Sustained employment, work disability and work functioning in CKD patients: a cross-sectional survey study

Manna A Alma; Sijrike F van der Mei; Sandra Brouwer; Luuk B Hilbrands; Paul J M van der Boog; Herma Uiterwijk; Femke Waanders; Maaike Hengst; Ron T Gansevoort; Annemieke Visser

doi:10.1007/s40620-022-01476-w

Sustained employment, work disability and work functioning in CKD patients: a cross-sectional survey study

J Nephrol. 2023 Apr;36(3):731-743. doi: 10.1007/s40620-022-01476-w. Epub 2022 Oct 31.

Authors

Affiliations

¹ Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. m.a.alma@umcg.nl.
² Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³ Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁴ Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
⁵ Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Dialysis Center Groningen, Groningen, The Netherlands.
⁷ Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands.
⁸ Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands.
⁹ Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Abstract

Introduction: Kidney failure negatively affects opportunities for work participation. Little is known about work functioning of employed CKD patients. This study investigates work-related outcomes, and examines associations between patient characteristics and employment status.

Methods: We performed a cross-sectional survey study in nine nephrology outpatient clinics in the Netherlands among working age (18-67 years) CKD Stage G3b-G5, dialysis and transplant patients (n = 634; mean age 53.4 years (SD 10); 53% male; 47% Stage G3b-G5, 9% dialysis, 44% transplantation). We assessed employment status, work disability, work-related characteristics (i.e., work situation, working hours, job demands), work functioning (i.e., perceived ability to work, productivity loss, limitations in work), work environment (i.e., work accommodations, psychosocial work environment), as well as health status and fatigue.

Results: Sixty-five percent were employed reporting moderate work ability. Of those, 21% received supplementary work disability benefits, 37% were severely fatigued, 7% expected to drop out of the workforce, and 49% experienced CKD-related work limitations. Work accommodations included reduced working hours, working at a slower pace, adjustment of work tasks or work schedule, and working from home. Multivariable analysis of sustained employment showed associations with younger age, male gender, higher level of education, better general and physical health and pre-emptive transplantation. Transplant patients had the highest work ability and highest expectation to maintain work. Dialysis patients had the highest productivity loss and perceived the most limitations regarding functioning in work. Stage G3b-G5 patients reported the lowest social support from colleagues and highest conflict in work and private life.

Conclusions: Employed CKD patients experience difficulties regarding functioning in work requiring adjustment of work or partial work disability. In addition to dialysis patients, stage G3b-G5 patients are vulnerable concerning sustained employment and work functioning.

Keywords: Chronic Kidney Disease; Survey study; Sustained employment; Work functioning.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Cross-Sectional Studies
Employment*
Female
Health Status
Humans
Male
Middle Aged
Renal Dialysis
Renal Insufficiency, Chronic*
Young Adult

Grants and funding

SWO14.01/Nierstichting