Chronic kidney disease (CKD) is the sequential loss of a patients’ renal function over time (Peralta, 2009) leading to a need for such a patient to attend dialysis treatment or even renal replacement therapy. According to Coppo (2010) major causes of this disease includes hypertension, diabetes mellitus and to some extent, glomerulonephritis.

Family nurse practitioners (FNPs) can play an important role in the reduction of kidney disease burden and the overall improvement in the quality of life of the people living with CKD.It is instructive to note that this disease has undesirable impacts on the patients, their families and national health budgets. It may cause disabilities to patients, treatment and care is expensive and there is high possibility of a patient developing other health complications such as increased cardiovascular risk(van Zuilen et al, 2011) and ultimately, death.

FNPs can tremendously improve the conditions of CKD patients and alleviate their suffering. According to a research carried out by van Zuilen et al (2011), it was established that changes in lipid management and medication use were more pronounced when FNPs resorted to adopting intervention mechanisms, rather than putting the patients under physician care. This shows that CKD patients can benefit from coaching of the FNPs.. McIntyre, Burden, O’Donoghue and Blades (2007) and Campbell, Woods & Sankey (2008) regular exercises, keeping down weight, shunning smoking and avoiding excessive intake of salt and alcohol may keep risk factors down. Yet, information on these inexpensive methods may not be available to the patients. Therefore FNPs can play an important role in assisting those who have already developed CKD to maintain a healthy lifestyle.

Kendall (2008) and Campbell, Woods & Sankey (2008) are of the opinion that NFPs can play an important role in ensuring that action is taken to slow down the progression of the kidney disease once diagnosis has been made. If such interventions are not taken, disease may progress at a fast rate, leading to high mortality in patients. Besides, more and more patients may need dialysis treatment and other forms of medication such as renal replacement therapies, and palliative care, further pushing up a country’s overall cost of CKD medication. Some of these interventions may include timely referral to a specialist nephrologist once diagnosis is made. Also, those at risk of developing CKD such as those who are diabetic or obese can be assisted to keep their risk of developing CKD low.

Patients with CKD also have a lot of problems accessing information as regards to renal replacement therapy (Campbell, Woods & Sankey, 2008).This is a key decision for such patients, and can put them in an awkward situation. Besides, making such a decision requires a professional. The downside of family members taking a leading role in making this decision is that they may be blinded by feelings of guilt and filial responsibility (Campbell, Woods & Sankey, 2008).The patient’s best interests may thus not be considered. Besides, during that period a patient is likely to experience a lot of physical and emotional upheavals. An FNP is therefore poised to play a critical role in the lives of CKD patients at this stage.

In conclusion, it can be noted that FNPs can play an important role in attending to CKD patients. They should therefore be involved more, given the need to cut back on medication costs and help patients live longer and fulfilling lives. Besides, given the high cost of medication, it is important to ensure that those who are at risk in developing CKD, once identified, can be put under a regime of lifestyle change by an FNP, to ensure that the risk factors in such individuals are kept low or even eliminated.

Theoretical Framework

Dependent Variables for this study would include:

CKD related complications being avoided.

Proportion of medical cost related to CKD that is reduced.

Reduction of deaths related to CKD

Independent variables for this study would include the various interventions carried out by the FNP. These interventions will ensure that the progress of CKD is managed.

Some of these variables include:

Dissemination of information regarding lifestyle change

Timely referral to nephrologist specialist

It is anticipated that if FNP nurses are proactive in giving information to patients as regards necessary changes to their lifestyle, make timely referrals to specialist nephrologist, then cost of treating CKD and its complications will be reduced. This is important because budgets of most countries regarding treatment of various diseases cannot stretch fast enough to cover increase in disease incidences. It is sad that most of the medical related expensed relating to CKD can be avoided through inexpensive ways such as managing weight of CKD patients, helping them quit smoking and assisting them adopt a regime of exercising frequently.

The FNP therefore plays critical dual roles of both reducing the cost of medication and ensuring that the patients live longer and fulfilling lives. Patients are therefore able to cope with the demands of their daily lives, and be around their families.

References

Campbell, S., Woods M. & Sankey, J. (2008). Chronic kidney disease and the primary health

care framework. Renal Society. 4(3),81-89.

Coppo, R. (2010). Predictors of the outcome in Henoch-Schonlein nephritis in children and                                                                            adults. NewYork: Williams and sons publishers.

Kendall, S. (2008). Nursing perspectives and contribution to Primary Health Care. Retrieved

October 17, 2013 from www.icn.ch/PHC.pdf

McIntyre, N., Burden, R., O’Donoghue, K. and Blades, S. (2007). What can be done about

Chronic Kidney Disease (CKD)? Retrieved     October 17, 2013 from

http://www.renal.org/Libraries/CKD_eGUIDE/National_leaflet_about_CKD_and_eGFR

_for_patients_January_2007.sflb.ashx

Peralta, C,A.(2009).The metabolic syndrome and chronic kidney disease. Curr Opin: Nephrol

van Zuilen, A.D.,Blankestijn, P.J.,van Buren, M., ten Dam, M.A., Kaasjage,r K.A., Ligtenberg,

G.,Sijpkens, Y.W., Sluiter, H.E.,van de Ven. P.J. (2011). Nurse practitioners improve

quality of care in chronic kidney disease: two-year results of a randomized study.

Retrieved October 17, 2013 from http://www.ncbi.nlm.nih.gov/pubmed/22173365.