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Kidney Week

Abstract: TH-PO354

Alternatives to Daytime In-Center Hemodialysis and Employment in Patients with Kidney Failure

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Erickson, Kevin F., Baylor College of Medicine, Houston, Texas, United States
  • Cavanaugh, Kerri L., Vanderbilt University, Nashville, Tennessee, United States
  • Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States
  • Pappadis, Monique R., The University of Texas Medical Branch at Galveston Development Office, Galveston, Texas, United States
  • Perez, Jose Jesus, Baylor College of Medicine, Houston, Texas, United States
Background

Maintaining employment is a priority for many patients with kidney failure. Yet, many working aged patients in the U.S. stop working with the onset of kidney failure. Access to a dialysis treatment schedule outside of working hours may help patients to remain employed.

Methods

We analyzed data from the US National Dialysis Registry to determine whether access to nearby facilities offering evening dialysis shifts and home dialysis increases the likelihood that patients are able to continue working after they start dialysis. Our cross-sectional analysis included working-aged patients (ages 18-54) receiving dialysis in US facilities in 2016. In a negative binomial regression model, we examined the associations among exposures of interest (the presence of facilities offering home dialysis or evening dialysis shifts in a patient’s locality) and the number of employed working-aged adults at each dialysis facility. The multivariable model adjusted for observed patient, dialysis facility, and geographic characteristics, including information about individual patient employment at the onset of dialysis.

Results

We identified 4,860 US dialysis facilities with information about patient employment in 2016. Median employment among working-aged adults at these facilities was 17.9% (interquartile range 8.8% to 28.6%). In fully adjusted regression models, the presence of at least one facility offering an evening dialysis shift in a county was associated with a 5% increase in the relative rate of maintaining employment among working-aged patients receiving dialysis in the county (risk ratio (rr) 1.05; 95% Confidence Interval (CI) 1.01 to 1.09; p=0.02). The presence of at least one facility offering home dialysis in a county was associated with a 26% increase in the relative rate of maintaining employment (rr 1.26; 95% CI 1.18 to 1.34; p<0.001). The likelihood of employment did not increase with additional facilities in a county offering home dialysis.

Conclusion

Access to dialysis schedules outside of regular working hours – evening dialysis shifts and home dialysis – is associated with increased employment among patients with kidney failure. Efforts to increase access to these alternative dialysis treatments could help patients to continue working.