Physician Assistant Clinics aims to provide an authoritative and continuously updated clinical information resource that covers all of the relevant PA specialties. Our clinical review articles address the key points, diagnosis, prognosis, clinical management, and complications of disease and techniques, evidence, and controversies in the field. Information for quick reference, as well as in-depth coverage of a topic, is a hallmark of the Clinics' series. This issue of Physician assistant Clinics, guest edited by Kim Zuber, PA-C and Jane S. Davis, DNP, CRNP, brings together expert PAs, NPs, and MDs to give PAs deep insights into the latest advancements in renal disease and show how they are applicable in practice. Articles in this issue include: Will the Real Kidney Patient Please Stand Up?; Introduction of the Kidney Patient; The Surgical Kidney Patient; CardioRenal: The Pump and the Filter; Dosing the Kidney Patient; ABCs of the ICU; Pediatrics: Forgotten Stepchild of Nephrology; Acute Kidney Injury (AKI); Outpatient Management of the CKD Patient; Nephrolithiasis: The Rolling Stones; Transplant and the New Protocols; Health Disparities in Kidney Disease; and Diet and the Kidney.

This book tells the extraordinary story of how the function of the first - and so far almost the only - human organ was replaced by a machine, and the "artificial kidney" entered medical and public folk-lore. A practical artificial kidney, or dialyser, came about by advances in science followed by the acquisition of new synthetic materials which made the application of these ideas possible. However it was the dedication and persistence of a number of talented pioneers who pressed ahead against professional opposition to achieve success, first in the treatment of temporary, recoverable kidney failure, and then permanent renal shut-down which made it a success. The apparent high cost and limited availability of this form of treatment immediately raised ethical questions which had never been questioned before, centering around equity of access to treatment, when and if treatment could be denied, and - worst of all - the agonising decision of when, once established, it should be stopped. Spiralling costs as the true number of people with kidney failure became evident raised major political and financial questions, which were addressed in different countries in different ways which reflected - but also helped change - patterns of how medical care is provided. In developed countries, the problem could be solved by allocating a disproportionate amount of money to the treatment of relatively few kidney patients, but in the developing world the cost of treatment still limits its availability, as it does all forms of modern health care. Nevertheless, today almost one million people world-wide are maintained alive following terminal kidney failure, two thirds of them by various forms of dialysis and the remainder bearing kidney transplants, almost always placed after a period on dialysis. The story is also the sum of the often heroic lives of these hundreds of thousands of patients, a few of whom have today been maintained alive and active for more than 35 years, and many of whom suffered known, but also unexpected complications as a result of their treatment.

Nutritional Management of Renal Disease, Fourth Edition, offers in-depth reviews of the metabolic and nutritional disorders prevalent in patients with renal disease and serves as an in-depth reference source concerning nutrition and kidney disease. This classic translational reference provides correct diagnosis - and therefore correct treatment - of renal, metabolic, and nutritional disorders. Nephrologists, diebetologists, endocrinologists, dieticians, and nutritionists depend on a strong understanding of the molecular basis for the disease. This fourth edition includes thorough new case reports, offering expert advice on how to use the latest research and clinical findings in counseling patients about dietary and lifestyle options. Readers gain insight into which treatments, medications, and diets to use based on the history, progression, and genetic make-up of a patient.

Methods in Kidney Cell Biology, Volume 153, represents state-of-the-art techniques in renal research that are ideal for veterans, graduate students, postdoctoral fellows, and clinical scientists and principal investigators. Topics in the new release include Single glomerular proteomics - a novel method in translational glomerular cell biology, Measurement of cytosolic and intraciliary calcium in live cells, Differentiation of human kidney organoids from pluripotent stem cells, Quantifying autophagic flux in kidney tissue using structured illumination microscopy, the Generation of primary cells from ADPKD and normal human kidneys, ADPKD cell proliferation and Cl-dependent fluid secretion, In vitro cyst formation of ADPKD cells, and much more.

Edited and written by top experts and pioneers in dialysis, Handbook of Dialysis Therapy, 6th Edition, provides the entire dialysis team with a comprehensive overview of this growing field. It covers traditional and advanced procedures, what pitfalls to expect and how to overcome them, and how best to treat various patient populations-all with a practical approach that can be directly applied to patient care. This must-have resource has been updated with the latest cutting-edge technology, dialysis techniques, and complications related to various diseases for both pediatric and adult patients. Explains complex dialysis concepts through abundant diagrams, photos, line drawings, and tables, while its readable, hands-on approach allows for quick review of key information. Covers both adult and pediatric patients in detail, and offers guidance on special populations such as the geriatric patients and the chronically ill. Features increased content on home-based dialysis modalities, new alternatives for establishing vascular access for hemodialysis, new protocols for reducing the risk of infection and complications, and advancements in establishing and managing peritoneal dialysis. Includes extensive pediatric content such as prevention and treatment of bone disease, management of anemia, assessing quality of life in pediatric patients undergoing dialysis, and immunizations in children undergoing dialysis. Defines the quality imperatives, roles, and responsibilities of dialysis facility medical directors and attending nephrologists. Updates nephrologists on the latest alternative dialysis modalities. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

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 1-adrenoceptors and increase renin secretion rate by activation of 1-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. Under normal conditions, the renal mechanosensory nerves activated by stretch 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.

