Chinese nephrology today

In China’s case, not all aspects of a country’s remarkable economic development are positive. Increasing affluence can be accompanied by growing unhealthy diets and obesity problems, which have reached epidemic proportions in industrialized countries and are the driving forces behind the increased prevalence of diabetes and hypertension, and consequently the high prevalence of CKD in the USA, UK and other developed countries.

It is noteworthy that on March 3, 2012 The Lancet reported on the results of the first comprehensive study exploring the prevalence of CKD in China using a complex survey methodology which enables national representative inferences to be made. This was thanks to investigators at Peking University Institute of Nephrology in Beijing led by Prof Haiyan Wang (one of the original leaders of Chinese nephrology). They researchers were able to involve centers and coordinate data collection from major divisions of nephrology in 13 provinces of China. ISN’s contribution to this great achievement was not marginal thanks to many ISN Fellowships, Sister Renal Centers, Research and Prevention programs and continuing education events that supported young Chinese doctors/nephrologists in the past three decades. These activities have allowed them to be trained in the excellence of nephrology centers in Europe and USA.

Back to China, these young doctors have contributed to today’s outstanding nephrology programs operating in cities like Beijing, Nanjing, Shanghai and Guangzhou. Some doctors have reached rewarding positions within the Chinese nephrology community, like Dr Zhi-Hong Liu in Nanjing, the current President of the Chinese Society of Nephrology. Others have played a key role in developing nephrology clinical and research centers all over the country, and transferred their know-how and experience to new generations of young Chinese nephrologists.

I would like also mention the case of Dr. Peng Li, a young nephrologist, from the Affiliated Guilin Hospital of China Southern Medical University. He spent one year in 2004 in our Clinical Research Center, in Bergamo, Italy, through an ISN GO Fellowship and helped prepare the KHDC document for CKD prevention programs and associated risk factors in developing countries under the guidance of Prof. Robert Aktins and myself. This KHDC document is now the global template on which screening programs for non-communicable diseases, including kidney disease, are currently based in many low-middle-income countries. The rapid growth of academic nephrology in China is also witnessed by the high scientific quality of the several applications to the ISN GO Research and Prevention Committee submitted in the past 10 years by major nephrology centers in the country.

In general, it is very rewarding to see that the progressive growth in the number of paper submissions to The Lancet from China has allowed the country to be ranked third just after UK and USA. This is a further demonstration of the vitality, liveliness and great advances made by medical academy in China, including nephrology.

Knowledge exchange is never a one-way street. While China is learning from other countries in healthcare delivery and research, it has much to share for reciprocal benefit. In the forthcoming years, China should consider implementing or establishing new partnerships with other industrialized nations for joining efforts in more technologically advanced clinical and laboratory research to address the many unsolved problems around acute and chronic kidney diseases that affect patients worldwide, and eventually develop innovative therapeutic interventions. I look forward to this.