Work-hemodialysis treatment interface in patients with chronic kidney disease: a scoping review

Alvarenga, Willyane de Andrade; Amorim, João Vitor Martins; Magalhães, Laylla Harlete Ferreira; Neris, Rhyquelle Rhibna; Nascimento, Lucila Castanheira; Rocha, Silvana Santiago da

doi:10.37689/acta-ape/2023AR024111

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Original Article • Acta Paul Enferm 36 • 2023 • https://doi.org/10.37689/acta-ape/2023AR024111 copy

Work-hemodialysis treatment interface in patients with chronic kidney disease: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze the scientific evidence on the impact of hemodialysis treatment on the work of patients with chronic kidney disease.

Methods

This is a scoping review carried out through searches in five databases: PubMed, LILACS, CINAHL, PsyInfo and Scopus. We included studies published between 2010 and 2020, in Portuguese, Spanish and English, with a qualitative or quantitative approach, with patients undergoing hemodialysis for chronic kidney failure, who focused on work, employment or productivity.

Results

The 18 studies included in the review show the impact of hemodialysis treatment on the relationship with work and the reasons associated with unemployment. Such reasons involve sociodemographic characteristics, physical weakness, treatment and family and employer support.

Conclusion

After starting hemodialysis, we identified impairment in patients’ functional capacity, both physical and psychological, requiring changes in life habits due to restrictions imposed by chronic kidney disease and decreased productivity.

Renal insufficiency, chronic; Employment; Renal dyalisis

PCC	Search terms
P- Population Patients with chronic kidney disease	“Kidney Failure, Chronic”[Mesh] OR “End-Stage Kidney Disease” OR “Disease, End-Stage Kidney” OR “End Stage Kidney Disease” OR “Kidney Disease, End-Stage” OR “Chronic Kidney Failure” OR “End-Stage Renal Disease” OR “Disease End-Stage Renal” OR “End Stage Renal Disease” OR “Renal Disease, End-Stage” OR “Renal Disease, End Stage” OR “Renal Failure, End-Stage” OR “End-Stage Renal Failure” OR “Renal Failure, End Stage” OR “Renal Failure, Chronic” OR “Chronic Renal Failure” OR “ESRD” OR “Renal Insufficiency, Chronic”[Mesh] OR “Chronic Renal Insufficiencies” OR “Renal Insufficiencies, Chronic” OR “Chronic Renal Insufficiency” OR “Kidney Insufficiency, Chronic” OR “Chronic Kidney Insufficiency” OR “Chronic Kidney Insufficiencies” OR “Kidney Insufficiencies, Chronic” OR “Chronic Kidney Diseases” OR “Chronic Kidney Disease” OR Disease, Chronic Kidney OR Diseases, Chronic Kidney OR “Kidney Disease, Chronic” OR “Kidney Diseases, Chronic” OR “Chronic Renal Diseases” OR “Chronic Renal Disease” OR “Disease, Chronic Renal” OR “Diseases, Chronic Renal” OR “Renal Disease, Chronic” OR “Renal Diseases, Chronic”
C - Concept Work/productivity	“Employment”[Mesh] OR Employment OR “Labor Force” OR Occupation OR income OR “Labor Forces” OR “Employment Status” OR “Status, Employment” OR “Status, Occupational” OR “Occupational Status” OR Underemployment OR “Unemployment”[Mesh] OR “Occupations”[Mesh] OR Occupation “Return to Work”[Mesh] OR “Work, Return to Back-to-Work” OR “Return-to-Work” OR “Back to Work OR “Work, back to”
C- Context: Hemodialysis treatment	“Renal Dialysis”[Mesh] OR “Dialyses, Renal” OR “Renal Dialyses” OR “Dialysis, Renal” OR Hemodialysis OR Hemodialyses