Biomarkers of Kidney Disease, Second Edition, focuses on the basic and clinical research of biomarkers in common kidney diseases, detailing the characteristics of an ideal biomarker. The latest techniques for biomarker detection, including metabolomics and proteomics are covered in the book. This comprehensive book details the latest advances made in the field of biomarker research and development in kidney diseases. The book is an ideal companion for those interested in biomarker research and development, proteomics and metabolomics, kidney diseases, statistical analysis, transplantation, and preeclampsia. New chapters include biomarkers of cardiovascular disease in patients with CKD, biomarkers of Polycystic Kidney Disease, and biomarkers and the role of nanomedicine.

Progression of chronic diseases in general and chronic kidney disease in particular has been traditionally viewed in the light of various contributors to development of glomerulosclerosis and tubulointerstitial scarring culminating in renal fibrosis. Indeed, this dogma prevailed for decades underscoring experimental attempts to halt fibrotic processes. Breakthrough investigations of the past few years on stem/progenitor cell involvement in organ regeneration caused a conceptual shift in tackling the mechanisms of nephrosclerosis. It has become clear that the rate of progression of chronic kidney disease is the net sum of the opposing trends: degenerative fibrotic processes and regenerative repair mechanisms. The latter part of this equation has been by and large ignored for years and only recently attracted investigative attention. This book revisits the problem of kidney disease by focusing on regenerative mechanisms in renal repair and on the ways these regenerative processes can become subverted by an intrinsic disease process eventuating in its progression. Cutting-edge investigations are summarized by the most experienced international team of experts.

Kidney Development, Disease, Repair and Regeneration focuses on the molecular and cellular basis of kidney development, exploring the origins of kidney lineages, the development of kidney tissue subcompartments, as well as the genetic and environmental regulation of kidney development. Special coverage is given to kidney stem cells and possible steps towards kidney repair and regeneration. Emphasis is placed on the fetal origins of postnatal renal disease and our current understanding of the molecular basis of damage and repair. Biomedical researchers across experimental nephrology and developmental biology will find this a key reference for learning how the underlying developmental mechanisms of the kidney will lead to greater advances in regenerative medicine within nephrology.

Genetic Diseases of the Kidney identifies and analyzes genetic abnormalities causing renal diseases in human subjects. Although in a sense the genome contains all the instructions required for the formation of a phenotype, the information is encoded in an extremely complicated fashion. In primary genetic diseases, the genetic instruction specifies a phenotype clearly linked with a discreet lesion confined to the kidney. However, the genetic disturbance may be imbedded in a complicated physiologic ensemble, so that the nexus between the genetic disturbance and the phenotype may be obscured; in consequence, the causal sequence is extremely difficult to unravel. In many instances the renal disease is one component of a complicated systemic hereditary disease, either monogenic or polygenic. Indeed, renal disease may arise as the sum of minor inputs from many different, seemingly unrelated genes, so that the genetic contributions may be difficult to identify. Confounding the problem further are environmental influences, originating either in the chromosomal environment from modifier genes, or in the extra-chromosomal environmental from intrauterine or postnatal influences. These considerations have determined both the organization of the text as well as the detailed description of the genetic disorders and the physiologic derangements that emerge.
* Lays the essential foundation of mammalian genetics principles for medical professionals with little to no background in genetics
* Analyzes specific renal diseases - both monogenic disorders confined to the kidney as well as systemic diseases with renal involvement - and explains their genetic causes.
*World-renowned editors andauthors offer expert frameworks for understanding the links between genes and complex clinical disorders (i.e., lupus, diabetes, HIV, and hypertension)

Psychosocial Aspects of Chronic Kidney Disease: Exploring the Impact of CKD, Dialysis, and Transplantation on Patients provides an overview of the emotional and psychological challenges faced by people with renal disease. This book outlines the epidemiology and treatment of the psychosocial factors affecting them. The sections in the book cover psychiatric illness in the earlier and middle stages of chronic kidney disease, end-stage renal disease treated with dialysis, and renal transplantation. The book concludes with a section on special considerations, delving into topics such as treating children and adolescents, quality of life, caregiver burden, challenges in psychosocial research in kidney disease, and future directions for intervention.

More than 400,000 people in the United States undergo kidney dialysis. For many, the prospect of a regular appointment with a dialysis machine seems like the end of life itself. But that reaction couldn't be more wrong.
In Dialysis Without Fear, psychiatrist and dialysis patient Dr. Daniel Offer joins with his wife, Marjorie Kaiz Offer, and daughter, Susan Offer Szafir, to reveal how life can be lived--and lived well--on dialysis. Drawing on his long career as a medical expert and more than seven years of
experience as a patient, Dr. Offer convincingly dispels the misconceptions surrounding this treatment, revealing how most dialysis patients can travel, work, and continue to partake in life's joys and celebrations. But the fears and hardships can be quite real, and Dr. Offer brings his years as a
psychiatrist to bear as he provides practical advice on how patients can overcome them. He walks the reader through each step of dialysis, explains different types of treatment, examines the pros and cons of a transplant, and discusses side effects. Dialysis, he notes, affects the entire family; his
own wife and daughter provide realistic insights into how relatives can cope and thrive together. Along the way, they provide a treasure trove of tips on adapting to the new diet, traveling overseas, and adjusting working hours. The Offers also relate inspiring success stories, sharing the humor,
courage, and triumphs of real families.
Life on dialysis is unquestionably difficult--but the difficulties can be overcome. With this inspiring, practical guide, patients can learn to live without fear, fulfill their hopes, and enjoy every day.