摘要：Objective: To describe em.loym.nt achievem.nt and social independence of adul ts with childhood end- stage renal disease (ESRD) and to explore determ.ning fa ctors. Study design: Em.loym.nt, occupational level, living arrangem.nts, social engagem.nts, 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 eterm.nants were established by m.ans of a review of all m.dical charts. Results : Com.ared with age- m.tched Dutch citizens, patients were m.re often involunta rily unem.loyed (19.4% vs 11.1% ), had a lower occupational level, m.re often still lived with their parents, and m.re 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 hom. was associated with the m.le 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 m.y decrease the abili ty to gain high- skilled professions and social independence. Unem.loym.nt is t wice as high in adult patients with childhood ESRD than in healthy persons, but m.re than twice as low as com.ared with young ESRD patients with an adult onset of the disease, according to previous reports.