Back to  work? Socioeconomic status after kidney transplantation

Leila Eppenberger; Patricia Hirt-Minkowski; Michael Dickenmann

doi:10.4414/smw.2015.14169

Original article

Vol. 145 No. 3132 (2015)

Back to work? Socioeconomic status after kidney transplantation

Leila Eppenberger
Patricia Hirt-Minkowski
Michael Dickenmann

DOI: https://doi.org/10.4414/smw.2015.14169
Cite this as:: Swiss Med Wkly. 2015;145:w14169
Published: 26.07.2015

Summary

PRINCIPLES: Employment after kidney transplantation is an important marker of health recovery. The study addresses the impact of successful kidney transplantation on socioeconomic factors and employment in a Swiss cohort.

METHODS: Patients who received a kidney allograft at the University Hospital of Basel between 2000 and 2011 were investigated. A standardised survey was used to obtain information on socioeconomic factors 1 year before and after successful transplantation.

RESULTS: A total of 610 patients were contacted; 354 (58%) answered the survey. The median age of respondents was 53.5 (interquartile range 42‒61) years at the time of transplantation, 31.2% were females. Overall, 201 out of 282 working-age patients (71.3%) were working 1 year after transplantation: 102 full-time, 55 part-time, 30 patients part-time with additional disability pension, and 14 housework. Seventy-two patients (25.3%) did not work 1 year after transplantation: 63 patients had a full or partial disability pension, and nine patients were unemployed. Thirty out of 282 working-age patients (10.6%) had improved working ability after transplantation. Employment after transplantation was favoured by: living donor transplantation (p <0.0001), pre-emptive transplantation (p <0.0001), dialysis duration ≤1 year (p <0.0001), preserved employment before transplantation (p <0.0001), and higher education (p = 0.003), whereas age above 50 years (p = 0.006), and dialysis duration > 1 year (p <0.0001) had a negative impact.

CONCLUSION: The employment rate in this Swiss cohort before and after successful kidney transplantation is high compared with the literature. A high number of living donors, of pre-emptive transplantations, and short dialysis vintages contribute to this observation.

