(HealthDay News) — 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.

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“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.


Nie Y, Witten B, Schatell D, et al. Changes in employment status prior to initiation of maintenance hemodialysis in the USA from 2006 to 2015. Clin Kid J, sfz077, doi:10.1093/ckj/sfz077

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