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Extra-high dose hepatitis B vaccination for peritoneal dialysis patients: a randomised controlled trial.

1. The response rate to recombinant hepatitis B vaccine was suboptimal (70.1%) in the peritoneal dialysis population. 2. We investigated whether a three-dose regimen of extrahigh dose (80 μg) of Engerix-B would achieve a higher rate of primary seroconversion and more persistent seroprotection in peritoneal dialysis patients, compared with the conventional 40-μg dose. 3. The rates of seroconversion (hepatitis B surface antibody level of ≥10 IU/L 3 months after treatment) were not significantly different between the two regimens. 4. The normalised protein nitrogen appearance was the only predictor for the development of primary seroconversion and persistent seroprotection. 5. Although the extra-high-dose regimen had no significant clinical benefit, improved protein intake may improve the immune response to hepatitis B vaccine in peritoneal dialysis patients.