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Abstract: FR-PO0421

Employment Status and KDQOL Scores in a New York City Dialysis Population

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bae, Edward, Weill Cornell Medicine, New York, New York, United States
  • Simmons, Will, Weill Cornell Medicine, New York, New York, United States
  • Silberzweig, Jeffrey I., Weill Cornell Medicine, New York, New York, United States
  • Tummalapalli, Sri Lekha, Weill Cornell Medicine, New York, New York, United States
Background

End-stage renal disease (ESRD) drastically impacts patient quality of life. Compared to the national unemployment rate of 4.2%, United States Renal Data System data show that over 75% of ESRD patients receiving dialysis are unemployed. We examined the relationship between employment status and quality of life.

Methods

We extracted electronic health record data from a dialysis organization in New York City including patients on all dialysis modalities. Employment was defined as working full-time or part-time. We evaluated the five subscales of the Kidney Disease Quality of Life (KDQOL) Instrument: physical component summary (PCS), mental component summary (MCS), burden of kidney disease (BKD), symptoms and problems of kidney disease (SPKD), and effects of kidney disease (EKD). We compared KDQOL scores between employed and unemployed patients using Wilcoxon rank-sum tests. We used multivariable linear regression models to examine the cross-sectional association of employment with KDQOL scores, adjusted for demographics, cause of ESRD, and number of comorbidities.

Results

Of 546 dialysis patients analyzed, 20.9% were employed; 79.1% were not employed. Employment status was significantly associated with differences in sex, race, marital status, and cause of ESRD, but not with age, education, and primary payor. In unadjusted analyses, employed patients had significantly higher PCS, BKD, and SPKD scores compared to unemployed patients while MCS and EKD scores were not significantly different (Table 1). In multivariable linear regression models, average PCS scores were 2.5 points higher (95% CI 0.26, 4.75; p=0.029) in employed patients, and BKD scores were 7.4 points higher (95% CI 1.1, 13.8; p=0.022). Employment was not significantly associated with MCS, SPKD, or EKD scores in multivariable adjusted results. Limitations include potential selection bias due to missing data and residual confounding.

Conclusion

In our urban dialysis population, one in five patients were employed, and employed patients had significantly higher quality of life, especially related to their physical health, physical functioning, and symptoms. Employed patients perceived a lower burden of kidney disease on their daily life than those unemployed.

Digital Object Identifier (DOI)