Almost every practising doctor will admit to difficulty in knowing how best to investigate, treat and advise the pregnant patient with renal problems. These doubts and difficulties may be exacerbated if the patient seeks pre-pregnancy advice - would a possible pregnancy cause a deterioration in renal function, what are the risks of the pregnancy for mother and baby? As the general public become more informed on medical matters these questions are being asked more frequently and doctors must be prepared to offer advice which is based on detailed factual knowledge. This book examines some of these increasingly common clinical problems. Each chapter has been written by a recognized expert in the field and provides the type of specific information now expected by discerning patients. The advances in treatment of the last decade clearly indicate that a knowledge of pregnancy and renal disorders is essential for doctors in many branches of medical practice.

This book is a gift from the international community of amyloid friends, presented to Professor Dr. Enno Mandema on the occasion of his retirement from the University of Groningen, the Netherlands. It is the "precipitation" of up to date knowledge of amyloidosis, as presented at the International Course on Amyloidosis in Groningen, on the 10th and 11th of October 1986. Twenty years ago, Professor Mandema invited a group of scientists, who were studying the various aspects of amyloidosis from different points of view, to discuss their mutual interest in the subject. This "First International Symposium" was held for five days in September 1967. It was a wonderful experience for the participants, as most of them had until then only read each others work in the literature. The proceedings of that symposium, which contained the "lively" dis cussions, became a text-book for the following years. Research continued, and while the book was still in preparation, the revolutionary method of "water-soluble amyloid" was published. In the following years, different amyloid proteins were discovered and the mo lecular basis of the different amyloid syndromes was elucidated. The increase in knowledge parallelled the availability of modern, ingenious and also rapid methods in the biomedical sciences."

Ethical rational, facts, and center techniques for choosing kidney donors all in one volume. This is the first book of its kind, devoted solely to preoperative issues for living kidney donors and those who counsel them. The eight chapters are devoted to vital areas that are comprehensively addressed by experienced professionals. The book presents a unified ethical and factual approach that is essential for all transplant centers to understand. It is a readable and understandable ethical foundation for living kidney donation that is free of jargon. It includes balanced, hard to find factual summaries that are essential for acceptable kidney donor counseling. As transplant centers increasingly turn to living kidney donors, this book is an essential step forward in the field.
The book will appeal to transplant physicians and surgeons, transplant coordinators and social workers, nephrologists who have patients on dialysis or who evaluate potential living kidney donors and to potential living kidney donors and their recipients. As a practical application of medical ethics to an important field, it will be of interest to medical ethicists as well.

Glomerulonephritis is one of the commonest causes of end-stage renal failure worldwide. Although there have been considerable advances in the management of renal failure by dialysis and transplantation, there has been relatively little progress in its prevention. This volume sets out to review current practice in the treatment of glomerulonephritis, which is aimed both at controlling the clinical manifestations, e.g. nephrotic syndrome, and at preventing the progression to renal failure. The term glomerulonephritis covers a wide range of conditions with different immunological, histological and clinical features. This volume therefore starts with reviews of the immunology and pathology of different types of glomerulonephritis. This is followed by detailed consideration of the treatment of the commoner primary and secondary forms of the disease. There are separate chapters on special circumstances, such as glomerulonephritis in pregnancy or following renal transplantation. In each chapter, attempts are made to review the evidence for the effectiveness of treatment, based on controlled trials, immunopathological principles and the authors' considerable experience. Although some aspects of the treatment of glomerulonephritis can be found in the standard texts on renal disease, this volume provides an up-to-date, thoroughly referenced, and practical guide to management. As such, it should be of value to nephrologists and general physicians, including those in training, and to postgraduate students of nephrology.

Kidney Transplantation: A Guide to the Care of Transplant Recipients is an easy to read, up to date, clinical resource written by experts in the field of kidney transplantation. The book explains how donors and recipients are selected for transplantation, how the surgical procedure is performed, and how the experts recognize and treat rejection.

Clearly illustrated chapters show how the immune system works in the setting of transplantation and how immunosuppressive medications prevent rejection of the transplanted kidney; knowledge essential for the proper care of the transplant recipient.

