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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.
Easily understood, up-to-date and clinically relevant, this book provides junior anaesthetists with an essential physiology resource.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
The kidney is innervated with efferent sympathetic nerve fibers reaching the renal vasculature, the tubules, the juxtaglomerular granular cells, and the renal pelvic wall. The renal sensory nerves are mainly found in the renal pelvic wall. Increases in efferent renal sympathetic nerve activity reduce renal blood flow and urinary sodium excretion by activation of α1-adrenoceptors and increase renin secretion rate by activation of β1-adrenoceptors. In response to normal physiological stimulation, changes in efferent renal sympathetic nerve activity contribute importantly to homeostatic regulation of sodium and water balance. The renal mechanosensory nerves are activated by stretch of the renal pelvic tissue produced by increases in renal pelvic tissue of a magnitude that may occur during increased urine flow rate. Activation of the sensory nerves elicits an inhibitory renorenal reflex response consisting of decreases in efferent renal sympathetic nerve activity leading to natriuresis. Increasing efferent sympathetic nerve activity increases afferent renal nerve activity which, in turn, decreases efferent renal sympathetic nerve activity by activation of the renorenal reflexes. Thus, activation of the afferent renal nerves buffers changes in efferent renal sympathetic nerve activity in the overall goal of maintaining sodium balance. In pathological conditions of sodium retention, impairment of the inhibitory renorenal reflexes contributes to an inappropriately increased efferent renal sympathetic nerve activity in the presence of sodium retention. In states of renal disease or injury, there is a shift from inhibitory to excitatory reflexes originating in the kidney. Studies in essential hypertensive patients have shown that renal denervation results in long-term reduction in arterial pressure, suggesting an important role for the efferent and afferent renal nerves in hypertension. Table of Contents: Part I: Efferent Renal Sympathetic Nerves / Introduction / Neuroanatomy / Neural Control of Renal Hemodynamics / Neural Control of Renal Tubular Function / Neural Control of Renin Secretion Rate / Part II: Afferent Renal Sensory Nerves / Introduction / Neuroanatomy / Renorenal Reflexes / Mechanisms Involved in the Activation of Afferent Renal Sensory Nerves / Part III: Pathophysiological States / Efferent Renal Sympathetic Nerves / Afferent Renal Sensory Nerves / Conclusions / References
Experts in the field of renal disease offer careful pathologic descriptions, appropriate clinical correlations, and extensive discussions on causes and pathogenesis to clarify the clinicians understanding and help facilitate easy, accurate diagnosis. This updated edition features hundreds of razor-sharp illustrations along with more international contributors than before.
Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.
A classic nephrology reference for over 20 years, Seldin & Giebisch's The Kidney, is the acknowledged authority on renal physiology and pathophysiology. The fourth edition follows the changed focus of nephrology research to the study of how individual molecules work together to affect cellular and organ function, emphasizing the mechanisms of disease. With over 40 new chapters and over 1000 illustrations, this edition offers the most in-depth discussion anywhere of the physiologic and pathophysiologic processes of renal disease. Comprehensive, authoritative coverage progresses from molecular biology and cell physiology to clinical issues regarding renal function and dysfunction. If you research the development of normal renal function or the mechanisms underlying renal disease, Seldin & Giebisch's The Kidney is your number one source for information.* Offers the most comprehensive coverage of fluid and electrolyte regulation and dysregulation in 51 completely revised chapters unlike Brenner & Rector's The Kidney which devotes only 7 chapters to this topic.* Includes 3 sections, 31 chapters, devoted to regulation and disorders of acid-base homeostasis, and epithelial and nonepithelial transport regulation. Brenner & Rector's only devotes 5 chapters to these topics.* Previous three editions edited by Donald Seldin and Gerhard Giebisch, world renowned names in nephrology. The title for the fourth edition has been changed to reflect their considerable work on previous editions and they have also written the forward for this edition. * Over 20 million adults over age 20 have chronic kidney disease with the number of people diagnosed doubling each decade making it America's ninth leading cause of death.
A comprehensive and authoritative survey of recent findings, ideas, and hypotheses about the causes and treatment of diabetic nephropathy. The authors cover both the basic pathogenic mechanisms of the disease, as well as many of its clinical aspects of identification, management, and new therapeutic approaches. Highlights include an entire section devoted to novel approaches to studying diabetic nephropathy with the most advanced molecular techniques, and complete descriptions of the most up-to-date views on the diagnosis and treatment of the disease. The Diabetic Kidney offers both researchers and practicing clinicians a clear understanding of the of the progress that has been made regarding the pathogenesis of diabetic nephropathy and of the therapeutic interventions needed to prevent its development or treat it.