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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
Reflex Control of the Circulation presents an interdisciplinary discussion of concepts in the reflex control of circulation. This volume describes aspects of autonomic receptor physiology, central pathways of reflex control, the electrophysiology of cardiovascular afferents, the interaction between reflexes, the autonomic control of regional blood flows, the autonomic control of fluid and electrolyte balance, and neurohumoral control of the circulation through normal and pathological states (e.g., hypertension, congestive heart failure). In addition, the regulation of regional blood flow during exercise and developmental aspects of reflex control are examined. Any researcher interested in the autonomic system and its role in circulation will find this book fascinating reading.
Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.
Hypertension remains the leading cause of cardiovascular morbidity and mortality in spite of current medical therapies. It has been estimated that 50% of Western civilization has hypertension and approximately 20% of patients have resistant hypertension. Renal denervation (RDN) is a minimally invasive, endovascular catheter based procedure using radiofrequency ablation aimed at treating resistant hypertension. Early studies show a high degree of effectiveness in renal denervation to treat hypertension. This book examines renal pathophysiology and the rationale for renal denervation, as well as possible long term benefits and risks of this new therapy. The myriad of devices involved in the evolution of this therapy are discussed and the book concludes with analyses of the cost effectiveness and future applications.
Basic Physiology is an introduction to vertebrate physiology, stressing human physiology at the organ level, and includ ing requisite anatomy integrated with function. One chapter deals solely with topographic anatomy in atlas form and microscopic anatomy of the principal tissues of the body. Additional chapters cover cellular and general physiology; nervous system, muscle; blood and tissue fluids, heart and circulation; respiration, digestion and absorption; intermedi ary metabolism; energy metabolism; temperature regulation; nutrition; kidney; endocrinology, including hypophysis, re production; thyroids, parathyroids, adrenals and pancreas. All concepts are emphasized and well illustrated, and con troversial material is omitted. It is written at a level suited to undergraduate students who have had introductory courses in biology, chemistry, and mathematics, and to more ad vanced students who wish to review the basic concepts of physiology. This volume should be especially useful as a text for de partments of biology, zoology, nursing, health, and agricul tural sciences that offer courses in vertebrate and human physiology. Basic Physiology is written by seven subject matter special ists who have considerable experience in teaching their specialty to undergraduates studying physiology and biology.
This book introduce neurourology as an emerging interdisciplinary area that covers the basic and clinical studies of the neural control on the normal lower urinary tract and the lower/upper urinary tract dysfunction due to neuropathy disorders. It systematically describes all aspects of neurourology from the epidemiology of the neurogenic bladder; to the pathology and pathophysiology of the lower urinary tract; to the diagnosis and treatment of the neurogenic bladder by conservative therapies or surgeries. This book provides a useful resource for medical doctors, nurses and students in the field of neurourological conditions. All the topics are written by internationally recognized specialists in their field.
This book presents up-to-date information on the clinical-pathophysiological features of acute renal injury and discusses the KDIGO diagnostic criteria, as well as novel experimental findings, including in the area of regenerative medicine. It also highlights the clinical-pathophysiological importance of AKI in clinical settings, including differential diagnoses and management of AKI. In the past, the pathology associated with sudden renal impairment was characterized as acute renal failure (ARF). However, in the 2000s, the joint efforts of specialists in fields including nephrology, intensive care medicine, and cardiovascular medicine led to the introduction of a novel concept known as acute kidney injury (AKI). As medical care progressed, patients such as high-risk elderly subjects who were not deemed to be candidates for invasive therapy came to be treated in intensive care units (ICUs). As a result, kidney injury as a subset of multiple organ failure was re-considered as AKI, especially in intensive care medicine. AKI was then proposed as a novel disease concept to emphasize the importance of early diagnosis and early intervention to improve prognosis.Presenting novel features, such as the definition of AKI, risk factors and management; biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL) and L-type fatty acid-binding protein (L-FABP); long-term outcomes of AKI; as well as renal regeneration using iPS cell, manipulation of embryonic genes, and Xenotransplanted embryonic kidney, this book is of interest to all physicians and researchers in this field around the globe.
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.
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