Working in the six months before initiating hemodialysis (HD) is associated with better survival, according to a large study published online in the Clinical Kidney Journal.

Yuxin Nie, from Fudan University in Shanghai, and colleagues assessed employment (full-time or part-time) for 496,989 patients initiating maintenance HD from 2006 to 2015. The relationships between patient and dialysis facility characteristics and employment were explored.

The researchers found that 26% of patients were employed six months prior to HD initiation compared with 15% at HD initiation. Pre-HD initiation employment decreased from 29% in 2006 to 23% in 2014. The percentage of employed patients who maintained employment increased from 57% in 2006 to 64% in 2015. Maintaining employment was less likely among patients who were older, female, Hispanic, or black, those with more comorbidities, and those living in low-income zip codes. Employment maintenance was associated with the facilities that held nonprofit status, more stations, dialysis availability after 5 pm, and home dialysis training.

Mortality was lower and transplantation rates were higher among patients who maintained employment during the six months prior to HD compared with patients who became unemployed.

“We should further strengthen peritoneal dialysis as well as home hemodialysis, which are often better dialysis modalities for patients who want to continue working,” Alberto Ortiz, MD, PhD, editor-in-chief of the Clinical Kidney Journal, said in a statement.

SOURCE: https://www.renalandurologynews.com/home/news/maintaining-work-during-dialysis-tied-to-higher-survival/

REFERENCE: Nie et al. Changes in employment status prior to initiation of maintenance hemodialysis in the USA from 2006 to 2015. https://academic.oup.com/ckj/advance-article/doi/10.1093/ckj/sfz077/5516481