Social consequences in adult life of end-stage renal disease in childhood.
OBJECTIVE
To describe employment achievement and social independence of adults with childhood end-stage renal disease (ESRD) and to explore determining factors.


METHODS
Employment, occupational level, living arrangements, social engagements, and subjective health perception were cross-sectionally established between 1998 and 2000 in 144 of all living 187 adult Dutch patients with ESRD with an onset at age 0 to 15 years between 1972 and 1992. Potential clinical determinants were established by means of a review of all medical charts.


RESULTS
Compared with age-matched Dutch citizens, patients were more often involuntarily unemployed (19.4% vs 11.1%), had a lower occupational level, more often still lived with their parents, and more often had no partner. A low occupational level was associated with a dialysis duration >8 years (OR, 9.6; 95% CI, 1.9-47.6); living at the parental home was associated with the male sex (OR, 3.4; 95% CI, 1.5-7.8) and with a dialysis duration >8 years (OR, 3.7; 95% CI, 1.3-10.2).


CONCLUSIONS
Prolonged dialysis during childhood may decrease the ability to gain high-skilled professions and social independence. Unemployment is twice as high in adult patients with childhood ESRD than in healthy persons, but more than twice as low as compared with young ESRD patients with an adult onset of the disease, according to previous reports.
Groothoff
Jaap W
JW
Department of Pediatric Nephrology, Emma Children's Hospital AMC, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands. j.w.groothoff@amc.uva.nl
Grootenhuis
Martha A
MA
Offringa
Martin
M
Stronks
Karin
K
Hutten
Gerard J
GJ
Heymans
Hugo S A
HS
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D007676:Kidney Failure, Chronic; D008297:Male; D012189:Retrospective Studies; D018434:Sickness Impact Profile