Lakshmi B S, Kumar A C V, Reddy H K, Gopal J, Chaitanya V, Chandra V S, Sandeep P, Nagaraju R D, Ram R, Kumar V S
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.
Indian J Nephrol. 2017 Sep-Oct;27(5):384-388. doi: 10.4103/ijn.IJN_151_16.
The long-term dialysis therapy for end-stage renal disease takes a heavy toll of quality of life of the patient. Several factors such as fatigue and decreased physical capability, impaired social and mental functioning, contribute to this forlorn state. To meld maintenance dialysis treatment with a regular employment can be a serious test. A cross-sectional study of employment of patients on hemodialysis and peritoneal dialysis in a state government tertiary institute in South India was performed between June 2015 and December 2015. Patients who completed 3 months of regular dialysis were only included in the study. The number of patients on hemodialysis was 157 and on peritoneal dialysis was 69. The employment status before the initiation of dialysis was 60% (93 out of 155) and 63.7% (44 out of 69) in hemodialysis and peritoneal dialysis, respectively. After initiation, the loss of employment was observed in 44% (41 out of 93) in hemodialysis and 51.2% (26 out of 44) in peritoneal dialysis ( = 0.2604). Even though there was fall of absolute number of job holders in both the blue and white collar jobs, the proportion of jobholders in the white collar job holders improved. On univariate analysis, the factors which influenced the loss of employment were males, age between 50 and 60 years, number of comorbidities >2, illiteracy and blue collar versus white collar job before the initiation of dialysis. The majority of patients had the scores above 80 on Karnofsky performance scale and the majority belonged upper and middle classes than lower classes on modified Kuppuswamy's socioeconomic status scale; however, the loss of employment was also disproportionately high. There appeared a substantial difference in the attitude of the patients toward the employment. There was no difference between hemodialysis and peritoneal dialysis in the loss of employment of our patients.
终末期肾病的长期透析治疗给患者的生活质量带来了沉重负担。疲劳、身体能力下降、社会和心理功能受损等多种因素导致了这种凄凉的状态。将维持性透析治疗与正常工作相结合可能是一项严峻的考验。2015年6月至2015年12月期间，在印度南部一所邦政府三级医疗机构对接受血液透析和腹膜透析的患者就业情况进行了一项横断面研究。仅将完成3个月规律透析的患者纳入研究。血液透析患者有157例，腹膜透析患者有69例。透析开始前血液透析和腹膜透析患者的就业状况分别为60%（155例中的93例）和63.7%（69例中的44例）。开始透析后，血液透析患者中有44%（93例中的41例）失去工作，腹膜透析患者中有51.2%（44例中的26例）失去工作（P = 0.2604）。尽管蓝领和白领工作的就业者绝对数量都有所下降，但白领工作就业者的比例有所提高。单因素分析显示，影响就业丧失的因素有男性、年龄在50至60岁之间、合并症数量>2、文盲以及透析开始前从事蓝领工作而非白领工作。大多数患者在卡诺夫斯基功能状态量表上得分高于80分，在改良库普苏瓦米社会经济地位量表上大多数属于中上层阶级而非下层阶级；然而，就业丧失的比例也高得不成比例。患者对就业的态度存在显著差异。我们的患者在血液透析和腹膜透析后的就业丧失情况没有差异。
