This issue of the Urologic Clinics provides a timely update on Renal Cancer and the evolving treatment standards in urology.? Articles include Contemporary Imaging of the Renal Mass, Surgical Approach to Multifocal Renal Cancers, and Systemic Therapy Prior to Surgery.? Effects of the various existing surgical approaches on long-term renal function is also discussed, along with a review of the current trends in surgical management of renal cancers with specific attention to utilization of laparoscopic approach, partial nephrectomy, ablative technologies and observation.

Topics for this issue will include: Epidemiology of RCC;New Insights into the Biology of RCC;Pathology of Renal Neoplasms;Imaging in RCC;Small Renal Tumors: Prognosis and Management;The Role of Surgery in the management of RCC: Nephrectomy and metastatectomy;Cytoreductive Nephrectomy: Rationale and current Applications;Adjuvant Therapies in RCC and Management of Side Effects from Current Therapies in RCC

The kidneys participate in all vital processes of the body to maintain overall homeostasis and health. When kidneys are injured during surgical interventions, metabolic and hemodynamic control is disrupted, leading to dysfunction associated with greater mortality, length of hospital stay and cost.

"Peri-operative Kidney Injury" presents the epidemiology, risk factors, diagnosis, treatment and outcomes associated with kidney injury during the peri-operative period. Concepts and principles of care to prevent kidney complications during surgical procedures are provided to equip health care professionals along with strategies to manage acute kidney injury and associated challenges when they occur. Chapters detail diverse surgical settings, ranging from the more common, such as abdominal, cardiac and vascular surgeries, to the intricately complex, including the use of the left ventricular assist device and organ transplants. This practical and comprehensive text blends the evidence-based standards of care with cutting edge advances in the field, while also providing the reader with a peek into innovations on the horizon.

This timely volume provides an overview to the causes, effects on systems and clinical approaches of metabolic acidosis. Beginning with a basic understanding of the physiology, pathophysiology and development of this disease, subsequent chapters cover the characteristics and context of the processes that can cause it and a thorough presentation of management strategies. Recommended treatments include those carried out by the health care provider as well as the individual patient, such as dietary management. Clinicians and healthcare professionals will find the tools needed to recognize, work up and manage patients with metabolic acidosis in this practical and concise resource.

Recent work has begun to elucidate at the molecular level how albumin is handled by the kidney and how albuminuria develops in various proteinuric diseases including minimal change disease and focal segmental glomerulosclerosis. This volume provides a comprehensive overview of the renal handling of albumin - from basic mechanisms to the pathophysiology of proteinuric diseases. In describing the basic mechanisms of albuminuria, a particular highlight will be the focus on advanced imaging techniques such as intravital microscopy that have allowed a detailed "window" into albumin transit through the kidney. The volume will cover the epidemiological studies which show that albuminuria is a strong and independent marker of kidney disease progression and cardiovascular events, the molecular details of albumin handling in the kidney at the level of the glomerulus and the proximal tubule and the pathophysiology of proteinuric diseases including minimal change disease, membranous nephropathy, focal segmental glomerulosclerosis and diabetic nephropathy.

This manual provides practical and accessible information on all aspects of general nephrology, dialysis, and transplantation. It outlines current therapies in straightforward language to help readers understand the treatment rationale, and does not assume extensive knowledge of anatomy, biochemistry, or pathophysiology. Consisting of 33 chapters written by 31 experts from four continents, this volume covers all the practical tips in the emergency and long-term management of patients with electrolyte disturbance, acid-base disturbance, acute renal failure, common glomerular diseases, hypertension, pregnancy-related renal disorders, chronic renal failure, and renal replacement therapy. It is thus an essential source of quick reference for nephrologists, internists, renal fellows, and renal nursing specialists, and is also suitable for graduate students and research scientists in the field of kidney diseases.

