Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study

Abstract Background Patients treated with chronic dialysis or kidney transplantation have difficulties in maintaining employment. We aimed to estimate employment rates among dialysis and kidney transplant patients from 3 years before to 3 years after initiating dialysis or undergoing transplantation...

Full description

Saved in:
Bibliographic Details
Main Authors: Rasmus Kirkeskov Carlsen, Lilli Kirkeskov, Margit S. Riis, Rikke K. Jacobsen, Frederikke Hørdam Gronemann, Merete Osler, Janne Petersen, Niels Henrik Buus
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Nephrology
Subjects:
Online Access:https://doi.org/10.1186/s12882-025-03969-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832571972594171904
author Rasmus Kirkeskov Carlsen
Lilli Kirkeskov
Margit S. Riis
Rikke K. Jacobsen
Frederikke Hørdam Gronemann
Merete Osler
Janne Petersen
Niels Henrik Buus
author_facet Rasmus Kirkeskov Carlsen
Lilli Kirkeskov
Margit S. Riis
Rikke K. Jacobsen
Frederikke Hørdam Gronemann
Merete Osler
Janne Petersen
Niels Henrik Buus
author_sort Rasmus Kirkeskov Carlsen
collection DOAJ
description Abstract Background Patients treated with chronic dialysis or kidney transplantation have difficulties in maintaining employment. We aimed to estimate employment rates among dialysis and kidney transplant patients from 3 years before to 3 years after initiating dialysis or undergoing transplantation. Methods All first-time dialysis and kidney transplantation patients aged 18–65 years in Denmark from 2005 to 2019 were identified using the Danish Nephrological Register and linked with information about social security benefits. Each dialysis or kidney transplant patient was matched with 3 references. Results In total, 4,469 patients undergoing dialysis (median age 55 years, 65% males) and 2,294 patients receiving kidney transplants (median age 49 years, 64% males) were included together with 13,262 and 6,790 matched references, respectively. The employment rate was 11% when initiating dialysis compared to 61% for the reference group. Kidney transplantation patients had an employment rate of 20% compared to 67% for the reference group. At all time points (3 years before, 1 year before, at the time of intervention, 1 year after, and 3 years after) both dialysis and kidney transplant patients had lower employment rates compared to references (P < 0.001). There was only a partial return to work after transplantation. Employment rates increased in ESKD patients in the period 2005–2019, however, the increase was not different from corresponding reference groups. Conclusions Employment rates in ESKD patients are very low and decline long before initiation of dialysis or kidney transplantation. Of concern, kidney transplantation only leads to a small increase in employment. There has been no improvement in the employment of ESKD patients from the period 2005–2009 to 2015–2019.
format Article
id doaj-art-fffa36ebd8be4a66993f94c5a97ac961
institution Kabale University
issn 1471-2369
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series BMC Nephrology
spelling doaj-art-fffa36ebd8be4a66993f94c5a97ac9612025-02-02T12:12:36ZengBMCBMC Nephrology1471-23692025-01-012611910.1186/s12882-025-03969-9Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort studyRasmus Kirkeskov Carlsen0Lilli Kirkeskov1Margit S. Riis2Rikke K. Jacobsen3Frederikke Hørdam Gronemann4Merete Osler5Janne Petersen6Niels Henrik Buus7Department of Renal Medicine, Aarhus University HospitalDepartment of Social Medicine, University Hospital Bispebjerg-FrederiksbergCenter for Clinical Research and Prevention, University Hospital Bispebjerg-FrederiksbergCenter for Clinical Research and Prevention, University Hospital Bispebjerg-FrederiksbergCenter for Clinical Research and Prevention, University Hospital Bispebjerg-FrederiksbergCenter for Clinical Research and Prevention, University Hospital Bispebjerg-FrederiksbergCenter for Clinical Research and Prevention, University Hospital Bispebjerg-FrederiksbergDepartment of Renal Medicine, Aarhus University HospitalAbstract Background Patients treated with chronic dialysis or kidney transplantation have difficulties in maintaining employment. We aimed to estimate employment rates among dialysis and kidney transplant patients from 3 years before to 3 years after initiating dialysis or undergoing transplantation. Methods All first-time dialysis and kidney transplantation patients aged 18–65 years in Denmark from 2005 to 2019 were identified using the Danish Nephrological Register and linked with information about social security benefits. Each dialysis or kidney transplant patient was matched with 3 references. Results In total, 4,469 patients undergoing dialysis (median age 55 years, 65% males) and 2,294 patients receiving kidney transplants (median age 49 years, 64% males) were included together with 13,262 and 6,790 matched references, respectively. The employment rate was 11% when initiating dialysis compared to 61% for the reference group. Kidney transplantation patients had an employment rate of 20% compared to 67% for the reference group. At all time points (3 years before, 1 year before, at the time of intervention, 1 year after, and 3 years after) both dialysis and kidney transplant patients had lower employment rates compared to references (P < 0.001). There was only a partial return to work after transplantation. Employment rates increased in ESKD patients in the period 2005–2019, however, the increase was not different from corresponding reference groups. Conclusions Employment rates in ESKD patients are very low and decline long before initiation of dialysis or kidney transplantation. Of concern, kidney transplantation only leads to a small increase in employment. There has been no improvement in the employment of ESKD patients from the period 2005–2009 to 2015–2019.https://doi.org/10.1186/s12882-025-03969-9End-stage kidney diseaseEmploymentDialysisKidney transplantationCohort study
spellingShingle Rasmus Kirkeskov Carlsen
Lilli Kirkeskov
Margit S. Riis
Rikke K. Jacobsen
Frederikke Hørdam Gronemann
Merete Osler
Janne Petersen
Niels Henrik Buus
Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study
BMC Nephrology
End-stage kidney disease
Employment
Dialysis
Kidney transplantation
Cohort study
title Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study
title_full Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study
title_fullStr Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study
title_full_unstemmed Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study
title_short Employment before and after initiation of dialysis or kidney transplantation– a Danish nationwide registry-based cohort study
title_sort employment before and after initiation of dialysis or kidney transplantation a danish nationwide registry based cohort study
topic End-stage kidney disease
Employment
Dialysis
Kidney transplantation
Cohort study
url https://doi.org/10.1186/s12882-025-03969-9
work_keys_str_mv AT rasmuskirkeskovcarlsen employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT lillikirkeskov employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT margitsriis employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT rikkekjacobsen employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT frederikkehørdamgronemann employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT mereteosler employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT jannepetersen employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy
AT nielshenrikbuus employmentbeforeandafterinitiationofdialysisorkidneytransplantationadanishnationwideregistrybasedcohortstudy