The acute and long-term care of the patient is described from the perspective not only of proper immunosuppressive medication management, but also from the perspective of comorbidities most common to transplanted patients, including cardiovascular disease, diabetes mellitus, infectious diseases, malignancies, and bone disease. Special issues that impact the care of the transplant recipient, such as unusual donor sources, nonadherence and insurability are also addressed in separate chapters.

This comprehensive practical guide to transplant patient care is an essential source for the practicing community nephrologist that cares for transplanted patients, as well as medical and surgical residents and fellows in training.

Clear illustrations as well a therapeutic algorithms complement the text, making this an easy to read, up to date source on the clinical practice of kidney transplantation.

aintaining extracellular calcium concentrations within a narrow range is critical for the survival of most vertebrates. PTH, together with vitamin D, responds to hypocalcemia to increase extracellu M lar calcium levels, by acting on bone, kidney and intestine. The recent intro duction of PTH as a major therapeutic agent in osteoporosis has directed renewed interest in this important hormone and in the physiology of the parathyroid gland. The parathyroid is unique in that low serum calcium stimulates PTH secretion. As hypocalcemia persists, there is also an increase in PTH synthesis. Chronic hypocalcemia leads to hypertrophy and hyper plasia of the parathyroid gland together with increased production of the hormone. Phosphate is also a key modulator of PTH secretion, gene expres sion and parathyroid cell proliferation. Understanding the biology of the parathyroid as well as the mecha nisms of associated diseases has taken great strides in recent years. This book summarizes the molecular mechanisms involved in the function of the para thyroid gland. The first chapter reviews the development of the parathyroid gland and the genes involved in this process as identified using genetically manipulated mice. Then the biosynthetic pathway of PTH from gene ex pression to its intracellular processing and the sequences in the gene control ling its transcription as well as those regulating mRNA processing, stability and translation are described."

The aquaporin field has matured at an exceptionally fast pace and we are at the verge to develop serious strategies to therapeutically modulate aquaporin function directly or via regulatory networks. Key prerequisites are available today: i. a considerable (and growing) number of aquaporin crystal structures for the rational design of inhibitory molecules, ii. elaborate molecular dynamics simulation techniques for theoretical analyses of selectivity mechanisms and docking experiments, iii. comprehensive data on aquaporin immunohistochemistry, iv. aquaporin knockout animals for physiological studies, and v. assay systems for compound library screenings. The structure of this volume on aquaporins follows the points laid out above and thus covers the developments from basic research to potential pharmacological use. Situated between pharmacology textbooks and recent scientific papers this book provides a timely overview for readers from the fundamental as well as the applied disciplines.

Increased recognition of the overlap between critical care and renal medicine, and recent advances in the understanding of acute renal failure and the application of renal replacement therapies, have brought increased attention to the nephrologist's role in the intensive care unit (ICU). This book is written to provide an approach for the resident in nephrology, at any level of training, with regards to critically ill patients. This text provides the information necessary to provide care for the nephrology patient in the ICU.

This invaluable guide, endorsed by the UKMi and reflecting the extensive experience of the UK Renal Pharmacy Group, features drug monographs guiding physicians in how to prescribe, prepare, and administer drugs to patients with different levels of kidney function and when undergoing renal replacement therapy. It has been fully updated for this fifth edition to include up to 100 additional drugs, while maintaining the clear structure and format that is easy to use and simple to follow in the busy clinical setting. It continues to offer support and guidance to health care professionals enabling them to prescribe medications to their renal patients appropriately and safely.