Gabriel of Urantia asked the question, in the beginning of his struggle with dialysis, "God, why is this happening to me?" Throughout his 8-month dialysis experience, 3 days a week, 4 hours a day, being tied down to a chair while his blood flowed from his body through a machine and back, he realizes-from the people he meets also on dialysis and in the hospitals after post-kidney-transplant-that very bad things happen to very good people. He met young and old alike, tied down to the machines just like he was, and the young people were the hardest for him to resolve in his mind with God and also to try to give them hope. As a minister, he felt obligated to do so. Being a Pastor of a church (Global Community Communications Alliance-a very social, environmental, and spiritual activist church), he knew that bad things happened to good people who try to change the world. But this disease is personal, between him and God you might say. So he had to discover for himself why God allowed this to happen to him and to the other very good people he met with various traumatic illnesses in the hospitals and dialysis centers. Gabriel of Urantia tries to explain how he felt along the path, from the beginning to the receiving of his new kidney from his 22-year-old daughter and gaining the hope and health to continue not only his spiritual work, but his work as a musician, guitar player, and singer (in which he was planning a tour around the country with his 11-piece Bright & Morning Star Band), while now taking immunosuppressant drugs to keep him alive. He had all the fears that a new transplant patient has. How long will the kidney last? What other affects do these drugs have on my body? He writes about his experience with the medical world, the services he experienced from both very qualified people and those not so qualified (experienced and inexperienced care givers), as well as the bureaucracy of the medical field and insurance companies (both private and governmental). He realized that often in the medical field, the right hand didn't know what the left hand was doing and the patient suffered the results. Beyond that, Gabriel of Urantia tries to give hope to people with life-threatening illnesses by sharing his faith in the Creator to all who may read his book. A must-read for anyone on dialysis or with any life-threatening illness, from a writer who went through this and can identify with what they are going through and give them hope through this trauma in their lives.

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)

Liver Transplantation: Challenging Controversies and Topics grew out of a need I perceived within the fields of transplant hepatology and liver transplantation. Liver transplantation has rightly gained recognition as an established therapy for end-stage liver disease. Few would argue that liver transplantation is one of the few truly lifesaving and life-altering treatments within medicine and surgery. Not many realize that 20 years passed from the time of the first human liver transplantation in 1963 to its acceptance as therapy by the 1983 NIH Consensus Conference on Liver Transplantation. In 2008, 25 years will have passed since the 1983 NIH conference-a mere 25 years for a field that has provided patients hope, doctors options, and to some the "gift of life. " Many issues in liver transplantation involve indications, patient selection, and outcomes after transplantation-these are standard topics, covered by textbooks of hepatology and transplantation. In contrast, the field of liver tra- plantation is young, evolving, dynamic, and issues and decisions are often controversial. Thus, Dr. Trotter and I, as well as our colleagues at the University of Colorado, felt that a text with a different focus was required, one that highlighted controversy and challenged dogma. Out of this perceived need emerged Liver Transplantation: Challenging Controversies and Topics. To meet the transplant community's need for emerging information about liver transplantation, Dr. Larry Chan, Dr. Igal Kam, and I initiated the Controversies in Transplantation Conference.

