Survival in dialysis in relation to work

Abstract

Introduction: Little is known about the impact of the occupational situation on the mortality of patients on maintenance hemodialysis. Objective: The objective of this study was to evaluate de impact and importance of paid occupational therapy. Methods: We retrospectively evaluated 291 patients over 19 years. Patients were divided in 4 groups: Not able (NA), because of the degree of deterioration for realizing occupational tasks; Incidental or informal work (IW): those that being in adequate psychophysical conditions to work in a regular form, were not doing it; formal work (FW), that is to say external, paid work and last, paid occupational therapy (POT), work in dependence relationship in the same dialysis clinic. Results: The patients classified as NA presented the least survival 4.25 +- 0.56 years. With respect to the other groups, age as the presence of diabetes affected survival. Of the other three groups, the mean treatmentime was for IW 7.23+- 0.71 y; FW 8.11+- 0.62 y vs POT 11.69 +- 1.24 y. A significant difference was found between NA and IW vs FW and POT. Conclusions: The occupational situation in hemodialysis is clearly related to mortality. The impact of dialysis on the different groups is more due to the primary diseases than the dialectic treatment. We believe that the variable working condition should be included to compare different populations. The inclusion of the patient in the group POT places him in a better situation with respect to his perspective of living.