Chronic Kidney Disease in Primary Care

Duaine D. Murphree, MD; Sarah M. Thelen, MD


J Am Board Fam Med. 2010;23(4):542-550. 

In This Article

Health Maintenance

Family physicians play a key role in ensuring that patients with chronic kidney disease receive appropriate counseling and health maintenance interventions; this is a pivotal component to successful management of chronic kidney disease. Immunizations that are recommended for all chronic kidney disease patients are influenza and pneumovax vaccinations.[19,20] Once a patient develops stage 4 chronic kidney disease, they should also receive the hepatitis B series because hemodialysis patients are at an increased risk of exposure to hepatitis B, despite precautions.[21] Additional health maintenance measures should be implemented according to the patient's other disease-specific recommendations and age.

Patients who smoke should be strongly encouraged to attempt to quit smoking because smoking is associated with increased cardiovascular disease and has been shown to accelerate the progression of chronic kidney disease.[3] In addition, patients should be encouraged to follow a healthy lifestyle with exercise as a component to combat their increased risk of cardiovascular disease.