Comparison of Risk for End-Stage Renal Disease Between Physicians and the General Population: A Nationwide Population-Based Cohort Study

Chin-Kai Yen, Tian-Hoe Tan, I-Jung Feng, Chung-Han Ho, Chien-Chin Hsu, Hung-Jung Lin, Jhi-Joung Wang and Chien-Cheng Huang
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Chin-Kai Yen: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
Tian-Hoe Tan: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
I-Jung Feng: Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
Chung-Han Ho: Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
Chien-Chin Hsu: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
Hung-Jung Lin: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
Jhi-Joung Wang: Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
Chien-Cheng Huang: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan

IJERPH, 2019, vol. 16, issue 12, 1-9

Abstract: Physicians experience high stress and have much responsibility during a night shift, which contributes to increased sympathetic activity, the risk factor for renal disease. The risk for end-stage renal disease (ESRD) in physicians is still unclear. Therefore, we conducted a nationwide population-based cohort study to clarify this issue. Using Taiwan’s National Health Insurance Research Database, we identified 30,268 physicians and 60,536 individuals from the general population matched with a ratio of 1:2 by age and sex. All participants who had ESRD before 2006 and residents were excluded. ESRD risk between physicians and the general population and among physician subgroups was compared by following up their medical histories until 2012. We also compared the treatments between both cohorts with ESRD. Physicians had a lower ESRD risk than the general population (adjusted odds ratio (AOR): 0.5; 95% confidence interval (CI): 0.4–0.7), particularly in the middle-age subgroup (35–64 years) (AOR: 0.4; 95% CI: 0.3–0.7); however, there was no difference in the older age subgroup (≥65 years) (AOR: 1.0; 95% CI: 0.6–1.7). More physicians received peritoneal dialysis (63.0% vs. 11.1%) and renal transplantation (5.6% vs. 1.7%) than the general population after being diagnosed with ESRD. Compared with the general population, physicians had a lower ESRD risk and higher treatment selection for peritoneal dialysis and renal transplantation after being diagnosed with ESRD. Better medical knowledge, a greater awareness of diseases and their risk factors, more rigorous implementation of preventive measures, and easy access to medical care may play a role in this aspect. Further studies are warranted for elucidating the associated mechanisms.

Keywords: end-stage renal disease; hemodialysis; peritoneal dialysis; physician; renal transplantation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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