Foreword; B.H. Scribner. Preface; R. Gokal, K.D. Nolph. 1. Historical Development and Overview of Peritoneal Dialysis; R. Gokal, K.D. Nolph. 2. Peritoneal Ultrastructure; J. Dobbie. 3. Peritoneal Circulation; R. White, D.N. Granger, R. Korthius. 4. Peritoneal Physiology -- Transport of Solutes; R.T. Krediet, B. Rippe. 5. Peritoneal Lymphatics; R. Khanna, R.A. Mactier. 6. Ultrafiltration with Colloid Osmosis; J.K. Leypoldt, C. Mistry. 7. Peritoneal Pharmacokinetics and Pharmacological Alterations of Peritoneal Transport; P. Hirszel, N. Lameire, M. Bogaert. 8. Solutions and Systems; J. Winchester, G. LaGreca, M. Ferriani. 9. Peritoneal Dialysis Access and Exit Site Care; Z.J. Twardowski. 10. Placement Procedures for Peritoneal Access; S. Ash, W.K. Nichols. 11. Organization of a Peritoneal Dialysis Program -- Nurses' Role; B. Prowant, L. Uttley. 12. Continuous Ambulatory Peritoneal Dialysis; G.E. Digenis, N.V. Dombros, J.W. Moncrief, D.G. Oreopoulos, R.P. Popovich. 13. Automated Peritoneal Dialysis; J.A. Diaz-Buxo, W. Suki. 14. Adequacy of Peritoneal Dialysis; P. Keshaviah, K. D. Nolph. 15. Nutritional Management of Patients on Peritoneal Dialysis; J. Bergstrom, J. Kopple, B. Lindholm. 16. Peritonitis; W. Keane, S.I. Vas. 17. Host Defence and Effects of Solutions on Peritoneal Cells; G. Coles, S. Lewis, J.D. Williams. 18. Calcium Phosphate and Renal Osteodystrophy; R. Gokal, A. Hutchison. 19. Other Complications of Peritoneal Dialysis; J.M. Bargman. 20. Pediatric Peritoneal Dialysis; S.R. Alexander, J.W. Balfe, E. Harvey. 21. Peritoneal Dialysis in Diabetics; R. Khanna. 22. Peritoneal Dialysis in the Elderly; A. Nissenson. 23. Quality of Life and Cost Effectiveness; R. Gokal. 24. Outcome of Peritoneal Dialysis -- Comparative Studies; R. Maiorca, G. Cancarini. 25. Registry Results; K.D. Nolph. 26. Use of Peritoneal Dialysis in Special Situations; S. Prichard, J.M. Bargurar. 27. Intraperitoneal Chemotherapy; R. Dedrick, M.F. Flessner. Index of Subjects.

Edited by the same team that developed the successful Pediatric Dialysis and its second edition, this text features clinical management principles that are integral to the care of children receiving chronic dialysis. Each chapter is introduced by a case presentation that serves as the basis for key learning points that are clinically applicable and presented in a succinct manner. The topics included in Pediatric Dialysis Case Studies cover virtually all aspects of pediatric dialysis care and represent the efforts of an international group of experts with firsthand clinical expertise from all disciplines represented in the pediatric dialysis team. This resource is certain to help the clinician achieve improved outcomes for these often complex patients.

Fluid, electrolyte, and acid-base disorders are central to the day-to-day practice of almost all areas of patient-centered medicine - both medical and surgical. Virtually every aspect of these disorders has experienced major developments in recent years. Core Concepts in the Disorders of Fluid, Electrolytes and Acid-Base Balance encompasses these new findings in comprehensive reviews of both pathophysiology and clinical management. In addition, this volume offers clinical examples providing step-by-step analysis of the pathophysiology, differential diagnosis, and management of selected clinical problems. Written by leading experts in fluid, electrolyte, and acid-base disorders, this reference is an invaluable resource for both the nephrologist and the non-specialist physician, or medical trainee.

Therapeutic regimens for visceral leishmaniasis (also Kala-azar, Dum-dum fever or black fever), caused by parasitic protozoa of the Leishmania genus, evolve at a pace never seen before. Spread by tiny and abundant sand flies, the parasite infects internal organs and bone marrow and if left untreated will almost always result in the death of the host. In developing countries successful diagnosis and treatment are complicated by asymptomatic cases, undernutrition and Kala-azar/HIV co-infections.

This book brings together world-renown experts writing state-of-arts review on the progress in diagnosis and treatment of visceral leishmaniasis, ultimately leading to the complete elimination of this fatal disease from South Asia. The chapters provide valuable information for disease control as well as therapy and the diagnostic improvements necessary for early treatment, subclinical detection and drug-resistant cases. The presented methods allow for points-of-care testing in the endemic area, enabling rapid detection in resource-poor settings with easy handling and low costs.

This book provides essential information for scientists, medical practitioners and policy makers involved in the diagnosis, treatment and elimination of Kala-azar.