Supportive Care for the Renal Patient Second Edition provides a comprehensive, evidence-based overview of supportive care for the nephrology patient. An international group of contributors emphasise the continuum of palliative care from the time of diagnosis through to end-of-life care and the issues surrounding withdrawal of dialysis. The book addresses the psychological impact of the disease, the importance of involving the patient in making decisions about their care, ethical considerations, the role of the family and the multidisciplinary team. This new edition includes two new chapters on conservative management of advanced kidney disease (AKD) and dialysis in the very elderly. The chapters covering non pain symptoms, advance care planning, quality of life, psychological and psychiatric consideration and end-of-life care have also be completely revised to include new evidence and current thinking. This book will be of particular interest to palliative care practitioners; nephrologists, who increasingly need to know more about palliative care; nurse practitioners, dialysis nurses, social workers, dieticians, and psychiatric consultants. ABOUT THE SUPPORTIVE CARE SERIES Supportive care is the multidisciplinary holistic care of patients with chronic and life-limiting illnesses and their families - from the time around diagnosis, through treatments aimed at cure or prolonging life, and into the phase currently acknowledged as palliative care. It involves recognising and caring for the side-effects of active therapies as well as patients' symptoms, co-morbidities, psychological, social and spiritual concerns. It also values the role of family carers and helps them in supporting the patient, as well as attending to their own special needs. Unlike traditional palliative care, which grew from the terminal care of cancer patients, supportive care is not restricted to dying patients nor to cancer. This series covers the support of patients with a variety of long-term conditions, who are currently largely managed by specialist medical teams in hospital and by primary care teams in community settings. Each volume therefore provides a practical guide to the supportive care of patients at all stages of illness. Series Editor: Sam H. Ahmedzai

More than 400,000 people in the United States undergo kidney dialysis. If you or a member of your family are one of them, then the prospect of a regular appointment with a dialysis machine may seem 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 medical career and more than seven years of personal experience with dialysis, Dr. Offer dispels many misconceptions surrounding this treatment, explaining how you can adapt to the new diet, 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. Walking through each step of dialysis, he explains different types of treatment, examines the pros and cons of a transplant, and discusses side effects. Since dialysis affects the entire family, Dr. Offer and his coauthors also provide realistic insights into how relatives can cope and thrive together, sharing the humor, courage, and triumphs of real families who have successfully faced the challenges of dialysis. The result is an inspiring, practical guide that will help you and your family learn to overcome the difficulties of dialysis, live without fear, and enjoy every day.

The book focuses on pharmacological and non-pharmacological approaches of psychiatric syndromes that commonly occur in patients with kidney disease. It specifically reviews principles of psychotherapy and psychopharmacology with an emphasis on organ impairment and drug-drug interactions specific to nephrology. This book also covers issues with medication nonadherence in patients with chronic kidney disease and psychiatric comorbidity, as well as the associated issues in dialysis and renal transplantation. Additionally, chapters cover various other topics addressing an active stance towards health promotion in chronically ill patients, including the critical role of the diet and physical activity. Such advice is often complex and changing depending on the stage of chronic kidney disease and the individual needs of the patient. Written by specialists in the field, Psychonephrology: A Guide to Principles and Practice serves as a valuable reference and teaching tool that provides an opportunity for learning across a rapidly evolving medical field.

This superbly written text gives students, residents, and practitioners the edge in understanding the mechanisms and clinical management of acid-base disorders. Presents the core information to understand renal and electrolyte physiology, and reviews the treatment rationale for all major acid-base and electrolyte disturbances. The entire text is exhaustively revised, and now includes questions and answers in each chapter.

Increasingly, medicine in general and nephrology specifically is based on clinical trials and verifiable presumption. Still, however, much of everyday clinical practice is the consensus of pundits and experts unable to validate their suggestions beyond personal bias.

In this unique volume, several core beliefs in renal medicine are examined and challenged. Starting as assignments for nephrology fellows, this book grew out of surprising revelations' indicating that the emperor has no clothes'.

The book is suitable as a stimulus for provocative discussions for nephrologists, internists, house staff, and medical students.

Immunosuppression in solid organ transplantation is experiencing a worldwide revival since new drugs are now available in the late-1990s and others are under development. In order to contribute to the design of future strategies, a critical approach of surrogate endpoints is given and long-term side effects are analyzed, together with the impact of non-compliance, quality-of-life and economical parameters. In this book, international specialists have set up the scientific rationale and provided new bases for further immunosuppressive strategies.

