Work and Dialysis: Navigating Employment Challenges Among Young Adults on Maintenance Hemodialysis in Tanzania

Abstract

Introduction: Chronic kidney disease (CKD) increasingly affects young adults in low-and middle-income countries, with significant social and economic consequences. In Tanzania, many patients begin dialysis during their most productive years, often disrupting employment and financial stability. This study aimed to examine employment patterns and dialysis-related work challenges among young adults on maintenance hemodialysis at Muhimbili National Hospital. Methods: We conducted a hospital-based cross-sectional study at Muhimbili National Hospital from October to December 2024, involving adults aged 18–49 years on maintenance hemodialysis for at least three months. Data were collected using a structured questionnaire and supplemented with clinical records to assess sociodemographic, dialysis-related, employment, and transplant-related factors. Descriptive statistics were used to summarize the findings. Results: We included 134 patients aged between 18 and 49 years, with a mean age of 35.8 years (SD: 8.9). A total of 58.3% were either employed or self-employed, with 44.9% reporting that they did not work on dialysis days. Among those working, 65.4% experienced changes in their work patterns due to treatment demands, and 42.4% worked fewer than 4 days per week. Among the unemployed participants (24.6%), more than half (57.6%) reported resigning from work due to dialysis-related challenges. Out-of-pocket payment for dialysis was common, reported by 52.3% of participants. Although awareness of kidney transplantation was high (92.5%), only 27.6% had previously pursued or were actively pursuing it, primarily hindered by the absence of a donor (48.3%), high cost (23.0%), or both (28.7%). Conclusion: Young adults on maintenance hemodialysis in Tanzania face significant employment disruptions and limited access to kidney transplantation, highlighting the need for integrated interventions to support their social and economic well-being.