Chronic kidney disease and the primary health care framework

Chronic kidney disease (CKD) is a worldwide public health issue where kidney function progressively deteriorates over many years and ultimately results in complete kidney failure, known as end stage kidney disease [ESKD] (Johnson and Usherwood, 2005). Renal replacement therapy must be instituted once ESKD has been diagnosed to preserve life. The numbers of people being diagnosed with CKD arc increasing with the dialysis-dependent population rising by an average of 6% per year over the past 10 years. This article reviews the status of CKD in Australia and examines how the primary health care (PHC) framework can be incorporated into the contextual nursing care of people with CKD. Exemplars explain how five interconnecting principles of the PHC framework; accessibility; appropriate technology; increased emphasis on health promotion; intersectorial collaboration and public participation can be applied to the nursing management of people with CKD. Finally, specific areas where nephrology nursing research can be focused are suggested.