Changes in Employment Status in End-Stage Renal Disease Patients during Their First Year of Dialysis

Abstract

Objective To assess employment status in new end-stage renal disease (ESRD) patients at the start of dialysis and after 1 year, and to determine whether demographic and clinical variables and physical and psychosocial functioning at the start of dialysis are risk factors for loss of employment after 1 year of dialysis. Design Prospective follow-up study in which 38 of 48 Dutch dialysis centers participate. Patients 659 patients who had started on dialysis and who were between 18 and 65 years old were included. Patients were re-examined after 12 months. Main Outcome Measures Demographic data, physical and psychosocial functioning with the Short-Form Health Survey (SF-36), and data on employment status were obtained using questionnaires. Nephrologists provided the clinical data. Results At the start of dialysis, 35% of patients were employed, in contrast to 61% of the general Dutch population. Within 1 year, the proportion of employed patients decreased from 31% to 25% of hemodialysis patients, and from 48% to 40% of peritoneal dialysis patients. In patients who were working at the start of dialysis, independent risk factors for loss of work within 1 year were impaired physical and psychosocial functioning [odds ratio physical: 3.4, 95% confidence interval (%CI), 1.0 – 11.2; odds ratio psychosocial: 4.2, 95% CI, 1.2 – 14.2]. Conclusions As the percentage of employed patients at the start of dialysis is about half the expected percent-age, loss of work is an important issue in both predialysis and dialysis patients. Improvements in physical and psychosocial functioning are potentially preventive of loss of work in patients who are employed when they start dialysis.

Estimated Loss of Lifetime Employment Duration for Patients Undergoing Maintenance Dialysis in Taiwan

“…Because the penetration rates of peritoneal dialysis are <10%, and the utilization of home hemodialysis is uncommon in Taiwan (38), these two modalities may contribute to only a minor proportion of the high employment rates among patients undergoing dialysis in Taiwan. In contrast, the predialysis employment rates in our study were generally above 55%–60% among those younger than 55 years, which seems higher than those found in other studies (13,16,37). In addition, the density of dialysis centers is high in Taiwan, and most of them provide regular services after 5:00 pm .…”

“…Several factors associated with employment among patients undergoing dialysis have been commonly proposed, including dialysis modalities (11,12,35,36) and predialysis employment (16,37). Although a direct causal relationship may still be debatable (16), it is known that peritoneal dialysis and home hemodialysis are associated with higher employment rates compared with other dialysis modalities (11,12,35,36). Because the penetration rates of peritoneal dialysis are <10%, and the utilization of home hemodialysis is uncommon in Taiwan (38), these two modalities may contribute to only a minor proportion of the high employment rates among patients undergoing dialysis in Taiwan.…”

Fatores Associados a Depressão em Pacientes com Doença Renal Crônica em Guanambi-Bahia

“…Os pacientes, em sua maioria, eram casados e dependentes do auxílio doença para sustento da família e de si próprio. Alguns estudos mostram que a doença crônica e seu tratamento limitam e restringem atividades e a vida laboral dos pacientes, assim a condição socioeconômica destes pode estar associada à doença, visto que é comum a aposentadoria precoce ou desemprego neste grupo de pacientes (BARROS;VAN MANEN;BIRMELÉ;.…”

Influences of Financial Strains Over the Life Course Before Initiating Hemodialysis on Health Outcomes Among Older Japanese Patients: A Retrospective Study in Japan

“… 2 In the future, the number of deaths due to CKD and the number of patients with ESKD are projected to increase rapidly. 1 , 2 Patients with ESKD have various health problems, such as frailty, 3 , 4 malnutrition, 5 cognitive impairment, 6 and depression, 7 as well as daily-life problems, such as impaired quality of life, 8 low levels of recreational and work activities, 9 , 10 and poor dietary habits. 11 Furthermore, CKD brings a serious financial burden on the society.…”

“…Patients undergoing dialysis have a high likelihood of financial strains as a result of resignation from paid work when initiating dialysis. 10 By considering financial strains over the life course before initiating dialysis, it is possible to eliminate the influence of financial strains associated with initiating dialysis as much as possible. We evaluated which of the four types of models (latent, pathway, social mobility, and accumulation) best describe the influences of financial strains over the life course.…”