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A job can be fulfilling, help support a household, provide medical insurance and other benefits, and be socially rewarding. So how do you keep your job when you learn that you have kidney disease or need to start dialysis? Here are some tips on how you can continue your career.

Knowing what you can do at your job when you have kidney disease

Whether you work in an office, a factory, a retail store, a warehouse or outdoors, realizing what you can and cannot do at your job is the first step to continue working. People with kidney disease may experience tiredness or weakness, and may consider the type of job they are performing. You may want to talk to your manager or supervisor about what you can do. Is there anything that needs to be modified for your position? Are there different departments that may be more accommodating to your physical needs? Should you work fewer hours or maybe work on different days?

For people on dialysis, they will have an access that needs to be protected. Those who do hemodialysis treatments, whether in center or at home, will need a vascular access that goes either on your lower or upper arm, or upper leg. If there are physical demands at your job, make sure this won’t harm your access area. People on peritoneal dialysis (PD) have an abdominal catheter that also should be considered when doing physical labor, such as heavy lifting. Your doctor will give you guidelines such as how much weight you can lift if you are peritoneal dialysis.

You will also have to make time to see your doctor and schedule dialysis treatments. If it is an option perhaps you can work from home some days.

Temporary leave when you begin dialysis

According to the U.S. Department of Labor, the Family and Medical Leave Act (FMLA) is for covered employers to grant eligible employees 12 weeks of unpaid time off within a 12-month period for certain reasons. People with chronic kidney disease may be able to take advantage of FMLA to get time off and keep their job. FMLA will help when you get an access operation or train for home dialysis.

You can also consider using paid time off or vacation time if you need to tend to your medical needs. A temporary leave of absence can be discussed between you and your employer, too.

Dialysis treatment options and your work schedule

When going over dialysis treatments, you will see some options may be more conducive to your job and lifestyle than others. When you work, where you work and what type of job you have can be factors in deciding your dialysis treatment choice. Home dialysis can be the most flexible dialysis treatment, because it is performed at home around your work schedule.

• In-center hemodialysis – If you have a job with flexible hours, a job that allows you to work from home or you work a night shift, in-center hemodialysis may be right for you.
• Nocturnal in-center hemodialysis – For people who have full-time work during the day, nocturnal in-center hemodialysis allows you to dialyze overnight at the dialysis center.
• Peritoneal dialysis (PD) – Peritoneal dialysis is often done overnight using an automated peritoneal dialysis (APD) machine, or cycler, while you sleep. This allows you to be free during the day to work and participate in other activities. When necessary, peritoneal dialysis users can also perform dialysis exchanges in a clean area at work during the day in addition to performing exchanges at home.
• Home hemodialysis (HHD) – Home hemodialysis is another flexible home dialysis treatment, because it is performed in the comfort of your home. The hemodialysis machine for home is much smaller than the in-center machine, and you can do treatments at any time during the day or in the evening. The home hemodialysis machine, as well as the PD cycler, is portable so you can use it if you travel for your job.

Managing fatigue and anemia when you work

If you have felt fatigued or run down, you may have anemia. Usually people with early stages of kidney disease develop anemia, becoming worse as kidney function declines. Almost everyone with end stage renal disease (ESRD) has anemia. You may experience the following symptoms:

• Weakness
• Fatigue
• Shortness of breath
• Dizziness
• Rapid heartbeat
• Pale skin and gums
• Inability to think clearly

If you’ve had these symptoms, ask your doctor to test you for anemia. If anemia is what you have, your doctor can prescribe medicine called erythropoiesis-stimulating agents (ESAs), which work to form and produce red blood cells. The names that may be prescribed are EPOGEN® and Procrit®, among others. Once anemia is managed, you will likely feel better and can remain working.

Getting back to work with kidney disease

If you want to keep your career when you have kidney disease, you will likely be able to do so. Sometimes continuing to work can help you feel healthy, productive and able to provide for yourself and loved ones. If you need dialysis, educate yourself on which treatment may be the most work-friendly. Also communicate with your boss about what you are going through and be realistic when it comes to physical labor and time-oriented demands at work. Talk with an insurance specialist for even more answers to your questions.