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BMC Nephrology

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Open Access 01-12-2021 | Kidney Transplantation | Research

Employment of patients with kidney failure treated with dialysis or kidney transplantation—a systematic review and meta-analysis

Authors: Lilli Kirkeskov, Rasmus K. Carlsen, Thomas Lund, Niels Henrik Buus

Published in: BMC Nephrology | Issue 1/2021

Abstract

Background

Patients with kidney failure treated with dialysis or kidney transplantation experience difficulties maintaining employment due to the condition itself and the treatment. We aimed to establish the rate of employment before and after initiation of dialysis and kidney transplantation and to identify predictors of employment during dialysis and posttransplant.

Methods

This systematic review and meta-analysis were carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for studies that included employment rate in adults receiving dialysis or a kidney transplant. The literature search included cross-sectional or cohort studies published in English between January 1966 and August 2020 in the PubMed, Embase, and Cochrane Library databases. Data on employment rate, study population, age, gender, educational level, dialysis duration, kidney donor, ethnicity, dialysis modality, waiting time for transplantation, diabetes, and depression were extracted.

Quality assessment was performed using the Newcastle–Ottawa Scale. Meta-analysis for predictors for employment, with odds ratios and confidence intervals, and tests for heterogeneity, using chi-square and I² statistics, were calculated. PROSPERO registration number: CRD42020188853.

Results

Thirty-three studies included 162,059 participants receiving dialysis, and 31 studies included 137,742 participants who received kidney transplantation. Dialysis patients were on average 52.6 years old (range: 16–79; 60.3% male), and kidney transplant patients were 46.7 years old (range: 18–78; 59.8% male). The employment rate (weighted mean) for dialysis patients was 26.3% (range: 10.5–59.7%); the employment rate was 36.9% pretransplant (range: 25–86%) and 38.2% posttransplant (range: 14.2–85%). Predictors for employment during dialysis and posttransplant were male, gender, age, being without diabetes, peritoneal dialysis, and higher educational level, and predictors of posttransplant: pretransplant employment included transplantation with a living donor kidney, and being without depression.

Conclusions

Patients with kidney failure had a low employment rate during dialysis and pre- and posttransplant. Kidney failure patients should be supported through a combination of clinical and social measures to ensure that they remain working.

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Title: Employment of patients with kidney failure treated with dialysis or kidney transplantation—a systematic review and meta-analysis
Authors: Lilli Kirkeskov
Rasmus K. Carlsen
Thomas Lund
Niels Henrik Buus
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Peritoneal Dialysis
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Published in: BMC Nephrology / Issue 1/2021
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-021-02552-2

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