References

Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30.
Schnuelle P, Lorenz D, Trede M, Van Der Woude FJ. Impact of renal cadaveric transplantation on survival in end-stage renal failure: evidence for reduced mortality risk compared with hemodialysis during long-term follow-up. J Am Soc Nephrol. 1998;9(11):2135–41.
Collaborative Transplant Study (CTS) 2015 Feb 1. http://www.ctstransplant.org
Swiss Transplant Cohort Study (STCS) 2015 Apr 9. http://www.stcs.ch
McGee J, Jackson NR, Slakey DP. Disability and kidney transplantation in the United States. Clin Transplant. 2012;26(3):377–81.
Petersen E, Baird BC, Barenbaum LL, Leviatov A, Koford JK, Shihab F, et al. The impact of employment status on recipient and renal allograft survival. Clin Transplant. 2008;22(4):428–38.
Raiz L, Monroe J. Employment post-transplant: a biopsychosocial analysis. Soc Work Health Care. 2007;45(3):19–37.
Sangalli V, Dukes J, Doppalapudi SB, Costa G, Neri L. Work Ability and Labor Supply after Kidney Transplantation. Am J Nephrol. 2014;40(4):353–61.
Slakey DP, Rosner M. Disability following kidney transplantation: the link to medication coverage. Clin Transplant. 2007;21(2):224–8.
Tzvetanov I, D’Amico G, Walczak D, Jeon H, Garcia-Roca R, Oberholzer J, Benedetti E. High rate of unemployment after kidney transplantation: analysis of the United network for organ sharing database. Transplant Proc. 2014;46(5):1290–4.
van der Mei SF, Kuiper D, Groothoff JW, van den Heuvel WJ, van Son WJ, Brouwer S. Long-term health and work outcomes of renal transplantation and patterns of work status during the end-stage renal disease trajectory. J Occup Rehabil. 2011;21(3):325–34.
Helantera I, Haapio M, Koskinen P, Gronhagen-Riska C, Finne P. Employment of patients receiving maintenance dialysis and after kidney transplant: a cross-sectional study from Finland. Am J Kidney Dis. 2012;59(5):700–6.
Aitken E, Dempster N, Ceresa C, Daly C, Kingsmore D. The impact of socioeconomic deprivation on outcomes following renal transplantation in the West of Scotland. Transplant Proc. 2013;45(6):2176–83.
Axelrod DA, Dzebisashvili N, Schnitzler MA, Salvalaggio PR, Segev DL, Gentry SE, et al. The interplay of socioeconomic status, distance to center, and interdonor service area travel on kidney transplant access and outcomes. Clin J Am Soc Nephrol. 2010;5(12):2276–88.
Mistretta A, Veroux M, Grosso G, Contarino F, Biondi M, Giuffrida G, et al. Role of socioeconomic conditions on outcome in kidney transplant recipients. Transplant Proc. 2009;41(4):1162–7.
IV – Leistungsarten – IV-Renten [Internet]. [cited 2014 Mar 25]. Available from: http://www.svash.ch/site/index.cfm?id_art=11470&actMenuItemID=6616&vsprache/DE/V___Leistungsarten___IV_Rent.cfm.[electronic mail system]. 2014 May.
van der Mei SF, Kuiper D, Groothoff JW, van den Heuvel WJ, van Son WJ, Brouwer S. Long-term health and work outcomes of renal transplantation and patterns of work status during the end-stage renal disease trajectory. J Occup Rehabil. 2011;21(3):325–34.
Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30.
Jofre R, Lopez-Gomez JM, Moreno F, Sanz-Guajardo D, Valderrabano F. Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998;32(1):93–100.
Czyzewski L, Sanko-Resmer J, Wyzgal J, Kurowski A. Assessment of health-related quality of life of patients after kidney transplantation in comparison with hemodialysis and peritoneal dialysis. Ann Transplant. 2014;19:576–85.
Kutner N, Bowles T, Zhang R, Huang Y, Pastan S. Dialysis facility characteristics and variation in employment rates: a national study. Clin J Am Soc Nephrol. 2008;3(1):111–6.
Molsted S, Aadahl M, Schou L, Eidemak I. Self-rated health and employment status in chronic haemodialysis patients. Scand J Urol Nephrol. 2004;38(2):174–8.
van der Mei SF, Krol B, van Son WJ, de Jong PE, Groothoff JW, van den Heuvel WJ. Social participation and employment status after kidney transplantation: a systematic review. Qual Life Res. 2006;15(6):979–94.
Organ Donation and Transplantation activity in Switzerland Preliminary statistics 2013 Swisstransplant. 2015 Jan 7.
Feinstein JS. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993;71(2):279–322.
Marmot M, Feeney A. General explanations for social inequalities in health. IARC Sci Publ. 1997;(138):207–28.
Messias AA, Reichelt AJ, dos Santos EF, Albuquerque GC, Kramer JSP, Hirakata VN, Garcia VD. Return to Work After Renal Transplantation: A Study of the Brazilian Public Social Security System. Transplantation. 2014;98(11).

How to Cite

1.

Eppenberger L, Hirt-Minkowski P, Dickenmann M. Back to work? Socioeconomic status after kidney transplantation. Swiss Med Wkly [Internet]. 2015 Jul. 26 [cited 2024 Nov. 21];145(3132):w14169. Available from: https://smw.ch/index.php/smw/article/view/2064

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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[1] Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30.

[2] Schnuelle P, Lorenz D, Trede M, Van Der Woude FJ. Impact of renal cadaveric transplantation on survival in end-stage renal failure: evidence for reduced mortality risk compared with hemodialysis during long-term follow-up. J Am Soc Nephrol. 1998;9(11):2135–41.

[3] Collaborative Transplant Study (CTS) 2015 Feb 1. http://www.ctstransplant.org

[4] Swiss Transplant Cohort Study (STCS) 2015 Apr 9. http://www.stcs.ch

[5] McGee J, Jackson NR, Slakey DP. Disability and kidney transplantation in the United States. Clin Transplant. 2012;26(3):377–81.

[6] Petersen E, Baird BC, Barenbaum LL, Leviatov A, Koford JK, Shihab F, et al. The impact of employment status on recipient and renal allograft survival. Clin Transplant. 2008;22(4):428–38.

[7] Raiz L, Monroe J. Employment post-transplant: a biopsychosocial analysis. Soc Work Health Care. 2007;45(3):19–37.