First author, year and country	Objectives	Method	Participants
LEE (2020)⁽¹⁸⁾ Korea	Assess several clinical parameters, according to rehabilitation and employment status, to elucidate the characteristics correlated with the best rehabilitation status among patients under HD.	Cross-sectional study	29,865 patients under HD with information on the state of rehabilitation. They had independent daily life 46.8% of participants, 9% worked part-time and 21.6% full-time.
Ghani (2019)⁽¹⁹⁾ Sweden	Examine the impact of PD on labor market outcomes (employment, disability pension and labor income), compared to IH† in Sweden, controlling non-random selection for treatment.	Cross-sectional study	4,734 patients of productive age (20-60 years), who started the treatment of chronic dialysis between 1995 and 2012. They were under PD 44% of participants and 56% undergoing treatment for IH.
Walker (2019)⁽²⁰⁾ New Zealand	Describe the perspective and experience of patients under HD in community homes, to understand how and why it is used, as well as the advantages and disadvantages of this treatment modality.	Qualitative study, with an analytical approach	25 patients, men and women, aged between 31 and 56 years, 14 men and 11 women who had experience in HD in community homes. Only 20% had completed higher education. Regarding employment, 24% worked full-time and 32% worked part-time.
Anees (2018)⁽²¹⁾ Pakistan	Determine the effect of socioeconomic factors on the quality of life of patients under HD.	Descriptive multicenter follow-up study	135 patients with end-stage renal disease on regular maintenance dialysis for ≥3 months and literate. 74.9% of participants were unemployed and 84.6% had > 10 years of education.
Erickson (2018)⁽²²⁾ United States	Examine employment trends over time among patients starting dialysis.	Cohort study	480. 597 patients, aged between 18 and 54 years.
Kim (2018)⁽²³⁾ Korea	Explore individual income trends and estimate the variation in the mean monthly income of patients under HD.	Cohort study	138 people with a mean age of 61 to 81 years, with 68% being male. Of the sample, 76% were employed.
Imanish (2017)⁽²⁴⁾ Japan	Investigate the influences of employment and level of education on mortality and hospitalization among maintenance patients under HD in Japan.	Prospective cohort study	7,974 patients, male and female, under HD under 60 years of age. 62% of participants were male and 51% were employed. Regarding education, 15% graduated and 52% were at college.
Huang (2017)⁽²⁵⁾ China	Assess the employment situation and determine the variables for unemployment in Chinese patients on maintenance HD.	Cohort study	231 participants under HD for more than 3 months, aged between 18 and 61 years, when they started HD. 50% were employed and 60% were male.
Lakshmi (2017)⁽²⁶⁾ India	Investigate employment rates in patients on maintenance dialysis.	Cross-sectional study	226 participants: 155 patients under HD with a mean age of 54.1 years, 70.3% were men and 18.6% illiterate; 69 dialysis patients with a mean age of 55.8 years and 81.1% were men.
Kutner (2017)⁽²⁷⁾ United States	Understand the factors associated with employment maintenance among patients of working age with advanced CKD.	Cohort study	528 adults between 20 and 64 years old, with an average age of 50.3 years, English or Spanish speakers. 62.3% were male and 77.7% had completed at least high school. They were under HD for at least 3 months and were able to give informed consent.
Wells (2015)⁽²⁸⁾ United States	Explore the changes and occupational perceptions experienced by Mexican-Americans with end-stage renal disease and their families living with dialysis.	Qualitative studies, with a phenomenological approach	17 Mexican-Americans with end-stage renal disease, 8 women and 9 men, aged 21 ≥61 years. 9 participants were unemployed, 8 had higher education and 17 were family members, residing in the Republic of Cameroon.
Lewis (2015)⁽²⁹⁾ United Kingdom	Explore how a serious chronic disease in childhood affects education and employment in early adulthood.	Qualitative study of approach to Grounded Theory	931 participants with end-stage renal disease, aged between 20 and 30 years, diagnosed for the first time between 0 and 19 years of age.
Murray (2014)⁽³⁰⁾ United Kingdom	Assess the impact of end-stage renal disease on education and employment outcomes in young adults.	Mixed study	57 young adults, with a mean age of 25 years, in which 14% were undergoing dialysis and 78.9% were awaiting kidney transplantation. Of the sample, 59,7% were employed.
Helantera (2012)⁽³¹⁾ Finlândia	Investigate employment rate, in different modes of renal replacement therapy, in dialysis and treatment of transplant patients, in Finland, and to assess other factors associated with employment.	Cross-sectional cohort study	2,637 Finns, aged 16-64, receiving long-term dialysis. Men predominated (61.8%), with a mean age of 49 years.
Marinovish (2012)⁽³²⁾ Argentina	Check whether the low or absent income of the HD incident population is a poor prognostic factor.	Retrospective and longitudinal observational analytical study.	13,466 participants with a mean age of 60.4 years who started an HD program for the first time. 57.2% of participants are male.
Santos (2013)⁽³³⁾ Brazil	Identify the changes imposed by HD treatment on the quality of life of individuals with CKD in terms of entering the job market.	Cross-sectional, comparative and descriptive	24 patients with a mean age of 49.29 years, 50% men. 29.1% of participants continued to work after starting dialysis.
Muehrer (2011)⁽³⁴⁾ United States	Understand the factors associated with employment maintenance among patients of working age with advanced CKD.	Descriptive and retrospective study	102,104 patients between 18 and 64 years old who were working 6 months before starting their first chronic dialysis. 82.5% were under HD, and 17.5%, under PD.
Kutner (2010)⁽³⁵⁾ United States	To investigate the importance of depressed mood and usual activity level as predictors of job maintenance among patients after starting HD.	Prospective cohort study	1,643 patients, with a mean age of 56.6 years, 55% of whom were men. 32% continued to work after starting dialysis.

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[1] Corresponding author. Willyane de Andrade Alvarenga. E-mail: willyalvarenga@hotmail.com