Less than 30% of chronic dialysis patients are employed, but little is known about the factors affecting the employment status of these patients. Some conflicting reports about an improvement in vocational status with the use of erythropoietin and the lack of information about the contribution of dialysis adequacy (as assessed by KT/Vurea) to employment status prompted us to examine demographic and biochemical factors associated with employment status in chronic in-center hemodialysis (n = 46) and continuous peritoneal dialysis (n = 31) patients who were < or = 55 years of age. Thirty-three of the 77 patients (43%) were either working or attending school full-time. The working patients were noted to be better educated (20 of 33 working v 12 of 44 nonworking patients had > 12 years of education; P = 0.005) and on dialysis for a shorter mean time (44 +/- 52 months for the working patients v 77 +/- 78 months for the nonworking patients; P = 0.03). Sex, race, diabetes mellitus, mode of dialysis, and prior transplant were not associated with employment status. Similarly, mean hematocrit (30.2% +/- 5% in the working patients v 30.5% +/- 4% in the nonworking patients) and mean weekly delivered KT/V (1.4 +/- 0.7 v 1.3 +/- 0.6 for hemodialysis and 2.3 +/- 0.7 v 2.3 +/- 0.6 for peritoneal dialysis in the working and nonworking patients, respectively) were not different among the working and nonworking patients. Albumin was also not significantly different among the working and nonworking patients (4 +/- 0.3 v 3.9 +/- 0.4, respectively; P = 0.27).(ABSTRACT TRUNCATED AT 250 WORDS)