Employment Status and Work Functioning among Kidney Transplant Recipients

Abstract

Background and objectives: To date, employment figures of kidney transplant recipients in Europe are inconsistent. Additionally, little is known about work functioning of employed kidney transplant recipients and work functioning trajectories before and after transplantation.

Design, setting, participants, & measurements: Data from the ongoing TransplantLines Biobank and Cohort study and from community-dwelling employed adults were used. Health-related work functioning of kidney transplant recipients was assessed with the Work Role Functioning Questionnaire 2.0 and compared with potential kidney donors and community-dwelling employed adults.

Results: We included 668 kidney transplant recipients of working age (59% men, age 51±11 years) at median 3 (interquartile range, 2-10) years after transplantation, 246 potential kidney donors of working age (43% men, age 53±9 years), and 553 community-dwelling employed adults (70% men, age 45±11 years). The proportion of employed kidney transplant recipients was lower compared with potential kidney donors (56% versus 79%). If employed, the work functioning score of kidney transplant recipients was slightly lower compared with employed potential kidney donors yet higher compared with community-dwelling employed adults (medians 91 [interquartile range, 76-98], 94 [interquartile range, 85-99], and 88 [interquartile range, 79-95], respectively). Backward linear regression analyses revealed that lower educational level, having a kidney from a deceased donor, presence of tingling or numbness of hands or feet, presence of concentration/memory problems, presence of anxiety, and presence of severe fatigue were independently associated with lower work functioning among kidney transplant recipients. Additional subgroup analyses showed that work functioning scores were lower before transplantation than at 12 months after transplantation (83 [interquartile range, 66-93] versus 92 [interquartile range, 88-98], respectively; P=0.002).

Conclusions: Stable employed kidney transplant recipients report to function well at work. In addition, this study shows that self-reported work functioning is higher after successful kidney transplantation compared with before transplantation.

Clinical trial registry name and registration number: TransplantLines Biobank and Cohort study, NCT03272841 PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2022_09_26_CJN05560522.mp3.

Keywords: employment status; kidney transplantation; quality of life; side effects of immunosuppressive therapy; work functioning.

Graphical abstract

Figure 1.

Participants flow chart. WRFQ, Work Role Functioning Questionnaire.

Figure 2.

Differences in work functioning scores as assessed by the work role functioning questionnaire (WRFQ) between kidney transplant recipients, potential kidney donors, and community-dwelling employed adults. A lower score indicates worse work functioning. Differences between kidney transplant recipients and comparator groups were assessed using Mann–Whitney U tests.

Figure 3.

Work Role Functioning Questionnaire total scores before and 12 months after transplantation of 29 employed kidney transplant recipients. Self-reported work functioning was higher after transplantation in the vast majority of kidney transplant recipients. Four patients reported lower work functioning after transplantation (more than five points lower) compared with before transplantation.