Inter-discipline is formed by the interpenetration and integration of multiple disciplines, which has become a notable trend involving interdisciplinary activities and a combination of research and development. Learned from experience worldwide, the management mode for organ donation and procurement activities varies among countries, but the core of the disciplinary construction of organ donation remains the same. The theoretical basis and practice of organ donation is not purely a matter of coordination, but its ground of knowledge is built upon multidisciplinary integration and its implementation relies on a joint-effort approach and requires collaboration of multiple teams. From the sociological viewpoint, organ donation represents the gift of life for transplant patients, which founds the key element in enhancing the harmony of society. While, from a practical perspective, its professionalism has been widely recognized by the international medical community. As a complex medical and social act, organ donation is a medical-centered subject with sociological, humanistic, ethical, psychologic, and juristic attributes. This chapter will provide an overview of how multidisciplinary collaboration empowers the science of organ donation, followed by the summary of recent efforts taken in China in pursuit of this goal as an example.

近年来,我国的器官捐献与移植已经处于稳定发展的阶段.尽管如此,移植器官来源短缺、器官供需矛盾突出仍是实现世界卫生组织所倡导"实现器官移植自给自足"的瓶颈.世界卫生组织定义的"器官捐献关键路径"中阐述的供者丢失的关键原因包括潜在供者的识别和转介以及器官的维护与修复问题.器官捐献工作的顺利开展及高效率、高质量发展离不开重症医学的支持,并与重症监护室(ICU)医务人员对该项工作的认知、认可及参与程度息息相关.本文就ICU医务人员对器官捐献的认知、态度及意愿的研究现状进行综述,讨论相关影响因素,并尝试就如何改善相关困境给出针对性建议.

Inter-discipline is formed by the interpenetration and integration of multiple disciplines, which has become a notable trend involving interdisciplinary activities and a combination of research and development. Learned from experience worldwide, the management mode for organ donation and procurement activities varies among countries, but the core of the disciplinary construction of organ donation remains the same. The theoretical basis and practice of organ donation is not purely a matter of coordination, but its ground of knowledge is built upon multidisciplinary integration and its implementation relies on a joint-effort approach and requires collaboration of multiple teams. From the sociological viewpoint, organ donation represents the gift of life for transplant patients, which founds the key element in enhancing the harmony of society. While, from a practical perspective, its professionalism has been widely recognized by the international medical community. As a complex medical and social act, organ donation is a medical-centered subject with sociological, humanistic, ethical, psychologic, and juristic attributes. This chapter will provide an overview of how multidisciplinary collaboration empowers the science of organ donation, followed by the summary of recent efforts taken in China in pursuit of this goal as an example.

Introduction: While the reform of organ transplantation in China has achieved success, the organ procurement model for different regions in the country varies. Starting from a hospital-based organ procurement organization (OPO), Shanxi OPO was established as the first independent non-profit provincial OPO in China, which covers a donation area of 37.29 million population and serves 6 transplant hospitals in the region. Shanxi OPO was established in 2018 under the supervision of Shanxi provincial health commission. This study compares results before and after the establishment in regard to the quantity, quality and efficiency of organ donation and transplantation (OD & OT) within Shanxi Province, aiming at exploring a feasible and up-to-date procurement management mode in China. Method: From the point of organizational structure, personnel composition, equipment management and core quality indicators, we analyze the data from 2015 to 2021 and compare the results before and after the establishment of the provincial OPO. Results: In the past two years, a professional team with 7 departments has been built. Besides, advanced facilities like those for donor maintenance and information collection are equipped. Then in 2020, an ethics and scientific committee have been founded to guide scientific research and supervise ethical norm compliance. Through analyzing the quality control indicators, the number of OD has increased from 35 cases (PMP: 0.99) in 2015 to 126 cases (PMP: 3.61) in 2021, with an increase rate of 260%. The growth trend remains within Shanxi Province even under the influence of COVID-19 pandemic in 2020, while the case number of the country decreased. Since 2018, the number of organs procured from per donor and the organ utilization rate of Shanxi OPO have risen year by year, reaching 3.02 and 98.7% respectively in 2021. Moreover, the DBD rate has increased from 1.1% in 2019 to 20.63% in 2021, though there is still a gap compared to the national and international level. These positive changes indicate that the quality of our service in organ viability assessment, donor maintenance, organ recovery and coordination have been gradually improved. Conclusion: Efficiency and quality of the organ procurement and allocation have been greatly improved in the past few years because of the establishment of Shanxi OPO. This kind of provincial OPO also provides a solution, which will lead a clear direction for the standardization of organ procurement in China.

