel dizzy or weak, or you could have long-term pain or a rash on your face, changes in your vision, changes in how well you can think, or a rash that spreads.
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You may ask yourself, "How do I protect myself against Shingles?" Although people with CKD who have weakened immune systems are at highest risk of developing Shingles, the necessary vaccine is unfortunately seldom an option because it is a live vaccine. Hence the vaccine used to treat Herpes Zoster is not safe for people with poor immune systems.
Since removing factors that are suppressing the immune system is not possible for people with CKD, early treatment is often the best response to Shingles. In severe or frequent cases, ongoing medication to reduce the risk of Shingles may be an option. If your immunosuppression is severe and Shingles episodes are frequent, talk to your Nepheologist about the possibility of taking antiviral medication daily for a time. In some cases, this may help suppress subsequent episodes of Shingles.
People who have CKD and received a Kidney Transplant are no different from CKD patients without transplant. Due to an increased risk of developing infections post Kidney Transplant candidates and recipients are urged not to take the Shingles vaccine. Steven Katznelson, M.D., medical director of California Pacific Medical Center’s Kidney Transplant Program explains, “Live virus vaccines such as the Herpes Zoster vaccine (for Chicken Pox or Shingles) should never be given to kidney transplant recipients as these vaccines can actually cause life-threatening infections." He further notes that if your Nephrologist feels that a live virus vaccine is absolutely necessary, it should be administered at least one month prior to transplant. KidneyBuzz.com encourages CKD patients who suffer any of the listed issues that describe Shingles to contact their Nephrologist right away.
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"Shingles (Herpes Zoster) Treatment, Causes, Symptoms, Vaccine." WebMD - Better information. Better health.