The need for a prefecture-wide children support framework in the prevention of chronic kidney disease

The school-based proteinuria and hematuria screening program has contributed to the reduction of end-stage renal failure in children. A survey conducted on the state of this program in twenty-seven municipalities in Okayama revealed that regional medical committee participation in the program had only occurred in Kurashiki city. Cases of diabetic nephropathy and hypertensive nephrosclerosis, conditions which progress to end-stage renal failure in adulthood, are rapidly increasing. In order to prevent this, not only is the screening of type two diabetes essential, but also intervention in cases of obese or emaciated children and the introduction of health education for adolescents. To achieve this, a children support framework for the prevention of a progression to chronic kidney disease (CKD) needs to be established, which incorporates a network consisting of regional physicians, working with schools in the prefecture. This network would be prefecture-wide and facilitate the quality improvement of child health, supervised by various field pediatric specialists including pediatric nephrologists. The introduction of an ID-based system, security system and an information network is expected to achieve results and increase the efficiency of care in rural areas of the prefecture. The knowledge gathered as a result of this system would enable the creation of public health policy and medical guidelines.