Introduction: The total number of organ donation (OD) exceed 5,000 in 2020 in China, accounting for 14.5% of the global deceased OD. Under the supervision of the national health authority, currently there are 118 organ procurement organizations (OPOs) developed in China to manage daily practice of organ donation and procurement for transplantation. This study provides an overview for the development of OPOs in China and challenges facing in the developing phase. Suggestions were summarized, with aims at seeking up-to-date management model & strategies to increase operational efficiency and service quality. Methods: Characteristic of current Chinese OPOs management mode and key elements of constructing an OPO with high efficiency were summarized by an expert consensus meeting and a survey completed by 72 experts from 21 provinces. Among them, 42% are the leader from hospital/OPO/transplantation department, and 38% are OPO professionals/coordinators, and 11% are medical staff from transplant department. The rest are professionals in the field of ICU and others. Results: There are 4 OPO management models adopted in China, namely, provincial independent OPO (developed as an independent & unique non-profit organization in a province), provincial OPO (a unique but hospital-affiliated OPO in a province), the transplant hospital-based OPO (there are more than one OPOs in a province), and the OPO alliance (the OPO is developed by more than one transplant hospitals together. There are more than one OPO alliance in a province). Results from the survey show that different OPO management models have its pros and cons. In terms of medical resources & facilities, hospital-based OPO is better than the others. On the other hand, provincial independent OPO has stronger advantages on autonomous control in institutional and financial management. Provincial independent OPO model ranks first in the comprehensive competing score, followed by the hospital-based OPO model. By collecting the views of experts on the key elements of constructing an efficient OPO, 20 key elements were identified. The most important three elements are, namely, availability of support of national/ local policies for OPO, the creation of effective donation hospitals cooperation network and a well-organized financial management model. Conclusion: OPOs have been established in China to manage organ donation and procurement activities. The OPO management models & their performance metric vary among provinces. To achieve better results, the number of OPOs needed to be reduced in regions with more than one OPO.

Introduction: Although COVID-19 pandemic has caused a significant impact worldwide, organ donation & transplantation (OD & OT) practice continuous in most of the countries. Since China launched the pilot program of voluntary deceased OD in 2010, the national organ donation & procurement system has been developing towards standardization. In this study, features of the global & national trends in OD & OT during the COVID-19 pandemic were summarized. Method: A retrospective study using data from the global observatory on donation and transplantation (GODT) was conducted. We analyzed the collected data to obtain the results and conclusions. Results: The summed-up characteristics covered different aspects and could be outlined as the followings: 1) The number of global OT has been increasing until the outbreak of COVID-19 pandemic in 2020. There were 129,681 OT performed worldwide in 2020, a decrease of 17.6% comparing to that of 2019. The percentage of China’s annual OT to the global OT number rose from 7.9% among in 2015 (10,057 cases) to 13.8% in 2020 (17,949 cases). 2) In China, joint-efforts have been made to achieve self-sufficiency of OT on the national level. The total number of OD exceed 5,000 in 2020, accounting for 14.5% of the global deceased OD. The China OD & OT program works orderly with implementation of prevention control policy under the pandemic. 3) DBD remains as the major source for OT worldwide while the number of DCD has been increasing in the recent year. With the lasting promotion of clinical practice in brain death diagnosis, the percentage of DBD in China has increased over the past five years. 4) The percentage of global living donor (LD) transplants has decreased year-on-year. With the implementation of deceased OD program in different Asian countries, living donation does not comprise the majority of organ source for OT in Asia. 5) The percentages of liver, kidney and lung transplantation in China were on the rise compared to the global total and the liver transplantation accounted for the highest proportion. 6) China’s OT activity ranks second in the world, but the PMP of deceased OD & OT is low, indicating rooms for improvement. 7) Innovative transplant approaches were explored worldwide to meet the increasing transplant demands. Efforts have been made in China to promote innovation for transplantation, examples can be seen, such as the fact that China completed ischemia-free liver/kidney/heart transplantation, and successfully performed the world’s first double-lung transplant with COVID-19 patient in 2020. Conclusion: Summary of current features in OD & OT in China and worldwide were analyzed in this study. The degree of OT program development varies across the world but all making efforts to meet the ever-changing demands for transplants. Chinese reform on OD & OT marks it one of the countries contributing to the increase of OD & OT activities worldwide but still has room for improvement in operational efficiency.

