Department of Nephrology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Nephrology (Carlton). 2010 Jun;15 Suppl 2:31-6. doi: 10.1111/j.1440-1797.2010.01309.x.
Chronic kidney disease (CKD) is now a global health problem. One important strategy to prevent and manage CKD is to offer a prevention program which could detect CKD early as well as raise awareness of the disease. In Shanghai, a community-based study demonstrated that the prevalence of CKD was high while awareness was low. The results from Shanghai urged the necessity of a screening and prevention program of CKD. In Japan, the urinalysis screening system was established to early diagnose and prevent CKD. Due to modification of lifestyle and prevalence of diabetes, urine dip-stick test for microalbuminuria might be necessary in adults while screening for proteinuria and haematuria are necessary for students and young adults. In Taiwan, two CKD programs - a CKD care program and diabetic share care program - were initiated. The cost-effectiveness study indicated that both programs could reduce end-stage renal disease (ESRD) burden in Taiwan because integrated pre-ESRD care was important for patients with CKD stage 4 and stage 5 while a diabetic shared care program was cost-effective to prevent nephropathy to patients with diabetic mellitus. In Australia, studies demonstrated that screening of high-risk individuals as well as promoting awareness were cost-effective to early detection of CKD. Furthermore, opportunistic screening with emphasis on early detection was effective in CKD prevention. The studies from those regions share experiences on early prevention and management of CKD.
慢性肾脏病（CKD）现已成为全球性健康问题。预防和管理 CKD 的一项重要策略是提供预防计划，以便早期发现 CKD 并提高对该疾病的认识。在上海，一项基于社区的研究表明，CKD 的患病率很高，而知晓率却很低。上海的研究结果迫切需要开展 CKD 的筛查和预防计划。在日本，建立了尿分析筛查系统，以早期诊断和预防 CKD。由于生活方式的改变和糖尿病的流行，成年人可能需要进行尿微量白蛋白的尿试纸条检测，而蛋白尿和血尿筛查对于学生和年轻人则是必要的。在台湾，启动了两项 CKD 计划——CKD 护理计划和糖尿病共同护理计划。成本效益研究表明，这两项计划都可以减轻台湾的终末期肾脏疾病（ESRD）负担，因为对于 CKD 第 4 期和第 5 期的患者，综合 ESRD 前护理非常重要，而糖尿病共同护理计划对于预防糖尿病患者的肾病也具有成本效益。在澳大利亚，研究表明，对高危人群进行筛查以及提高认识对于早期发现 CKD 是具有成本效益的。此外，强调早期发现的机会性筛查在 CKD 预防方面也非常有效。这些地区的研究分享了 CKD 早期预防和管理方面的经验。
