摘要：Objective: To describe employment achievement and social independence of adul ts with childhood end- stage renal disease (ESRD) and to explore determining fa ctors. Study design: Employment, occupational level, living arrangements, social engagements, and subjective health perception were cross- sectionally establis hed between 1998 and 2000 in 144 of all living 187 adult Dutch patients with ESR D with an onset at age 0 to 15 years between 1972 and 1992. Potential clinical d eterminants were established by m.a.s of a review of all medical charts. Results : Com.a.ed with age- matched Dutch citizens, patients were more often involunta rily unemployed (19.4% vs 11.1% ), had a lower occupational level, more often still lived with their parents, and more often had no partner. A low occupation al levelwas associated with a dialysis duration >8 years (OR, 9.6; 95% CI, 1.9 - 47.6); living at the parental home was associated with the male sex (OR, 3.4; 95% CI, 1.5- 7.8) and with a dialysis duration >8 years (OR, 3.7; 95% CI, 1.3 - 10.2). Conclusion: Prolonged dialysis during childhood may decrease the abili ty to gain high- skilled professions and social independence. Unemployment is t wice as high in adult patients with childhood ESRD than in healthy persons, but more than twice as low as com.a.ed with young ESRD patients with an adult onset of the disease, according to previous reports.