Based on clinical evidence based medicine and organizational management model, investigators redesign the prevention and treatment of chronic kidney disease of public health system in Shanghai China. The investigators hope to find early chronic kidney disease, prevention and clinical intervention of orderly combination. The advantages of this system were confirmed by comparing the prevalence rate, awareness rate and treatment rate before and after the completion of the system.

The whole study mainly includes the following parts:

1. Establishment of a database of patients with kidney disease, and training data entry specialist in every center.
2. Conduct propaganda of kidney disease knowledge, training professional doctors in center hospital and community hospital.
3. Search for high-risk patients, and screening for patients with kidney disease from community residents in community hospital.
4. Establishment of a standardized and orderly patient referral process from community hospital to center hospital or three level of first-class hospital.

Inclusion Criteria:

• Over 18 years of age.
• Signed informed consent

Exclusion Criteria:

• Refused to accept the blood and urine test

The residents in Jing'an District and Minhang District, which medical services are provided by those collaborative Community Health Service Center.