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dc.contributor.authorAwan, Ahmed A.
Zhao, Bo
Anumudu, Samaya J.
Winkelmayer, Wolfgang C.
Ho, Vivian
Erickson, Kevin F.
dc.date.accessioned 2020-10-16T18:17:13Z
dc.date.available 2020-10-16T18:17:13Z
dc.date.issued 2020
dc.identifier.citation Awan, Ahmed A., Zhao, Bo, Anumudu, Samaya J., et al.. "Pre-ESKD Nephrology Care and Employment at the Start of Dialysis." Kidney International Reports, 5, no. 6 (2020) Elsevier: 821-830. https://doi.org/10.1016/j.ekir.2020.03.004.
dc.identifier.urihttps://hdl.handle.net/1911/109420
dc.description.abstract Introduction: Employment is associated with an improved sense of well-being and quality of life in patients with kidney disease. Earlier nephrology referral and longer duration of pre–end-stage kidney disease (ESKD) nephrology care are associated with improved health outcomes in patients with advanced kidney disease who initiate dialysis. It is unknown if pre-ESKD nephrology care helps patients stay employed leading up to dialysis initiation. Methods: We used the US ESKD registry to identify adults aged 18–54 years who initiated dialysis between 2007 and 2014. Analyses were restricted to patients who reported being employed 6 months prior to ESKD. We used multivariable regression models with estimated average marginal effects to examine the independent association between ≥6 months of pre-ESKD nephrology care and employment at dialysis initiation. To reduce bias, we conducted an instrumental variable (IV) analysis based on geographic variation in pre-ESKD care. Results: Of 75,700 patients included in study cohort, 49% reported receiving pre-ESKD nephrology care for ≥6 months, and 62% were employed at dialysis initiation. Although geographic variation in pre-ESKD nephrology care was strongly associated with the likelihood that working-aged patients in our analytic cohort received pre-ESKD care, the receipt of pre-ESKD nephrology care was not significantly associated with employment at dialysis initiation; estimated probability: 5%; 95% confidence interval (CI) –6% to 14%. Conclusions: Pre-ESKD nephrology care 6 months prior to initiation of dialysis is not associated with the likelihood of remaining employed at the initiation of dialysis. Although nephrology care has potential to help patients remain employed, this benefit is not manifested in current practice.
dc.language.iso eng
dc.publisher Elsevier
dc.rights This is an open access article under the CC BYNC-ND license
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title Pre-ESKD Nephrology Care and Employment at the Start of Dialysis
dc.type Journal article
dc.citation.journalTitle Kidney International Reports
dc.subject.keywordemployment
end-stage kidney disease
nephrology care
dc.citation.volumeNumber 5
dc.citation.issueNumber 6
dc.type.dcmi Text
dc.identifier.doihttps://doi.org/10.1016/j.ekir.2020.03.004
dc.type.publication publisher version
dc.citation.firstpage 821
dc.citation.lastpage 830


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