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Nephrology in China

Abstract

China has a large population and a high prevalence of chronic kidney disease (CKD). The increasing incidence of obesity and type 2 diabetes mellitus, coupled with an ageing population, will exacerbate the burden of CKD unless effective control and prevention strategies are implemented. The unmet challenges of managing the growing number of patients with end-stage renal disease (ESRD) in China are reflected by the lower rate of patients receiving dialysis relative to many Western countries, owing to a lack of financial and clinical resources, and inequalities in access to health care across regions and populations. The feasibility of expanding peritoneal dialysis is being examined, and ongoing health-care reforms provide an invaluable opportunity to improve the status and quality of dialysis for patients with ESRD in China. The Chinese Society of Nephrology (CSN) advocates for efforts focused on preventing CKD coupled with early detection, treatment, and adequate follow-up to reduce mortality and the long-term burden of CKD. In addition, rapid advances in nephrology research, from basic science to clinical epidemiology, as well as broad communication and collaboration between the CSN and other international nephrology societies, will promote the development of nephrology in China.

Key Points

  • China has a high prevalence of chronic kidney disease (CKD); an increasing prevalence of hypertension, obesity and type 2 diabetes mellitus, and an ageing population will exacerbate the burden of CKD

  • The current leading cause of CKD in China is glomerular disease, followed by diabetic nephropathy, and hypertension; IgA nephropathy is the most common glomerular disease

  • The proportion of patients with end-stage renal disease receiving dialysis is low owing to a lack of financial and clinical resources and inequalities in health-care access

  • The feasibility of expanding peritoneal dialysis, over more expensive haemodialysis, is currently has being examined

  • Ongoing health-care reform in China will increase the prevalence of dialysis and improve long-term outcomes for patients with CKD

  • The Chinese Society of Nephrology advocates for improved patient care, education and research; collaboration with international nephrology societies will promote the development of nephrology in China

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Figure 1: Different causes of ESRD in China, the USA and the UK.

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Acknowledgements

The author's research was supported by the National Basic Research Program of China (No. 2012CB517600, No. 2012CB517606) and the National Key Technology R&D Program (2011BAI10B04).

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Z-H. Liu is President of the Chinese Society of Nephrology

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Liu, ZH. Nephrology in China. Nat Rev Nephrol 9, 523–528 (2013). https://doi.org/10.1038/nrneph.2013.146

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