当前,新型冠状病毒肺炎（新冠肺炎）疫情全球各地形势不一,疫情防控仍然不能松懈。在面对各自的社会环境和医疗资源配置的考验下,以及在行业赖以生存的体系运作惯性及固有生产力的支撑下,各国器官捐献和移植工作仍在努力前行。山西省人体器官获取与分配服务中心是在国家专家委员指导下,由原山西省卫生和计划生育委员会于2018年8月28日批准成立的全省唯一、独立运行的非营利性医疗机构。本文通过剖析疫情期间美国和西班牙的器官捐献与移植数据,结合山西省人体器官获取与分配服务中心器官捐献工作的开展情况,进一步探索符合我国国情、省情的公民器官捐献与移植工作体系的建设。

器官短缺是全球移植界共同面临的难题,寻找多渠道的供者器官来源成为器官移植界的当务之急.近日,关于"扩大可控型经循环标准确定死亡后器官捐献(cDCDD)实践的联合声明"受到学术界的广泛关注,该声明旨在推广cDCDD,以提高器官捐献率,以期实现移植自给自足的最终目标.本文将整理声明提及的重点内容,阐述经循环标准确定死亡后器官捐献(DCDD)的学术名称更新及相关讨论、DCDD的发展趋势、构成cDCDD临床路径的基本部分及影响实施cDCDD的关键因素,思考该声明对我国器官捐献事业可持续发展的启示.

Kunhao Bai Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China Rui Chen Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Hong Chu Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Lanxia Gan China Standard Medical Information Research Center, Shenzhen, China Bixia Gao Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Xiangxiang He China Standard Medical Information Research Center, Shenzhen, China Lili Liu Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Jianyan Long Clinical Trial Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China Ying Shi China Standard Medical Information Research Center, Shenzhen, China Zaiming Su Center for Data Science in Health and Medicine, Peking University, Beijing, China Xiaoyu Sun Center for Data Science in Health and Medicine, Peking University, Beijing, China Wen Tang Department of Nephrology, Peking University Third Hospital, Beijing, China Fang Wang Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Haibo Wang China Standard Medical Information Research Center, Shenzhen, China; and Center for Data Science in Health and Medicine, Peking University, Beijing, China Jinwei Wang Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Song Wang Department of Nephrology, Peking University Third Hospital, Beijing, China Yue Wang Department of Nephrology, Peking University Third Hospital, Beijing, China Chao Yang Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Feng Yu Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China; and Blood Purification Center of Nephrology Department, Peking University International Hospital, Beijing, China Dongliang Zhang Blood Purification Center of Nephrology Department, Peking University International Hospital, Beijing, China Hong Zhang Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China Luxia Zhang Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China; and Center for Data Science in Health and Medicine, Peking University, Beijing, China Minghui Zhao Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, China; and Peking-Tsinghua Center for Life Sciences, Beijing, China Xinju Zhao Department of Nephrology, Peking University People's Hospital, Beijing, China Liren Zheng Blood Purification Center of Nephrology Department, Peking University International Hospital, Beijing, China Zhiye Zhou China Standard Medical Information Research Center, Shenzhen, China Li Zuo Department of Nephrology, Peking University People's Hospital, Beijing, China Tabled 1CK-NET International Advisory Committee (alphabetically)Joseph CoreshHarold FeldmanDavid JayneVivek JhaAndrew LeveyAdeera LevinVlado PerkovicPierre RoncoRajiv SaranSydney TangCK-NET Domestic Advisory Committee (alphabetically)Menghua ChenJie DingPing FuDetian LiGuisen LiShaomei LiXinling LiangYunhua LiaoHongli LinJian LiuZhangsuo LiuYingchun MaYonghui MaoLuying SunCaili WangRong WangWeiming WangWenke WangXiaoqin WangChangying XingZuying XiongXudong XuDongmei XuXiangdong YangXiaoping YangFan YiYan ZhaAihua ZhangChun ZhangJinghong ZhaoYiming ZhaoQiaoling ZhouCK-NET Technical Advisory Committee (alphabetically)Kevin HeGuilan KongXiaohua Zhou Open table in a new tab Tabled 1e6Dedicatione7Abbreviationse8Prefacee10Analytical methodse10 Introductione10 Data sourcese10HQMS databasee10CHIRA databasee10CHI databasee10COTRS databasee10 Database definitionse10Identifying CKD patientse10Identifying dialysis patientse11Cardiovascular diseasee11Diabetese11Infectious diseasee11Clinical indicatorse11Vascular accesse11 Statistical methodse12Section I. Chronic kidney diseasee12Chapter 1. Identification and characteristics of hospitalized patients with CKDe12 1.1 Prevalence of CKD among different types of underlying diseasee14 