The topic pen discusses the prevention and treatment of chronic kidney disease early detection of chronic kidney disease, improve the early prevention and treatment rate Wu Hua, Department of Nephrology, Beijing Hospital, Ministry of Health (Postal Code) Chronic diseases are the major enemy of human health and one of the main causes of human death. From the onset and development of chronic diseases to organ failure, about 35 million people die each year worldwide. In the 21st century, chronic kidney disease (CKD) has become a major threat to human health after cardiovascular diseases, tumors and diabetes. However, the awareness rate, diagnosis rate and treatment rate of CKD are still very low. According to the preliminary results of the Chinese epidemiological survey, the prevalence of CKD among people over 18 years old in Beijing is 13.0%, and the total number of CKD patients can reach 1.43 million (more than 100 million patients nationwide), but the awareness rate of these patients is only 7.9%. Some patients have already entered into end-stage renal disease and lost the opportunity of early treatment. Therefore, actively controlling the occurrence and development of CKD has become one of the important public health tasks for governments, health departments and society as a whole. CKD is a disease or injury of the kidney, such as glomerulonephritis, tubulointerstitial nephritis (disease), renal vascular disease > 3 months; or glomerular filtration rate (min ?1.73m2), are called chronic kidney disease. CKD is divided into 5 stages according to GFR. Stage 1 has kidney injury but normal GFR (> 90ml/min); stage 2 has mild decrease in GFR (60 to min); stage 3 has moderate decrease in GFR (30 to 59ml/nin); stage 4 has severe decrease in GFR (15 to 29ml/min); stage 5 is renal failure (GFR < 15ml/min), Ready for or needing renal replacement therapy. The staging of chronic kidney disease is helpful for patients to take appropriate prevention and treatment measures, and also for patients to understand their own condition. What diseases can develop into CKD and chronic renal failure? For patients who have no previous kidney disease but have risk factors for kidney damage, such as diabetes, hypertension, hyperlipidemia, gout or hyperuricemia, smoking and obesity, if the control of blood glucose, blood pressure and lipid indexes are not up to standard and microalbuminuria or persistent proteinuria gradually appear, they will easily progress to CKD and chronic renal failure. If the blood pressure and blood lipid indexes are controlled, microalbuminuria or persistent proteinuria will gradually appear, and CKD and chronic renal failure will develop. Glomerulonephritis (such as IgA nephropathy, lupus nephritis, purpura nephritis, etc.), amyloid nephropathy, myelomeningocele nephropathy, vasculitis kidney damage, chronic pyelonephritis, hereditary polycystic kidney disease, or those who already have abnormal kidney function at the first visit, or those who fail to adhere to follow-up treatment well, are more likely to develop chronic kidney failure. Third, how to detect chronic kidney disease at an early stage? In the early stage, most of them have no conscious symptoms, so it is difficult to detect them at an early stage without urine, blood and imaging tests. Therefore, in order to achieve early prevention and treatment, we must first achieve early diagnosis. To raise the awareness of health check-ups among the whole population and to increase government investment, routine urine examinations should be widely carried out, starting with primary and secondary school students, at least once a year, so that CKD can be clearly diagnosed at an early stage when there are no symptoms. For elderly people, it is recommended to have a comprehensive medical checkup once a year. For patients at high risk of kidney disease such as diabetes mellitus and hypertension, regular urine tests or urinary albumin excretion rate should be performed every 3-6 months, and renal function and renal imaging tests should be performed. Urine microalbumin test (urine albumin/creatinine) should be promoted and popularized, which is more sensitive than urine routine test and more convenient than urine protein excretion rate test, and can be used for early detection of diabetic nephropathy, hypertensive kidney damage and other renal lesions, and is one of the sensitive indicators for early diagnosis of kidney injury. For the evaluation of glomerular filtration function, it is recommended to apply the formula (such as MDRD formula Gault formula, etc.) to calculate GFR, or radionuclide method to determine GFR. We should strive to achieve early screening, regular examination, and improve the quality of screening, standardize the test methods and examination items. Patients with abnormalities in the examination or screening should be urged to go to the nephrology department of the hospital as soon as possible. The diagnostic requirements for kidney disease include the following ① assessment of kidney function, such as CKD staging; ② complications related to kidney disease staging, such as renal hypertension, renal anemia, renal bone disease, etc. ③ comorbidities of kidney disease. For the diagnosis of kidney disease, kidney aspiration biopsy should be actively promoted so that patients can get a clear pathological diagnosis and facilitate physicians to take appropriate treatment plans and estimate the prognosis, so that patients can follow the medical advice and better cooperate with physicians' treatment. 4. How to improve the treatment rate of CKD? Active treatment of all types and stages of kidney disease can significantly slow down its progression and delay the time to end-stage renal disease, thus reducing the high cost of renal replacement therapy. To achieve this goal, we need to start from many aspects. On the one hand, we need to raise the awareness of CKD prevention and treatment among patients, and increase the awareness rate, treatment rate and treatment compliance rate. We advocate the public to actively participate in health check-ups, regular urine routine and kidney function checks, so that patients can understand the development and prognosis of chronic kidney disease, so that they know how to cooperate with the physician's treatment plan, how to monitor the indicators of laboratory tests, how to achieve better treatment results, so that the abnormal indicators meet the standards, and when to prepare for renal replacement therapy. We should improve the medical knowledge and general knowledge of disease prevention of the general public through various publicity methods and lectures, and teach patients to learn self-management. On the other hand, we should improve the level and basic knowledge of CKD prevention and treatment among medical personnel. In particular, primary care physicians, general practitioners, community physicians, medical examiners, and general internists should be given continuing education on kidney disease, learning how to manage patients with CKD, how to prevent risk factors that accelerate the progression of kidney disease, how to treat various complications, and how to improve the treatment and compliance rates. With the support of the health administration, a system of long-term monitoring and follow-up of CKD patients in community and primary hospitals should be established. CKD is a "silent" disease that progresses slowly and silently, with many complications, poor prognosis and increased medical costs. Therefore, it is important to improve the understanding of CKD, early detection, early diagnosis and early treatment to reduce and delay the occurrence and development of CKD.