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Shingles hits dialysis patients hard. A large French study found nearly 10 herpes zoster cases per 1,000 person-years among dialysis patients — far higher than in the general population. About 1 in 5 needed nerve pain medication, and nearly 1 in 4 were hospitalized within a week of starting antiviral treatment, racking up millions in healthcare costs.
Dialysis patients are dealing with a serious and costly shingles problem. A large French retrospective cohort study tracking nearly 145,000 adults who started dialysis between 2009 and 2023 found a herpes zoster (shingles) incidence of 9.65 cases per 1,000 person-years — significantly higher than rates typically seen in the general population. Older patients, especially those aged 85 and above, and women were at the greatest risk.
The complications don't stop at the rash. Among the 4,007 patients who developed shingles, nearly 20% required neuropathic pain medications (mainly pregabalin), and 23% were hospitalized within a week of starting antiviral therapy. The financial toll was substantial, with total hospitalization costs reaching €3.4 million and neuropathic pain management running approximately €43,300 per month.
Dialysis patients are already immunocompromised and medically vulnerable, making shingles both more likely and more dangerous for them. The study's authors argue these findings make a strong case for preventive vaccination strategies in this high-risk group — a move that could meaningfully reduce suffering and cut healthcare costs.
