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Known worldwide, chronic kidney disease (CKD) is a disease that affects up to 4% of the population with increasing figures also in the developing countries. Life expectancy of patients affected by CKD is shortened compared to the overall population, and only a minority of patients reach end-stage renal disease (ESRD) with the need for dialysis or renal transplantation; death overtakes dialysis. In the 13 chapters, this book sheds light on the different aspects related to pathophysiology and clinical aspects of CKD, providing interesting insights into not only inflammation and cardiovascular risk but also the interplay of hormones and the functional aspects of endothelial function. In addition, chapters dealing with genetic aspects of polycystic kidney disease and also the clinical handling of patients with CKD and peritoneal dialysis will be beneficial for the open-minded reader.
The present book contains the Proceedings of a two day Symposium on Uremic Toxins organized at the University of Ghent in Belgium. A series of guest lectures, free communications and posters have been presented. An international audience of 163 scientists from 16 nationalities listened to and discussed extensively a spectrum of topics brought forward by colleagues and researchers who worked for many years in the field of Uremic Toxins. There is a striking contrast between all the new dialysis strategies available in the work to "clean" the uremic patients and the almost non-progression of our knowledge on uremic toxins in the past decade. In this sense the symposium was felt by all participants as a new start for the research in the biochemical field of the definition of uremia. If the present volume would stimulate new work in this field in order to define uremia, or identify the uremic toxins, the purpose of the organizers would be maximally fulfilled.
Cardiac disease is the major cause of death in dialysis patients, accounting for over one third of deaths. This book focuses on myocardial function and dysfunction in chronic uremia. It is aimed at practicing and training nephrologists, cardiologists, and internists, and at research workers in the field. We have tried to produce an up-to-date, in-depth review of the subject by inviting experts in clinical epidemiology, pathophysiology, and thera peutics to write the 18 chapters. The book is divided into three sections. The first section comprises five chapters that provide an overview of the burden of illness associated with cardiac disease in end-stage renal disease and a review of clinical epidemi ological aspects of various cardiac diseases that occur in renal patients. The second section discusses abnormalities of left ventricular contractility and mass, and the factors that predispose to both systolic and diastolic disorders. The importance of hypertension, anemia, hyperparathyroidism, hyper lipidemia, and diabetes mellitus in predisposing to these abnormalities is reviewed splendidly by researchers active in these areas. The final section concentrates on therapeutics. Data and opinion on management of congestive heart failure, cardiomyopathy, coronary artery disease, hypertension, and arrhythmias are provided. In editing this book, we have reviewed an extensive literature, but un fortunately we have become more aware that substantial gaps in our knowl edge exist. Insufficient high-quality clinical research has been undertaken xiii xiv Preface regarding the various cardiac diseases that occur in end-stage renal disease.
This fourth edition of the Oxford Textbook of Clinical Nephrology builds on the success and international reputation of the publication as an important resource for the practising clinician in the field. It provides practical, scholarly, and evidence-based coverage of the full spectrum of clinical nephrology, written by a global faculty of experts. The most relevant and important reference to clinical nephrology, this is an authoritative and comprehensive textbook combining the clinical aspects of renal disease essential to daily clinical practice with extensive information about the underlying basic science and current evidence available. Each section of the textbook has been critically and comprehensively edited under the auspices of a leading expert in the field. This new edition has been significantly expanded and reapportioned to reflect developments and new approaches to topics, and includes treatment algorithms to aid and enhance patient care where possible. The fourth edition offers increased focus on the medical aspects of transplantation, HIV-associated renal disease, and infection and renal disease, alongside entirely new sections on genetic topics and clinical and physiological aspects of fluid/electrolyte and tubular disorders. The emphasis throughout is on marrying advances in scientific research with clinical management. Richly illustrated throughout in full colour, this is a truly modern and attractive edition which reinforces the Oxford Textbook of Clinical Nephrology's position as an indispensable reference work of consistent quality and reliability. Enriched and refined by careful revision, this new edition continues the tradition of excellence. This print edition of The Oxford Textbook of Clinical Nephrology comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables. Oxford Medicine Online is mobile optimized for access when and where you need it.
The product of 15 years of intense collaborative research, this book explains the use of the pressure-volume diagram in evaluating cardiac performance. The authors describe the similarities between the ventricular pressure-volume relationship and the muscle tension-length relationship. The effects of various physiological mechanisms and pharmacological interventions are examined, as are the energetics of ventricular contractions and the hemodynamics of the entire circulatory system.
Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia –related processes. This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.
Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and organ death? Even if we have a positive biomarker pattern and we can identify patients at risk or patients with early or even subclinical AKI, how is this information affecting our clinical behavior and practice? The second part is dedicated to the appraisal of the current knowledge about the pathophysiological mechanisms involved in different forms of CRS: it contains contributions on the state-of-the-art knowledge and practice of CRS, particularly focusing on the pathophysiology of the five subtypes. Acute and chronic mechanisms of damage are explored in depth, with particular attention to the primacy of organ involvement and the subsequent pathways of organ crosstalk.Presenting the most recent research in the field of biomarkers, AKI and CRS, this publication is an important educational tool for advanced investigators and clinical experts, but also for students and fellows.
**Selected for Doody's Core Titles® 2024 in Transplantation Surgery** From basic science to practical clinical tools, Chronic Kidney Disease, Dialysis, and Transplantation, 4th Edition provides you with the up-to-date, authoritative guidance you need to safely and effectively manage patients with chronic renal disease. Covering all relevant clinical management issues, this companion volume to Brenner and Rector's The Kidney presents the knowledge and expertise of renowned researchers and clinicians in the fields of hemodialysis, peritoneal dialysis, critical care nephrology, and transplantation – for an all-in-one, indispensable guide to every aspect of this fast-changing field. - Contains expanded content on economics and outcomes of treatment, as well as acute kidney injury. - Covers hot topics such as the genetic causes of chronic kidney disease, ethical challenges and palliative care, and home hemodialysis. - Discusses the latest advances in hypertensive kidney disease, vitamin D deficiency, diabetes management, transplantation, and more. - Provides a clear visual understanding of complex information with high-quality line drawings, photographs, and diagnostic and treatment algorithms. - Expert ConsultTM eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
Despite constant significant advances, cardiovascular as well as more general outcomes of hemodialysis treatment remain unsatisfactory. The introduction of innovative 'high retention onset' membranes has led to the development of a new treatment modality called 'expanded hemodialysis' (HDx), which is the focus of this book. This new therapy is likely to benefit end-stage kidney disease patients, thanks to enhanced removal of molecules retained by current dialysis techniques. HDx is simple to set up and application does not require special hardware or specific nursing skills. This book contains emerging evidence and fascinating new hypotheses on HDx. It is highly recommended for all physicians and healthcare professionals who are caring for dialysis patients and are seeking innovation and improved care solutions. It will also be of considerable interest to students and fellows.
A complete clinically focused guide to managing the full spectrum of kidney diseases and hypertension A Doody's Core Title! "an up-to-date, accessible guide that covers all major clinical aspects of the adult patient with diseases involving the kidneys and hypertension. Numerous figures and tables are well integrated into structured chapters creating an easy flow of information that helps readers capture key points....In contrast to many other books in this area, this one provides a concise yet comprehensive review of each topic without getting lost in too much detail that interested readers can find in other places. It is a clinically useful tool for anybody interested in the field....Given its concise but comprehensive structure, this book is a great resource for students and residents who want to review basic physiology and pathophysiology but also get up-to-date information on diagnosis and therapy. The wide range of topics also makes it a useful tool for any clinicians at a more senior level who want to quickly review a particular subject. Lastly, due to its easily accessible structure, patients and families seeking medical information also might find it useful. 3 Stars."--Doody's Review Service Presented in the consistent, easy-to-follow CURRENT style, CURRENT Diagnosis & Treatment Nephrology & Hypertension offers incisive, ready-to-use management protocols and valuable therapeutic guidelines -- from authors who are recognized as the field's foremost authorities. Accessible, concise, and up-to-date, CURRENT Diagnosis & Treatment Nephrology & Hypertension features: One-of-a-kind clinical overview of all major diseases and disorders, from end-stage renal disease to primary and secondary hypertension A practical, learn-as-you-go approach to diagnosing and treating renal disorders and hypertension that combines disease management techniques with the latest clinically proven therapies Up-to-date coverage of transplantation medicine and need-to-know interventional procedures An important review of subspecialty considerations: renal disease in the elderly, diabetic nephropathy, critical care nephrology, and dialysis Expert authorship from prominent clinicians in the areas of kidney disease, dialysis, and hypertension