This second edition expands upon the previous volume with additional emphasis on recent innovation in basic renal research and has a more holistic approach on associated disorders such as complications associated with peritoneal dialysis, ischemic acute kidney injury, the sympathetic nervous system, and vascular calcification. The book is divided into five parts: Part I provides a number of in vitro, in vivo, and ex vivo models of kidney disease and associated complications; Part II looks at recent advances in imaging techniques; Part III covers recent developments in studying metabolism in renal ischemia and reperfusion; Part IV addresses study and measurement of vascular calcification; and Part V explores analytical techniques that are both topical and of widespread relevance to the study of experimental renal disease. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Authoritative and cutting-edge, Kidney Research: Experimental Protocols, Second Edition is a valuable collection of protocols useful to new and experienced researchers who are interested in the field of Nephrology.

This is the first textbook entirely dedicated to the endovascular treatment of complications related to arteriovenous accesses for hemodialysis (native fistulas and prosthetic grafts). The book addresses the anatomy of upper limb arteries and veins as well as the clinical presentation of patients and the way to perform and read a fistulogram. Many details and illustrations are provided, clarifying the subtleties in catheterization and the dilation of stenoses. From a strategic point of view, it is explained for the first time that many stenoses must either be ignored or deliberately underdilated. A wealth of images helps to understand the different stages of access recovery from thrombosis. As the number of incident dialysis patients is increasing by 5% every year, this is a field of growing interest. In testament to this there are several annual or bi-annual meetings held by numerous national and international societies (vascularaccesssociety.com, sfav.org, vasamd.org, dialysiscontroversies.org, asdin.org).

PNL is the gold standard for the management of large and/or otherwise complex renal stones. Since its introduction in the seventies PNL has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrument technology, lithotripsy devices and drainage management. The conventional prone position for PNL has been challenged in the last two decades by a variety of modifications, including the supine and Galdakao-modified supine Valdivia positions, which make simultaneous retrograde working access to the collecting system possible and have proven anesthesiological advantages. The Galdakao-modified supine Valdivia position allowed the development of ECIRS (Endoscopic Combined IntraRenal Surgery), a technique exploiting a combined antegrade and retrograde approach to the upper urinary tract, using both rigid and flexible endoscopes with the related accessories. The synergistic teamwork of ECIRS provides a safe and efficient, minimally-invasive procedure for the treatment of all kinds of urolithiasis. The aim of this book is to share with the urologic community worldwide our experience, our standardization of all the steps, and tips and tricks for the procedure.

Acute renal failure induced by rhabdomyolysis after strenuous, prolonged exercise such as marathon running or mountain climbing is a well-known medical phenomenon, but exercise-induced acute renal failure after short-term anaerobic exercise - for instance, short-distance track races - has been recognized only recently. This monograph provides in-depth information on exercise-induced acute renal failure after short-term anaerobic exercise, which causes severe pain in the loin and patchy renal ischemia with no sign of rhabdomyolysis. Half of the patients suffering from this condition experience renal hypouricemia, for which approximately 20% are treated with dialysis. This complete clinical reference book includes characteristics of the disease, diagnosis, treatment and prognosis, and corresponding preventive measures. Important information on gene analysis and etiology is also included, creating a valuable resource for nephrologists as well as for emergency physicians and those in the field of sports medicine.

Fresh insights into the pathogenic mechanisms by which hyperglycemia induces tissue and organ injurt are the basis for rapidly evolving promising therapies in diabetes. Especially promising as targets for intervention are products of oxidative stress, including kinins and growth factors. Improving results of renal replacement regimes now incorporating pancreatic islet transplants are able to delay and prevent end-organ damage in diabetic individuals. The evolving story of the taming of diabetes is of direct concern to nephrologists, endocrinologists, ophthalmologists, primary care physicians and medical students.

More than half a million people worldwide are now sustained by renal replacement therapy, mainly hemodialysis at a cost exceeding USD 30 billion per year. Each case of ESRD that is delayed or prevented saves funds that may be applied to other aspects of health care. Edited by an internationally renowned nephrologist, Prognosis for Kidney Disorders provides a timely summary of exciting work in progress directed toward renoprotection and of ultimate interdiction of ESRD.
Suitable for researchers and clinicians, Dr. Morrell Michael Avram has collected and commented on promising initiatives likely to enter everyday practice in the immediate future. Suitable for renal trainees, experienced kidney doctors, nurses, nutritionists and cardiologists.