1.2 Characteristics of CKDe16 1.3 Cause of CKDe18 1.4 Staging of CKDe20Chapter 2. Cardiovascular disease in hospitalized patients with CKDe20 2.1 Prevalence of CVD, stratified by patient groupe212.1.1 Prevalence of CHDe222.1.2 Prevalence of strokee232.1.3 Prevalence of heart failuree252.1.4 Prevalence of atrial fibrillatione26 2.2 Prevalence of CVD among patients with CKDe272.2.1 Prevalence of CHD among patients with CKDe282.2.2 Prevalence of stroke among patients with CKDe302.2.3 Prevalence of heart failure among patients with CKDe312.2.4 Prevalence of atrial fibrillation among patients with CKDe32 2.3 Cardiovascular procedures stratified by patient groupe332.3.1 Cardiovascular procedures: coronarographye342.3.2 Cardiovascular procedures: percutaneous coronary interventione362.3.3 Cardiovascular procedures: coronary artery bypass graftinge372.3.4 Cardiovascular procedures: pacemakere38 2.4 Cardiovascular procedures among patients with CKDe39Chapter 3. Health care resource utilization of hospitalized patients with CKDe39 3.1 Costse393.1.1 Overall medical care costs stratified by CKD, DM, and heart failuree403.1.2 Costs stratified by types of health insurancee403.1.3 Costs stratified by sexe413.1.4 Costs stratified by agee42 3.2 Length of staye423.2.1 Overall length of stay stratified by CKD, DM, and heart failuree423.2.2 Length of stay stratified by types of health insurancee433.2.3 Length of stay stratified by sexe443.2.4 Length of stay stratified by agee45Chapter 4. In-hospital mortality of hospitalized patients with CKDe45 4.1 In-hospital mortality rate stratified by CKD, DM, and heart failuree46 4.2 In-hospital mortality rate stratified by types of insurancee46 4.3 In-hospital mortality rate stratified by sexe47 4.4 In-hospital mortality rate stratified by agee48Chapter 5. Acute kidney injurye48 5.1 Characteristics of AKIe485.1.1 Sex distribution of AKI, stratified by agee495.1.2 Age distribution of AKI, stratified by sexe50 5.2 Percentage of AKIe51 5.3 Percentage of CKD and DM among patients with AKIe53Section II. End-stage kidney diseasee53Chapter 6. Prevalence, incidence, and characteristics of dialysis patientse57Chapter 7. Clinical measurement and treatment among dialysis patientse60Chapter 8. Vascular accesse62Chapter 9. Cardiovascular diseases and diabetes among dialysis patientse63Chapter 10. Hospitalizatione66Chapter 11. Medical expenditures for dialysis patientse68Chapter 12. Kidney transplant waiting liste74Chapter 13. Discussione75Referencese76Appendices: Definitions of ICD codinge76 Appendix 1 | Coding of various CKD etiologiese77 Appendix 2 | Coding of CKD stagese78 Appendix 3 | Coding of diabetes mellituse78 Appendix 4 | Coding of hypertensione78 Appendix 5 | Coding of CVDe80 Appendix 6 | Coding of CVD operationse81 Appendix 7 | Coding of AKI Open table in a new tab The China Kidney Disease Network (CK-NET), an initiative begun by the late Professor Hai-Yan Wang in 2014, is further developed in accordance with the national strategy of prompting big data application in China. Because surveillance systems for kidney disease are insufficient in China, CK-NET has provided resourceful information and benchmark data for kidney disease. For China, a country with large population and vast territory, prompt and effective integration and mining of existing databases could be a promising strategy to improve the management of kidney disease. Further, the excellent paradigm CK-NET has set up can serve as a model for other diseases. The establishment of CK-NET is the fruit of long-term preparation and unswerving effort. After the concept of chronic kidney disease (CKD) was proposed in 2002, epidemiological study of CKD soon started to be a hot topic all over the world. I am privileged to have the opportunity to bear witness to the important work and efforts of the team led by Professor Hai-Yan Wang over the past decade. Starting from a regional survey in Beijing in 2004 to a national multicenter cross-sectional study in 2012, and then to a large-scale population cohort study in 2014, CK-NET has provided invaluable data regarding the disease burden of CKD in China, which are extremely valuable but scarce in other developing countries. As big data