Strategies to reduce the incidence of chronic kidney disease in children: time for action.

Chronic kidney disease (CKD) is increasingly becoming a public health challenge worldwide, and its burden on our health care system is becoming enormous. CKD is not being detected early enough to initiate treatment regimens and reduce death and disability. Many children with CKD are unaware that they have this disorder. Therefore, initiatives should be undertaken to make healthcare providers, policy makers, and the general population more aware of the seriousness of CKD, its risk factors, and opportunities for early detection and intervention through screening. Addressing CKD effectively will require multiple initiatives. The strategic plan for CKD should define the path we must take to insure success in the prevention and treatment of this disease and serve as a roadmap to help educate adults, as well as children with this disease. The interventions should utilize the managed care system to develop CKD prevention and educate pediatricians, internists, nurse practitioners, and physician assistants about signs and symptoms of CKD. The strategic plan should also expand education outreach efforts to high risk patient populations in using the lay health advisor model by focusing on prevention, early detection, and control strategies targeting obesity, genetic causes of CKD, diabetes, and hypertension. The strategic plan should serve as a wake-up call for all mankind as the health care providers work together to create a healthy world and reduce the occurrence of this devastating disease.