World Kidney Day is celebrated every year on the second Thursday of March. 10 March 2016 is the 11th World Kidney Day, and this year’s theme is “Prevention of chronic kidney disease starts with children”. Why should the prevention of kidney disease start with children? Chronic kidney disease (CKD) is diagnosed if there is evidence of kidney damage (pathology, blood, urine, imaging abnormalities) for ≥ 3 months, or if the glomerular filtration rate (GFR) is < 60 ml/min for ≥ 3 months. For example, CKD can be diagnosed if the urine protein is positive for ≥ 3 months. The most sensitive, cost-effective and least invasive of all the indicators is the routine urine test. Do not neglect urine tests because you think they are too simple, as they are more important than blood tests for early kidney disease diagnosis. Abnormal urinalysis includes proteinuria, hematuria, tubular urine, etc. Second, early detection is the key to treat CKD In life, people often feel sick before they feel the disease, and early kidney disease often does not have any symptoms, even if there are symptoms such as urine protein, there may not be any discomfort, so kidney disease is often ignored. But when the discomfort occurs, kidney disease is often in the middle and late stages. Even if the kidney disease is actively treated, the quality of life may not be as good as before. Therefore, early detection, regular checkups and early intervention are the keys to treat kidney disease. In addition, understanding the risk factors of CKD and trying to avoid them is the key to prevent CKD. III. What are the risk factors of CKD? Autoimmune factors: including autoimmune reactions induced by the deposition of inflammatory complexes formed by respiratory and digestive tract infections in the kidney; autoimmune reactions induced by environmental pollution that changes the tissue properties of the kidney; autoimmune diseases such as systemic lupus erythematosus, small vasculitis, rheumatoid arthritis, etc. involving the kidney. Among them, the first two are the causes of what we often call glomerulonephritis. Diabetes: long-term hyperglycemia damages the kidneys sooner or later. Diabetic nephropathy is an early and also the most common and problematic complication of diabetes. In Europe and the United States, diabetes has become the most common cause of CKD, and our country is currently experiencing a high prevalence of diabetes, and perhaps our country will follow in its footsteps in N years. Hypertension: Hypertension is most closely related to CKD. CKD causes hypertension and hypertension causes CKD, and persistent hypertension is the culprit of deteriorating renal function, whether primary or secondary. Drugs: Heavy metals, antimicrobials, sulfonamides, contrast agents and many other drugs can damage the kidneys, and many Chinese medicines also cause kidney damage, and the factors of Chinese medicines account for about half or even more of the cases of drug-related kidney damage. Generally speaking, Western drugs tend to cause renal tubular damage and Chinese herbal medicines tend to cause interstitial kidney damage, the latter with more insidious symptoms and possibly more severe. Other factors: polycystic kidney, urinary tract obstruction, urethral malformation, urinary tract infection, allergy, viral infection such as hepatitis B, etc., can lead to CKD. Life factors: high salt diet, low water intake, long-term urine holding, long-term alcohol consumption, etc., are all good factors for kidney injury. 4. What are the causative factors of CKD in children? According to statistics, the top three causes of CKD in children are: congenital kidney and urinary tract malformations, accounting for 48%-59%, including urethral malformations, polycystic kidney, horseshoe kidney, congenital renal agenesis, etc. Urological ultrasound or CT examination can be detected early. Hypertensive nephropathy, accounting for 10-19%. Do not think that hypertension is only a disease of adults, some secondary hypertension such as primary aldosteronism often begins in childhood, in addition to obesity due to overnutrition may also develop hypertension in childhood. Glomerulonephritis, which accounts for 5-14% of cases, is induced by recurrent respiratory infections in many children with chronic glomerulonephritis. This condition may also develop in childhood or may wait until adulthood, and many adults with chronic nephritis have a history of recurrent respiratory infections in childhood. Therefore, recurrent respiratory infections, especially tonsillitis, must be taken seriously and treated better. Prevention of CKD should start from children Whether it is childhood CKD or adult CKD, the incidence rate is very high, but the awareness rate and prevention rate are very low. The purpose of World Kidney Day is to arouse people's attention to CKD and raise the level of awareness of CKD. Acute kidney injury (AKI) in children due to various factors is also common, but often overlooked. For example, many children with severe infectious diarrhea actually end up dying not from the infection, but from AKI caused by diarrhea. CKD in children, which not only causes painful disease in children, but also leads to higher mortality rate in children and affects their growth and development as well as their life as adults, should be taken more seriously by the society at large. Early detection and treatment can prevent greater tragedies, which is the real meaning of this year's World Kidney Day with children as the theme.