emerges in recent years, new methodologies and technologies have brought new opportunities for research on CKD at the population level. Against this backdrop, Professor Ming-Hui Zhao and Professor Luxia Zhang have led the CK-NET team to embark on tremendous innovative and creative tasks, such as building a team composed of nephrologists, epidemiologists, and statisticians as well as setting up a platform for data integration and sharing, efforts that greatly promoted the application of big data in the field of nephrology. The Annual Data Report (ADR) regarding kidney disease is the major output of CK-NET. The first ADR of CK-NET, which was published in 2017, focused on mostly pre-dialysis hospitalized patients in China. It is exciting to see that information regarding dialysis patients was included in this year’s ADR. This is a gift that allows China and the rest of the world to have a comprehensive understanding of characteristics and trends of kidney disease with limited resources. As the former president of the Chinese Society of Nephrology, it is my strong belief that CK-NET is a great initiative, and its contribution is a milestone for kidney disease management, prevention, and control. The ADR presented here shall provide nephrologists and health policy makers new insights into current the status of kidney disease in China. As depicted in an old Chinese poem, “10 years of effort it takes to grind this sword.” CK-NET, facilitated by big data, is developing rapidly on the solid foundation laid by its predecessors. Xue-Qing Yu, MD, PhD Former Chairman, Chinese Society of Nephrology Department of Nephrology Guangdong Provincial People’s Hospital Guangdong Academy of Medical Science Guangzhou, Guangdong, China Tabled 1ADRAnnual Data ReportAFatrial fibrillationAKIacute kidney injuryAMIacute myocardial infarctionAVFarteriovenous fistulaAVGarteriovenous graftCABGcoronary artery bypass graftingCADcoronary artery diseaseCAGcoronarographyCHDcoronary heart diseaseCHIcommercial health insuranceCHIRAChina Health Insurance ResearchCKDchronic kidney diseaseCK-NETChina Kidney Disease NetworkCOTRSChina Organ Transplant Response SystemCTINchronic tubulointerstitial nephritisCVAcerebrovascular accidentCVCcentral venous catheterCVDcardiovascular diseaseDKDdiabetic kidney diseaseDMdiabetes mellitusEPOerythropoietinESKDend-stage kidney diseaseFFBIFistula First Breakthrough InitiativeGNCKD due to glomerulonephritisHbA1chemoglobin A1cHDhemodialysisHFheart failureHQMSHospital Quality Monitoring SystemHThypertensionHTNhypertensive nephropathyIBNRincurred but not reportedICDInternational Classification of DiseasesICUintensive care unitIQRinterquartile rangei.v.intravenousLOSlength of stayMBDmineral and bone disorderNCCnoncuffed catheterNRCMSnew rural co-operative medical careONobstructive nephropathyPADperipheral arterial diseasePCIpercutaneous coronary interventionPDperitoneal dialysisPMPper million populationPPPYper person per yearPTHparathyroid hormoneRMBrenminbiSDstandard deviationTCCtunneled cuffed catheterTIAtransient ischemic attackUBMIurban basic medical insuranceUSRDSUnited States Renal Data SystemVAvascular access Open table in a new tab Chronic kidney disease (CKD) has received increased attention as a leading public health problem worldwide. Along with the rapid growth of economy and gradual changes of lifestyle, China is facing an ever-increasing burden of CKD. However, the lack of a national surveillance system for kidney disease and unmet need for nephrology research in China have become an obstacle to develop effective preventive strategies. The emergence and development of big data provided a unique opportunity to address the burden of CKD in China. After long-term planning, China Kidney Disease Network (CK-NET) was founded based on previous nationwide epidemiological studies regarding kidney disease led by Peking University First Hospital and the collaboration network involving 59 large renal centers in China (Figure 1). The mission of CK-NET is, by integrating various sources of data involving kidney disease in China and utilizing cutting-edge data analytics, to provide data-based evidence for health care policy, strengthen academic research, and promote effective