Seeing a patient die under his hands because there is no adequate treatment causes an emotion and a frustration in a doctor, which sometimes stimulates him to try to develop a new type of treatment. Seeing so many wounded young soldiers die due to renal failure in World War I incited the German doctor Georg Haas to try to develop an artificial kidney. He had to give up in despair in 1928. Ten years later doctor Willem Kolff saw a young man die in his ward in the University Hospital of Groningen due to renal failure. By that time two essential factors for an artificial kidney had become available: a drug to keep the blood from clotting outside of the body and an efficient dialysing membrane through which waste substances can pass from the blood into the dialysing fluid. Kolff succeeded in creating the rotating artificial kidney which he started using in the town hospital of Kampen in 1943. The rotation of this artificial kidney started a revolution that made it possible for thousands of kidney patients all over the world to keep on living - and sometimes to forget their disease for the time being. In addition it gave rise to the development of other artificial organs such as the heart-lung machine, the artificial heart and the artificial eye. Doctor Jacob van Noordwijk, the author of this book, was Kolff's first assistant in the treatment of the first 15 patients. How Kolff succeeded in spite of all the limitations imposed by the German occupation of the Netherlands and in spite of the absence of antibiotics and other medical tools which are common nowadays makes a story which may sound incredible. Yet it did happen and visitors to the town of Kampen can still see the hospital building where it all took place.

Having kidney failure is not a unique experience. Neither is receiving a kidney transplant or undergoing dialysis. Adopting to irreversible uremia - a devastating illness- by assisting others to cope with their own life trial represents the best of human traits. Bonded by marriage for 42 years, I was privileged to love and live with a marvelous and unique individual whose approach to life with this horrific disease taught me to regard every moment of our existence as precious. Preparation of this volume had two main objectives: 1) To honor the author for all of efforts in behalf of kidney patients. 2) To disseminate her insights and wisdom to those who may derive comfort and benefit from her words. Mildred (Barry) Friedman was a medical writer and patient advocate devoted to the American Association of Kidney Patients, who died at University Hospital of Brooklyn on September 21 st 1997 at the age of 61 of complications of type 1 diabetes. Barry, the second child of Leontine and Hardinge Barrett-Lennard, was born on October 17,1935 in Manhattan and attended Brooklyn College as a New York State Scholarship Awardee earning a Bachelor of Arts degree in 1953. She subsequently began teaching in the New York City elementary schools gaining a Master's degree in education. Following the birth of her third child, Barry developed both diabetes and Addison's disease forcing her retirement from teaching.

A practical primer for physicians wanting to learn about simple and complex urodynamic testing. The clear, concise workbook structure allows for quick reference to multichannel urodynamic tracings and their interpretation. Brief but thorough discussion of the underlying theory and concepts behind urodynamic testing enable readers to gain a firm grasp of the implications of test results in individual patients. It provides an understanding of all the techniques used for the evaluation and treatment of the incontinent or lower urinary tract dysfunctional female patient, and also includes a quick reference guide to outpatient treatment. In contrast to other didactic texts, this book allows readers to initiate testing programs and will thus be of practical benefit to all those interested in improving patient care.

This classification is based primarily on the microscopic charac- teristics of tumours and, therefore, is concerned with morpho- logically identifiable cell types and histological patterns, as seen with conventional light microscopy. The term tumours is used synonymously with neoplasm. The phrase tumour-like is applied to lesions which resemble neo- plasms, clinically or morphologically, but do not behave biologi- cally in a neoplastic manner. They are included in this classifica- tion because they give rise to problems in differential diagnosis and because of the unclear borderline between neoplasms and certain non-neoplastic lesions. Synonyms are listed only if they have been used widely, or if they are considered to be helpful to the understanding of the lesion. In such cases, the preferred term is given first, followed by the synonym. Although the emphasis of this classification is on histological typing, in the examination of kidney tumours, consideration should be given to the degree of cellular anaplasia, the extent of local spread, vascular and lymphatic invasion, and the occur- rence of metastasis. The scheme of histological grading suggested here is as fol- lows: Grade I applies to the tumours that have the least degree of cellular anaplasia compatible with a diagnosis of malignancy; . grade II! applies to tumours with the most severe degrees of cel- lular anaplasia; and grade I! applies to those tumours in be- tween. This scheme is applicable to the carcinomas of the renal parenchyma and pelvis.

