Employment Income Starts to Rebound After Kidney Transplantation

renalandurologynews.com · Feb 27, 2026 · Collected from GDELT

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Kidney transplantation can lead to economic recovery for patients with end-stage kidney disease (ESKD), according to a new Canadian study published in JAMA Network Open. Karim S. Ladha, MD, MSc, of Women’s College Hospital, Toronto, Ontario, Canada, and colleagues tracked employment income for 3 years before and after a first kidney-only transplant using hospital and tax record data from 5640 kidney transplant recipients aged 30 to 62 years using the 2007-2016 Canadian Hospitalization and Taxation Database (C-HAT). Total employment income included income from self-employment, T4 employment income, and any other employment-related compensation. On average, employment income significantly decreased by $4293.30 Canadian dollars each year per person (95% CI, -$4726.17 to -$3860.46; P<.001) in the 3 years leading up to a first kidney transplant. After kidney transplantation, employment income significantly increased by a mean $1005.70 annually (95% CI, $406.09 to $1605.29; P=.001). The top and bottom 1% of earners were excluded. Pre-transplant decline in income followed by a post-transplant uptick was observed across patients by sex, 30-day complication status, living donor and deceased donor organ, and rural and urban residency. The team suggested limited work participation before transplant surgery stems from the demands of obtaining dialysis treatments around work schedules, strict sick leave policies, physical factors such as fatigue, and comorbidity burdens, such as from diabetes. Other factors such as employer flexibility, insurance, education, age, and race likely play roles. While transplant candidates aged 30 to 55 years had an annual decrease in income of $3604.50 before surgery, those aged 56 years and older had a significant drop in pay twice as large: $7267.30 annually. After transplant surgery, recipients aged 56 years and older continued to see a numerical, statistically insignificant decline in annual income by $1769.80 (95% CI, −$3692.38 to $153.39; P = .07). Those with higher Elixhauser Comorbidity Index scores (ie, 3-6) also continued to experience a decline in employment. Future studies should examine other factors that may affect patient income, including clinical variables, such as chronic kidney disease (CKD) etiology, dialysis duration, and waitlist time, and socioeconomic factors such as family size, spousal income, and education, the investigators suggested. The current study could not account for distinctions between ESKD and preemptive kidney transplant or for dialysis modality and frequency. “Overall, the current analysis suggests that the positive effects on quality of life outweigh the negative sequelae of transplant which leads to a gradual increase in employment income observed after transplant,” Dr Ladha’s team wrote. In an accompanying editorial, Sue Fu, MD, MS, of Stanford University School of Medicine, in Stanford, California, and colleagues pointed out that employment income did not fully recover after kidney transplantation. Older patients and those with more comorbidities continue to be highly vulnerable to lost wages. Understanding this data may assist in informing health care stakeholders and policymakers to design programs and policy interventions to support patient employment and return to work.