Occupational stress is associated with impaired work ability and reduced quality of life in patients with chronic kidney failure

Int J Artif Organs. 2009 May;32(5):291-8. doi: 10.1177/039139880903200506.


Background: About 300,000 patients in the United States with Chronic Kidney Failure (CKF) are of working age, but up to 70% lose their job within the first year of renal replacement therapy .No study has examined how work ability and perceived health are influenced by the subjects' adjustment to their job. We assessed the association of occupational stress (Effort-Reward Imbalance, ERI),work ability (WAI) and health-related quality of life (QoL) in hemodialysis.

Methods: 40 employed hemodialysis patients completed a self-administered questionnaire. Associations between ERI, short Form 12 (sF-12), short Form - 6 Dimensions (sF-6D), Kidney Disease QOL- 36 (KDQOL-36) and WAI were tested with partial Spearman's correlation adjusted for age, income, and comorbidity burden.

Results: Study subjects were mainly low-income (82%), african-american (73%), men (75%); 16 were manual laborers and 9 worked in the industrial sector. Study subjects reported low levels of Occupational Stress: ERI scores indicated an imbalance between Job Efforts and Rewards in only 3 subjects. Nevertheless, ERI scores were inversely and strongly associated with WAI (rho=-0.41, p<0.012) and all QoL scales even after adjustment for known confounders.

Conclusion: Our study suggests that psychosocial workplace factors may play a substantial role in modulating patients' health perception and ability to continue working. The causal relationship between Occupational stress, perceived health, and work ability should be further investigated. Occupational Health professionals and nephrologists should closely collaborate to meet the needs of occupationally active hemodialysis patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Status Indicators
  • Humans
  • Kidney Failure, Chronic / psychology*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Missouri / epidemiology
  • Occupational Health*
  • Quality of Life
  • Renal Dialysis / psychology*
  • Stress, Psychological / epidemiology*
  • Young Adult