3 Steps for People Who Work and Have Kidney Disease

When you are part of the workforce and diagnosed with early stage or late stage chronic kidney disease (CKD), you will want to know how to maintain employment. First off, know that you may still work when you have CKD. The materials below are designed to help you determine the right time to talk to your employer, work with your doctor on treatment options and learn about your rights as an employee. You’ve come to the right place — use this general checklist to guide you through this transition.

Step 1: Make the Right Choices to Stay Healthy

Educate yourself about your condition, treatment options and how you can maintain your lifestyle.
- Attend a no-cost Kidney Smart℠ class led by trained kidney care instructors.
- Use the Treatment Evaluator to see what type of dialysis treatment fits your lifestyle, whether it’s in-center hemodialysis, peritoneal dialysis (PD), home hemodialysis (HHD), in-center nocturnal dialysis or in-center self care.
- A kidney transplant is another treatment option to discuss with your doctor. Many people start the transplant process long before they need dialysis.
- Continue to educate yourself about kidney disease at DaVita.com.

Step 2: Know Whether or Not You Can Afford Not to Work

Know the financial implications of not working, because Social Security Disability income is often available but may not be enough. Learn about common insurance plans (e.g., Employer Group Health Plans, Medicare, COBRA), other insurance options and more on the Insurance & Financial Management Support page.
Get help from tools and resources such as Ask an Insurance Specialist and the Social Security Benefit Calculators to determine if you can afford to not work.
Want to continue working? Tell your doctor so that he or she can help you manage your CKD, including anemia, a common condition among people with kidney disease.
People not on dialysis may receive help to pay for EGHP premiums and co-pays from various organizations:

Step 3: Make the Transition to Working on Dialysis

Taking action now will make it easier for you to work while on dialysis.
Know your rights as a worker. Use this guide to reference: A Guide to Disability Rights Laws – U.S. Department of Justice.
Explore your treatment options and ask questions about them at your next doctor’s visit.
- Schedule dialysis access placements.
- Going on home dialysis? Begin training on PD or HHD.
Ask questions about workplace accommodations or the Americans with Disabilities Act (ADA) at Job Accommodation Network.
Understand your employee benefits.
Learn about the Family and Medical Leave Act (FMLA).
Modifications may be necessary when you go back to work. Talk to your doctor about it as well as how much time you’ll need off.
Talk to your employer about leave of absence and an estimated return date. Accommodations and changes may be necessary when you return:

Accessibility	Flexibility
Parking	Modified work schedules
Work area	Reassigning non-essential tasks
PD exchange area	Unpaid leave
Restrooms	Reassignment to a vacant position

After your first day of dialysis, you may need to take a short-term leave of absences (4-12 weeks).
Continue working when you need dialysis. Work with your employer, physician and dialysis provider to modify any schedule and/or tasks as needed.
Keeping your job when you have kidney disease is likely to help you feel healthier, happier and financially secure.

Healthier	Happier	Financially Secure
Improved clinical outcomes	No withdrawal from usual social environments	Higher income
Lower mortality rate for people who continue to work²	Continue to contribute to family, community and society	Social Security Disability only covers 30-40% of current wages
Lower hospitalization rates²	Less likely to experience depression¹	Access to insurance through work³ Better choice⁴ Family coverage Lower out of pocket Transplant feasibility⁵

Depressed Mood, Usual Activity Level, and Continued Employment after Starting Dialysis. Nancy G. Kutner,* Rebecca Zhang,* Yijian Huang,* and Kirsten L. Johansen*†‡, 2012
Dialysis Patients' Mental Health Linked To Heart Health And Longevity.Clinical Journal of the American Society Nephrology (CJASN) April 2012. Ea Wha Kang, MD, PhD, from the Ilsan Hospital in Gyeonggi-do, Korea and Mark Unruh, MD, from the University of Pittsburgh Medical Center
Witten B, Schatell DR, Becker BN. Relationship of ESRD working-age patient employment to treatment modality (Abstract). J Am Soc Nephrol. 2004; 15:633A.
Kasper JD, Giovannini TA, Hoffman C. Gaining and losing health insurance: strengthening the evidence for effects on access to care and health outcomes. Med Care Res Rev. 57(3):298-318, 2000.
Kasiske BL, London W, llison MD. Race and socioeconomic factors influencing early placement on the kidney transplant waiting list. J Am Soc Nephrol 9(11):2142-2147, 1998.

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