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

doi:10.3390/ijerph16122211

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Title:	Comparison of Risk for End-Stage Renal Disease Between Physicians and the General Population: A Nationwide Population-Based Cohort Study
Authors:	Yen, Chin-Kai Tan, Tian-Hoe Feng, I-Jung Chung-Han Ho(何宗翰) Hsu, Chien-Chin Lin, Hung-Jung Wang, Jhi-Joung Huang, Chien-Cheng
Contributors:	Chi Mei Med Ctr, Dept Emergency Med Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Southern Taiwan Univ Sci & Technol, Dept Biotechnol Taipei Med Univ, Dept Emergency Med Southern Taiwan Univ Sci & Technol, Allied AI Biomed Ctr Natl Cheng Kung Univ, Coll Med, Dept Environm & Occupat Hlth Southern Taiwan Univ Sci & Technol, Dept Senior Serv
Keywords:	end-stage renal disease hemodialysis peritoneal dialysis physician renal transplantation
Date:	2019
Issue Date:	2020-07-29 13:50:26 (UTC+8)
Publisher:	MDPI
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.
Relation:	International Journal of Environmental Research and Public Health, v.16, n.12, 2211
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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