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Open AccessArticle

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

1
Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
2
Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
3
Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
4
Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
5
Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan
6
Allied AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
7
Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
8
Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally.
Int. J. Environ. Res. Public Health 2019, 16(12), 2211; https://doi.org/10.3390/ijerph16122211
Received: 21 May 2019 / Revised: 20 June 2019 / Accepted: 21 June 2019 / Published: 22 June 2019
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. View Full-Text
Keywords: end-stage renal disease; hemodialysis; peritoneal dialysis; physician; renal transplantation end-stage renal disease; hemodialysis; peritoneal dialysis; physician; renal transplantation
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Yen, C.-K.; Tan, T.-H.; Feng, I.-J.; Ho, C.-H.; Hsu, C.-C.; Lin, H.-J.; Wang, J.-J.; Huang, C.-C. Comparison of Risk for End-Stage Renal Disease Between Physicians and the General Population: A Nationwide Population-Based Cohort Study. Int. J. Environ. Res. Public Health 2019, 16, 2211.

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