Once the kidney function is damaged, it is very difficult to reverse it. Therefore, chronic kidney disease should establish a “cure” concept, early prevention, early diagnosis, early treatment in the prevention and treatment of kidney disease is particularly important. Four groups of people must prevent kidney disease “sneak attack” Chronic kidney disease is mostly insidious and not easily detected, especially primary kidney disease, the cause of which is unknown and can not be prevented, while secondary kidney disease is a preventable disease. Yang Xuejun, deputy chief physician of the nephrology department of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, said that four groups of people are vulnerable to secondary nephropathy and must be strengthened to prevent and treat it. Patients with metabolic diseases Diabetes: Diabetic patients with poor glycemic control will have diabetic nephropathy in 50% of those with a history of 5 years, about 70% of those with a history of 10 years, and 90% of those with a history of 15 to 20 years. Moreover, diabetic nephropathy is the most difficult to treat and has the worst prognosis among all secondary kidney diseases. Its core is to control blood sugar. Hypertension: Hypertensive patients with poorly controlled blood pressure and a history of 10-20 years will develop hyperalgesia, commonly with proteinuria, but without hematuria. Hypertensive nephropathy is one of the secondary nephropathies with relatively good prognosis, which can maintain a small amount of proteinuria for a long time without other significant changes. Its core is the control of blood pressure. Hyperuricemia: hyperuricemia can cause gout and complicate gouty kidney; on the other hand, uric acid-lowering drugs used to treat hyperuricemia have a greater impact on kidney function, and the two act simultaneously to accelerate kidney function damage. The core of this is the control of blood uric acid. Patients with rheumatic immune diseases/connective tissue diseases Lupus erythematosus: Lupus erythematosus can involve all organs of all systems. About 75% of SLE patients have renal damage with protein, red blood cells, white blood cells in urinalysis and a few patients have tubular pattern. Lupus nephritis occurs at an early stage. The lesions persist for many years and may have extensive damage, evolving into renal insufficiency and uremia. The treatment of this disease is currently a major clinical challenge. Purpura: renal involvement mostly occurs within one month after skin purpura. Since about 1/3 or more of patients with allergic purpura develop renal damage, their prognosis mainly depends on the severity of renal lesions, so the renal damage caused by allergic purpura is called purpura nephritis. Chinese medicine has better efficacy in treating purpura kidney, most of them can control and achieve clinical cure. Other: rheumatism, dry syndrome, leukodystrophy, scleroderma, polymyositis and other diseases may cause secondary nephropathy, leading to renal function damage. Long-term drug users The kidney is the main organ of drug metabolism and excretion, in the process of its metabolism and excretion, it can produce toxic effects on the kidney in many ways, causing kidney damage and toxic nephropathy. Common drugs are – antibiotics: penicillin, tobramycin, gentamicin, kanamycin, streptomycin, and ciprofloxacin, levofloxacin, ofloxacin, enoxacin, gatifloxacin and other quinolones, as well as sulfonamides, antituberculosis drugs, antifungal drugs, antiviral drugs, antitrichomonas drugs, etc. all have certain Nephrotoxicity, long-term or high dose use will cause renal function impairment. Diuretics: Diuretics are one of the most widely used drugs in our nephrology department and generally have fewer side effects, but excessive doses, long duration or wrong timing can cause kidney damage or aggravate existing kidney disease, with mannitol being the most common. Contrast agents: Almost every contrast agent has the potential to cause contrast nephropathy, which accounts for about 10% of acute renal failure in intensive care unit patients. Chinese herbs: Many clinical and experimental studies have proven that many herbs have toxic side effects on the kidneys, causing acute or chronic damage to the kidneys, and more than one hundred herbs with nephrotoxicity have been collected. There are more reported herbs such as aristolochia, lei gong teng, mu tong, santou roots, cang er zi, wei ling xian, strychnine, shang lu, ba dou, zedoary, guang fang ji, etc. Other non-steroidal anti-inflammatory drugs such as anti-inflammatory pain, ibuprofen, etc., may also cause kidney damage if taken for a long time due to the need of the disease. In recent years, due to the widespread clinical use or abuse of various drugs, the incidence of drug-induced acute and chronic renal failure is increasing, especially in the elderly population. Patients with vasculitis Vasculitis-like diseases such as polyarteritis nodosa, Wegener’s granulomatosis, allergic vasculitis, aortitis, and giant cell arteritis may accumulate in the kidneys and lead to secondary nephropathy. Finally, we remind patients with the above diseases to actively treat the primary disease, control the disease, prevent secondary nephropathy at an early stage, diagnose early, treat early, improve the quality of life of patients and prolong their life span.