The International Society of Nephrology (ISN) 2021 Annual Meeting was concluded in Canada on April 19, 2021 local time. It was announced that Professor Yu Xueqing from Guangdong Provincial People’s Hospital was elected as the Executive Director of the 26th International Society of Nephrology. This is another very important international academic position following Professor Yu’s appointment as President of the International Society for Peritoneal Dialysis in 2020, highlighting the rising academic status and influence of Chinese nephrology in the international academic community.

Professor Yu said that this appointment was not only a recognition of his work by ISN and the experts, but also an acknowledgment of China’s development and progress in nephrology. He will spare no efforts in performing his duties to promote the Guangzhou Model and Chinese experience in nephrology, making innovation for and leading the development of international nephrology.

Founded in 1960, the International Society of Nephrology is a top-level academic organization of the global nephrology community, working toward a future where all people have equitable access to sustainable kidney health. It bridges the gaps of available care through advocacy and collaboration with the global partners; builds capacity in healthcare professionals via granting programs, education and research; connects the kidney disease community to develop a stronger understanding of the management of chronic kidney disease. Its members come from 126 countries and regions, undertaking basic and clinical research on kidney disease, continuing education, training of nephrologists, international exchange and cooperation, evaluation of major achievements, and publication of international nephrology journals.

The Guangzhou Model addresses the key problem of low accessibility and high dropout rate of peritoneal dialysis (PD) due to irregular management of PD centers and shortage of primary PD medical and nursing staff. It innovatively proposes a management model with high-quality PD centers as the core and reference, i.e., the "Guangzhou Model" where high-level PD centers are taken as the core, and assistance and guidance are offered to primary PD satellite centers for improvement. This program was first launched in Guangdong Province, and was then expanded to other parts of southern China and later to the whole country. It has achieved significantly improved the level and capacity of PD medical staff in the rural areas, and increased the number and quality of PD centers of primary hospitals all over China. The successful experience was reported by The LANCET and written into international guidelines.

In 2006, a new model of PD center management and standardized PD operation procedures were initiated, and the number of patients followed up has increased from 297 in 2005 to over 1,000 in 2012. It is currently one of the largest PD centers in the world. Catheter intact rate of 1-year PD patients reached 94%; 1-, 2-, 3-, and 5-year patient survival rates reached 94%, 87%, 81%, and 64% respectively; technical survival rates were 98%, 95%, 91%, and 86% respectively; and the average peritonitis incidence fell to 1 episode in 68.5 patient/months. Clinical outcomes were significantly improved for elderly patients, diabetics, patients transitioning from hemodialysis to PD, and PD patients receiving remote treatment.

Invited by The LANCET, the PD center shared it successful operation experiences, which include (1) a well-trained and committed PD team; (2) standardized catheter insertion and management process; (3) well-designed patient training program; (4) comprehensive follow-up procedures; (5) continuous quality improvement and re-evaluation; and (6) high-quality, clinical question-driven research (http://thelancet.com/campaigns/kidney/updates/how-to-set-up-pd-centres-the-chinese-perspective).

In 2008, the Guangdong Province Peritoneal Dialysis Satellite Center Program, with the First Affiliated Hospital of Sun Yat-sen University as the center and 12 prefectural and municipal hospitals in Guangdong Province as sub-centers, was launched with the aim of expanding the quality management model of the above-mentioned PD centers to the whole province. The number of patients in primary hospital PD centers that participated in the project for only one year increased by 84.2%; the peritonitis incidence decreased by 38.9%.

In 2012, the number of partner hospitals continued to enlarge, with 29 hospitals from 11 provinces and autonomous regions in South China joining the Satellite Center Collaborative Group, offering much better medical services to more local PD patients.

In 2013, a national training program for county-level hospitals was launched, and as of December 2019, 6,164 medical and nursing staff were trained, covering 2,904 primary hospitals in 30 provinces/autonomous regions. This has significantly promoted PD technologies and quality in Chinese primary hospitals, strengthening the local capacities in major diseases treatment. Driven by government departments and societies, the number of PD patients in China grew from 37,942 in 2012 to 94,896 in 2018.

In 2020, under the leadership of Professor Yu, Guangdong Provincial People's Hospital led the intelligent management of peritoneal dialysis program and established the Smart Peritoneal Dialysis Center. Aiming at the important strategy of digital villages in rural revitalization, the intelligent management of peritoneal dialysis program was launched in the Smart Peritoneal Dialysis Center of Guangdong Provincial People's Hospital as a pilot program to construct the smart PD chronic disease management system. It provides one-stop services for uremic patients, including pre-screening, dialysis, patient education and rehabilitation, and provides an intelligent management platform for the whole process of diagnosis and treatment from hospital to home, so as to alleviate the difficulty for patients in remote areas in receiving hemodialysis, reduce their dependence on hospital operations, and allow them to enjoy the same quality treatment as the urban citizens.