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. 2011 Mar;6(3):489-96.
doi: 10.2215/CJN.02550310. Epub 2011 Mar 10.

Factors affecting employment at initiation of dialysis

Rebecca J Muehrer  1 , Dori Schatell, Beth Witten, Ronald Gangnon, Bryan N Becker, R Michael Hofmann
Affiliations

Factors affecting employment at initiation of dialysis

Rebecca J Muehrer et al. Clin J Am Soc Nephrol. 2011 Mar.

Abstract

Background and objectives: Half the individuals who reach ESRD are working age (< 65 years old) and many are at risk for job loss. Factors that contribute to job retention among working-age patients with chronic kidney disease before ESRD are unknown. The purpose of the study is to understand factors associated with maintaining employment among working-age patients with advanced kidney failure.

Design, setting, participants, & measurements: In this retrospective study we reviewed the United States Renal Data System database (1992 through 2003) and selected all patients (n = 102,104) who were working age and employed 6 months before dialysis initiation. Factors that were examined for an association with maintaining employment status included demographics, comorbid conditions, ESRD cause, insurance, predialysis erythropoietin use, and dialysis modality.

Results: Maintaining employment at the same level during the final 6 months before dialysis was more likely among (1) white men ages 30 to 49 years; (2) patients with either glomerulonephritis, cystic, or urologic causes of renal failure; (3) patients choosing peritoneal dialysis for their first treatment; (4) those with employer group or other health plans; and (5) erythropoietin usage before ESRD. Maintaining employment status was less likely among patients with congestive heart failure, cardiovascular disease, cancer, and other chronic illnesses.

Conclusions: The rate of unemployment in working-age patients with chronic kidney disease and ESRD is high compared with that of the general population. Treating anemia with erythropoietin before kidney failure and educating patients about work-friendly home dialysis options might improve job retention.

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