disease management in the field of nephrology. In 2017, CK-NET released its first publication of an Annual Data Report (ADR), which provided useful and substantial information regarding CKD. It was published in a supplement to the American Journal of Kidney Diseases.1Zhang L. Wang H. Long J. et al.China Kidney Disease Network (CK-NET) 2014 Annual Data Report.Am J Kidney Dis. 2016; 69: S1-S149Google Scholar This year marks the second publication of a CK-NET ADR. Based on the Hospital Quality Monitoring System (HQMS), which is also the data source of the first ADR, this year’s ADR describes 887,816 hospitalized patients with CKD in 2015. Compared with the first ADR, contents that are less relevant to international readers have been deleted and certain parts (especially the cardiovascular chapter) have been enriched in the second ADR. Acute kidney injury, as an important topic, is described in a separate chapter. Furthermore, 2 more nationwide claims databases, the China Health Insurance Research (CHIRA) database and commercial health insurance (CHI) database, were included and provided information regarding dialysis in China, which enriched the contents of the ADR substantially. Seven chapters were included to provide a better understanding of end-stage kidney disease (ESKD) in China. The strengths of the second CK-NET ADR include a large patient sample size, stringent data quality control during data collection, and maximum utilization of multiple-source data. However, several points should be considered when interpreting the results in the second CK-NET ADR. First, selection bias cannot be ruled out because of limitations in data sampling. Second, International Classification of Diseases (ICD) coding is used to define CKD and certain other diseases likely with low sensitivity and high specificity, which may be influenced by various diagnostic criteria and coding procedures. Finally, the current ADR includes only cross-sectional data, making causal inference difficult. A brief interpretation is included in each chapter to facilitate understanding of the contents. The second CK-NET ADR symbolizes a successful research effort in the era of big data. It uses the platform built by the National Health Commission of the People’s Republic of China, with support from the specialists of Peking University and its affiliated hospitals. The innovative collaborative model will bring inspiration and substantial changes to health service and medical research in China. Publication of this article was supported by Peking University. All the authors declared no competing interests. We thank the National Health Commission of China, China Health Insurance Research Association, China Organ Transplantation Development Foundation, Peking University, and China Standard Medical Information Research Center for support of this study. We thank CK-NET collaborating centers, members, and volunteers for their hard work and efforts. We thank every participant who has contributed important and invaluable data to CK-NET.

This work was supported by the China-WHO Biennial Collaborative Projects 2014-2015, under the project name "Research on the Monitoring, Evaluation, and Improvement of National Medical Service in China" (WHO reference 2014/435380-0; responsible department: Bureau of Medical Administration and Medical Service Supervision, National Health and Family Planning Commission; implementing unit: China Standard Medical Information Research Center); the National Key Technology R&D Program of the Ministry of Science and Technology (2011BAI10B01); and the Beijing Science and Technology Committee (D131100004713007).Suggested CitationZhang L, Wang H, Long J, et al. China Kidney Disease Network (CK-NET) 2014 Annual Data Report. Am J Kidney Dis. 2017;69(6)(suppl 2):S1-S149. Zhang L, Wang H, Long J, et al. China Kidney Disease Network (CK-NET) 2014 Annual Data Report. Am J Kidney Dis. 2017;69(6)(suppl 2):S1-S149.

In this letter, the authors report that chronic kidney disease related to diabetes has become increasingly common both in the general population and among hospitalized urban patients in China, a finding that is preceded by decades of increasing prevalence of type 2 diabetes.