[8] Sangalli V, Dukes J, Doppalapudi SB, Costa G, Neri L. Work Ability and Labor Supply after Kidney Transplantation. Am J Nephrol. 2014;40(4):353–61.

[9] Slakey DP, Rosner M. Disability following kidney transplantation: the link to medication coverage. Clin Transplant. 2007;21(2):224–8.

[10] Tzvetanov I, D’Amico G, Walczak D, Jeon H, Garcia-Roca R, Oberholzer J, Benedetti E. High rate of unemployment after kidney transplantation: analysis of the United network for organ sharing database. Transplant Proc. 2014;46(5):1290–4.

[11] van der Mei SF, Kuiper D, Groothoff JW, van den Heuvel WJ, van Son WJ, Brouwer S. Long-term health and work outcomes of renal transplantation and patterns of work status during the end-stage renal disease trajectory. J Occup Rehabil. 2011;21(3):325–34.

[12] Helantera I, Haapio M, Koskinen P, Gronhagen-Riska C, Finne P. Employment of patients receiving maintenance dialysis and after kidney transplant: a cross-sectional study from Finland. Am J Kidney Dis. 2012;59(5):700–6.

[13] Aitken E, Dempster N, Ceresa C, Daly C, Kingsmore D. The impact of socioeconomic deprivation on outcomes following renal transplantation in the West of Scotland. Transplant Proc. 2013;45(6):2176–83.

[14] Axelrod DA, Dzebisashvili N, Schnitzler MA, Salvalaggio PR, Segev DL, Gentry SE, et al. The interplay of socioeconomic status, distance to center, and interdonor service area travel on kidney transplant access and outcomes. Clin J Am Soc Nephrol. 2010;5(12):2276–88.

[15] Mistretta A, Veroux M, Grosso G, Contarino F, Biondi M, Giuffrida G, et al. Role of socioeconomic conditions on outcome in kidney transplant recipients. Transplant Proc. 2009;41(4):1162–7.

[16] IV – Leistungsarten – IV-Renten [Internet]. [cited 2014 Mar 25]. Available from: http://www.svash.ch/site/index.cfm?id_art=11470&actMenuItemID=6616&vsprache/DE/V___Leistungsarten___IV_Rent.cfm.[electronic mail system]. 2014 May.

[17] van der Mei SF, Kuiper D, Groothoff JW, van den Heuvel WJ, van Son WJ, Brouwer S. Long-term health and work outcomes of renal transplantation and patterns of work status during the end-stage renal disease trajectory. J Occup Rehabil. 2011;21(3):325–34.

[18] Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30.

[19] Jofre R, Lopez-Gomez JM, Moreno F, Sanz-Guajardo D, Valderrabano F. Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998;32(1):93–100.

[20] Czyzewski L, Sanko-Resmer J, Wyzgal J, Kurowski A. Assessment of health-related quality of life of patients after kidney transplantation in comparison with hemodialysis and peritoneal dialysis. Ann Transplant. 2014;19:576–85.

[21] Kutner N, Bowles T, Zhang R, Huang Y, Pastan S. Dialysis facility characteristics and variation in employment rates: a national study. Clin J Am Soc Nephrol. 2008;3(1):111–6.

[22] Molsted S, Aadahl M, Schou L, Eidemak I. Self-rated health and employment status in chronic haemodialysis patients. Scand J Urol Nephrol. 2004;38(2):174–8.

[23] van der Mei SF, Krol B, van Son WJ, de Jong PE, Groothoff JW, van den Heuvel WJ. Social participation and employment status after kidney transplantation: a systematic review. Qual Life Res. 2006;15(6):979–94.

[24] Organ Donation and Transplantation activity in Switzerland Preliminary statistics 2013 Swisstransplant. 2015 Jan 7.

[25] Feinstein JS. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993;71(2):279–322.

[26] Marmot M, Feeney A. General explanations for social inequalities in health. IARC Sci Publ. 1997;(138):207–28.

[27] Messias AA, Reichelt AJ, dos Santos EF, Albuquerque GC, Kramer JSP, Hirakata VN, Garcia VD. Return to Work After Renal Transplantation: A Study of the Brazilian Public Social Security System. Transplantation. 2014;98(11).