{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:50:45Z","timestamp":1786373445501,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>In this study, we identified individuals in the workforce with estimated kidney function based on sequential serum creatinine measurements.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Individuals with CKD were more likely to experience workforce detachment. The risk of workforce detachment was graded according to CKD severity.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>These findings were persistent irrespective of age, sex, diabetes status, and level of education.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Impaired kidney function is associated with mortality, cardiovascular events, and hospitalization as well as diminished functional capacity and health-related quality of life. We hypothesized that kidney function would be linked to employment status, which itself is closely linked to financial stability, physical and mental health, and personal identity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>By the use of weekly updated information of patients' occupational status, combined with laboratory data and nationwide registries on hospitalizations and deaths, we estimated kidney function in a working age population (18\u201360 years) to examine the absolute risk of workforce detachment by CKD status and CKD stage using the Aalen-Johansen estimator accounting for competing risks of retirement, and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 12,704 individuals with CKD and 68,938 matched individuals without CKD in the workforce at index date. Persons with CKD had a higher absolute risk of workforce detachment (1-year absolute risk: 9% versus 5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); the absolute risk was higher with more advanced CKD: (1-year absolute risk: eGFR &gt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      =5%; CKD stages G3a=8%, G3b=12%, G4=14%, and G5=20%). Older age, female sex, diabetes, and lower level of education were associated with higher likelihood of workforce detachment. Findings related to kidney function were persistent across all subgroups examined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Persons with CKD were significantly more likely to experience workforce detachment than persons with normal or near normal kidney function. These data highlight another, less well-documented burden of CKD, highlighting the urgency to develop and disseminate early detection and treatment interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000001003","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T17:01:21Z","timestamp":1771347681000},"page":"951-958","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Workforce Detachment in Persons with CKD"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2242-9380","authenticated-orcid":false,"given":"Rasmus","family":"R\u00f8rth","sequence":"first","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milos M.","family":"Koch","sequence":"additional","affiliation":[{"name":"Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Gerds","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"},{"name":"Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-470X","authenticated-orcid":false,"given":"Nicholas","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9102-3862","authenticated-orcid":false,"given":"Thomas","family":"Kumler","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"},{"name":"Department of Cardiology, Hiller\u00f8d Hospital, Hiller\u00f8d, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6635-1466","authenticated-orcid":false,"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-0534","authenticated-orcid":false,"given":"Glenn M.","family":"Chertow","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Epidemiology and Population Health, and Health Policy, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"issue":"10225","key":"B1-20260618","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the global burden of disease study 2017","volume":"395","year":"2020","journal-title":"Lancet."},{"issue":"9731","key":"B2-20260618","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","article-title":"Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis","volume":"375","author":"Matsushita","year":"2010","journal-title":"Lancet."},{"issue":"1","key":"B3-20260618","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of chronic kidney disease: an update 2022","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int Suppl (2011)."},{"issue":"5S","key":"B4-20260618","first-page":"S1","article-title":"KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease","volume":"102","year":"2022","journal-title":"Kidney Int."},{"issue":"15","key":"B5-20260618","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in patients with chronic kidney disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N Engl J Med."},{"issue":"23","key":"B6-20260618","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med."},{"issue":"2","key":"B7-20260618","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med."},{"issue":"24","key":"B8-20260618","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events with finerenone in kidney disease and type 2 diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N Engl J Med."},{"issue":"7","key":"B9-20260618","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1681\/ASN.2005101085","article-title":"Chronic kidney disease and mortality risk: a systematic review","volume":"17","author":"Tonelli","year":"2006","journal-title":"J Am Soc Nephrol."},{"issue":"5","key":"B10-20260618","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1080\/14034940701271882","article-title":"Register-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey","volume":"35","author":"Hjollund","year":"2007","journal-title":"Scand J Public Health."},{"issue":"4","key":"B11-20260618","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.kint.2020.06.024","article-title":"Executive summary of the 2020 KDIGO diabetes management in CKD guideline: evidence-based advances in monitoring and treatment","volume":"98","author":"de Boer","year":"2020","journal-title":"Kidney Int."},{"issue":"4","key":"B12-20260618","doi-asserted-by":"crossref","first-page":"543","DOI":"10.2215\/CJN.15691020","article-title":"Identification of patients with CKD in medical databases: a comparison of different algorithms","volume":"16","author":"Vestergaard","year":"2021","journal-title":"Clin J Am Soc Nephrol."},{"key":"B14-20260618","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2147\/CLEP.S448347","article-title":"Validity of prescription-defined and hospital-diagnosed hypertension compared with self-reported hypertension in Denmark","volume":"16","author":"Bonnesen","year":"2024","journal-title":"Clin Epidemiol."},{"issue":"12","key":"B15-20260618","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1016\/j.ekir.2020.09.028","article-title":"Health-related quality of life in people across the spectrum of CKD","volume":"5","author":"Krishnan","year":"2020","journal-title":"Kidney Int Rep."},{"issue":"10","key":"B16-20260618","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1093\/aje\/kwu359","article-title":"Employment and disability pension after central nervous system infections in adults","volume":"181","author":"Roed","year":"2015","journal-title":"Am J Epidemiol."},{"issue":"24","key":"B17-20260618","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1056\/NEJMoa1811744","article-title":"Canagliflozin and renal outcomes in type 2 diabetes and nephropathy","volume":"380","author":"Perkovic","year":"2019","journal-title":"N Engl J Med."},{"issue":"8","key":"B18-20260618","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1056\/NEJMoa2409183","article-title":"Long-term effects of empagliflozin in patients with chronic kidney disease","volume":"392","author":"Herrington","year":"2025","journal-title":"N Engl J Med."},{"issue":"2","key":"B19-20260618","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1056\/NEJMoa2204233","article-title":"Empagliflozin in patients with chronic kidney disease","volume":"388","author":"Herrington","year":"2023","journal-title":"N Engl J Med."}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:45:55Z","timestamp":1786369555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001003","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"assertion":[{"value":"2025-10-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}