Liu Jing, Shi Yunying, Diao Yongshu, Zeng Xiaoxi, Fu Ping
Renal Division, West China Hospital of Sichuan University, Chengdu, China.
Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, China.
Kidney Dis (Basel). 2023 Apr 11;9(4):265-276. doi: 10.1159/000530022. eCollection 2023 Aug.
Chronic kidney disease (CKD) is an incurable disease requiring lifelong management. China has a high prevalence of CKD, which disproportionately affects older adults and those with chronic risk factors for CKD development. The rising prevalence of CKD in China places a substantial burden on the general population and the healthcare system.
In China, there are currently many unmet needs for patients with CKD and high-risk individuals, resulting from a lack of education and support to reduce risk factors, delayed diagnoses, limited knowledge of CKD among primary-care physicians, and poor access to treatments among some patient populations. An integrated, nationwide approach is required to improve the current situation of CKD management in China. There are currently several national healthcare frameworks in place that focus on new major health policies to prevent disease and encourage people to adopt healthier lifestyles, and while they do not directly target CKD, they may have a positive indirect impact. We explore the unmet needs for patients with CKD in China and discuss the potential strategies that may be required to overcome them. Such strategies include improving physician and patient education, establishing a targeted screening programme, supporting patients to improve self-management behaviours, accelerating the creation of medical consortia and medical satellite centres, and migrating from hospital- to community-based management. In addition to policy-driven strategies, development of novel therapies will be key to providing new solutions for the long-term management of CKD.
An integrated, nationwide approach is required, incorporating policy-driven changes to the clinical management of CKD, as well as the development of novel CKD treatments.
慢性肾脏病（CKD）是一种需要终身管理的不治之症。中国CKD患病率很高，对老年人以及那些具有CKD发生慢性风险因素的人群影响尤为严重。中国CKD患病率的上升给普通人群和医疗保健系统带来了沉重负担。
在中国，由于缺乏降低风险因素的教育和支持、诊断延迟、基层医疗医生对CKD的了解有限以及部分患者群体获得治疗的机会不佳，CKD患者和高危个体目前存在许多未满足的需求。需要采取一种全国性的综合方法来改善中国CKD管理的现状。目前有几项国家医疗保健框架，侧重于预防疾病和鼓励人们采取更健康生活方式的新的重大卫生政策，虽然它们没有直接针对CKD，但可能会产生积极的间接影响。我们探讨了中国CKD患者未满足的需求，并讨论了可能需要克服这些需求的潜在策略。这些策略包括改善医生和患者教育、建立有针对性的筛查计划、支持患者改善自我管理行为、加速医疗联合体和医疗卫星中心的创建，以及从基于医院的管理转向基于社区的管理。除了政策驱动的策略外，开发新疗法将是为CKD长期管理提供新解决方案的关键。
需要采取一种全国性的综合方法，将政策驱动的CKD临床管理变革与新的CKD治疗方法的开发结合起来。