Concise, readable, and well-illustrated, Handbook of Glomerulonephritis is a convenient, one-stop resource for physicians, residents and fellows, advanced practice professionals, and nurses who are involved with the care of patients with glomerular diseases. Drs. Patrick H. Nachman, Michelle Rheault, and Edgar V. Lerma, along with a team of internationally renowned glomerulonephritis experts, provide practical guidance on both adult and pediatric glomerular diseases, across the spectrum of clinical presentations and pathogenic mechanisms.    

In about 5% of all organ (kidney, liver) transplant recipients, malignancies occur as a late complication of the massive immunosuppression. The malignancies are mainly skin cancers, lymphomas and renal carcinomas. The present book discusses the possible mechanisms of this type of tumorigenesis and inquires into possibilities of prevention. In particular, the described malignancies might be of viral origin. The book informs about a completely new type of carcinogenesis. Apart from the scientific aspects, it is of great practical value.

This invaluable guide, endorsed by the UKMi and reflecting the extensive experience of the UK Renal Pharmacy Group, features drug monographs guiding physicians in how to prescribe, prepare, and administer drugs to patients with different levels of kidney function and when undergoing renal replacement therapy. It has been fully updated for this fifth edition to include up to 100 additional drugs, while maintaining the clear structure and format that is easy to use and simple to follow in the busy clinical setting. It continues to offer support and guidance to health care professionals enabling them to prescribe medications to their renal patients appropriately and safely.

Advanced renal cell carcinoma is refractory to nearly forms of systemic therapy. For this reason the last decade has seen numerous research groups working on immunotherapeutic s trategies against it. Immunotherapy of Renal Cell Carcinoma reports the contributions of most of the world's leading re- search groups to two international conferences on the immu- nobiology of this illness. Sixteen chapters divided in expe- rimental and clinical studies provide an overview of immuno- therapy in renal cell carcinoma and a discussion of new la- boratory approaches to this topic.

International illicit trade in human organs is on the increase, fueled by growing demand and unscrupulous traffickers. In order to truly understand the problem of organ trafficking, an analysis should take into account the various perspectives that come into play in this multifaceted issue. With contributions from international scholars and experts, The International Trafficking of Human Organs: A Multidisciplinary Perspective provides a broad-based exploration of this controversial phenomenon. Divided into four parts, the book examines the issue of human organ trafficking from the perspectives of criminal justice, business, medicine, ethics, philosophy, and theology. The book begins by presenting case studies of the trafficking of body parts occurring in the U.S. and Mexico. It examines the increase in organ harvesting from Chinese prisoners and describes widespread instances of trafficking in Europe. Diverse perspectives Next, it examines the economic ramifications of possible legislation of the sale of body parts and discusses other proposals for increasing the supply of kidneys and other organs. It explores ethical issues surrounding the kidney shortage and incentives to promote donation. It also offers arguments for and against compensation for transplant organs from Kantian, Dworkinian, and other perspectives. Lastly, theologians discuss opposing Catholic and Protestant perspectives on the sale of human organs. Learning tools Each chapter provides discussion questions to provoke vigorous debate and references to facilitate further study. The wide-ranging analysis provided by this volume is certain to enhance further inquiry into a disturbing and increasingly prevalent issue.

This volume focuses on the investigatory methods applied to autosomal dominant polycystic kidney disease (ADPKD), one of the most common human genetic diseases. ADPKD is caused by mutations in PKD1 and TRPP2, two integral membrane proteins that function as receptor/ion channels in primary cilia of tubular epithelial cells. Thus, ADPKD belongs to ciliopathies, a group of disorders caused by abnormal cilia formation or function. This proposed book will cover the state-of-the-art methods ranging from molecular biology, biochemistry, electrophysiology, to tools in model animal studies. Key Features Explores the role of cilia in polycystic kidney disease Focuses on myriad state-of-the-art methods and techniques Reviews specific mutations integral to this autosomal genetic disease Includes discussions of model systems