This book gives a complete description of online hemodiafiltration, in five sections. It is unique in the systematic and complete way in which hemodiafiltration is described. Each chapter is completed by a point-to-point summary of essential information, in a separate text box. Part of the book is dedicated to the theoretical background of convective clearance. In this part, safety issues and quality control is reviewed (especially on the quality of water for dialysis and substitution fluid), as well as equipment (both dialyzers and machines) with which this treatment can be performed. As recently the results of several randomized controlled trials were available, the effect of hemodiafiltration on hard clinical end points (mortality and morbidity) is discussed in detail. This has not been done before, as the most recent book/journal on hemodiafiltration was published in 2011, before the results of the 3 randomized controlled trials were published. Furthermore, the methodological quality of the trials is discussed by an expert, in order to help the readers in their judgment of the trials Part of the book concentrates on the effect of the treatment on several biomarkers and uremic toxins. Several clinically relevant issues is discussed separately, such as the prescription of anticoagulation during the treatment, drug prescription and clearance for patients treated with hemodiafiltration, and hemodynamic stability. Finally, a practical guide on how to perform the treatment is provided. In this unique section, seemingly simple but important details of hemodiafiltration-treatment is discussed, such as the importance of needle size for blood flow rates, the difference between filtration fraction and substitution ratio, the different targets that can be set and how to reach them. As most literature is mainly focused on theoretical issues, this unique feature really will help the field to perform hemodiafiltration, and answer practical questions.

The detailed and comprehensive observations presented in this book on acquired cystic disease of the kidney and renal cell carcinoma in dialysis patients are drawn from the author's decades of experience. Beginning with the first clinical case in 1978 and including subsequent follow-up studies and questionnaires, the volume is an excellent clinical reference for practicing physicians. Color illustrations and numerous case studies assist the reader.

This case based resource focuses on kidney disease in patients with cancer. Chapters cover the pathophysiology and management of specific kidney diseases in cancer patients, as well as the impact of chemotherapy, toxicity of organ and stem cell transplantation and other emerging therapies. Filling a significant knowledge gap in this burgeoning field, Onconephrology features the latest evidence and clinical approaches for the beginner or experienced practitioner.

This practical guide is a compendium of contemporary views on the development, treatment, and prevention of urinary stone disease. Emphasis is placed on utilizing current research to highlight areas of potential discovery and inspire novel approaches to easing the burden of urinary stone disease.

Urolithiasis: A Comprehensive History provides a historical sojourn into the varied manifestations of kidney stone disease. Utilizing historical sources and integrating classic material with new concepts, this new volume provides depth and details on stone disease not found in modern overviews on the topic. This volume serves as a very useful tool for physicians and researchers dealing with kidney stone disease. Written by a renowned expert in the field, Urolithiasis: A Comprehensive History is an in depth resource that heightens our medical understanding of this ancient disease and is of great value to urologists, nephrologists, endocrinologists interested in stone disease.

This comprehensive book reviews our current state of knowledge about the pathogenesis of idiopathic nephrotic syndrome (INS), which comprises a heterogeneous group of diseases with distinct histological characteristics, such as minimal-change nephrotic syndrome (MCNS), focal segmental glomerulosclerosis (FSGS), and idiopathic membranous nephropathy (IMN). As the word "idiopathic" indicates, the pathogenesis of INS remains unclear. Historically, T-cell dysfunction has been thought to play an important part in the pathogenesis of MCNS, while circulating vascular permeabilities have been believed to induce proteinuria in FSGS. The book further describes recent advances in molecular biology, which have allowed us to speculate on the interactions between visceral glomerular epithelial cells (podocytes) and the relative significance of several molecules in the pathogenesis of INS, such as reactive oxygen species, nuclear factor-kappa B, CD80, angiopoietin-like 4, cardiotrophin-like cytokine-1, and M-type phospholipase A2 receptor. The normally rapid pace of scientific progress occasionally devolves into a state of chaos, and the pathogenetic research on INS is one such case. This volume will help researchers and scientists to collaborate, share resources, and expedite the design of protocols to evaluate the putative factors.

This practical handbook offers quick and sound advice on the many issues faced when dialyzing the older patient. It is authored by well-known international experts who have covered the full range of end stage renal disorders including treatment options, patient management and maximization of quality of life. Accessible and easy-to-read, Dialysis in Older Adults serves as the go-to reference for clinicians and members of their team as they treat this challenging patient population.

Core Concepts in Parenchymal Kidney Disease provides comprehensive and state-of-the-art information on the diagnosis, treatment, classification and pathogenesis of glomerular and tubulointerstitial diseases. Chapters feature various clinical scenarios and are authored by a team of renowned experts in the field. Experienced clinicians and trainees alike will find this authoritative reference to be a valuable resource and contribution to the literature.

This pocket-sized manual serves as a concise and ideal reference work for therapeutic approaches using apheresis, Covering both basic theory and clinical details to facilitate improved treatment and patient outcomes, the text considers a variety of diseases, including myasthenia gravis, multiple sclerosis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, nephrotic syndrome, TTP/TMA, dilated cardiomyopathy, and many other conditions. The books also reviews the growing trend towards adopting this unique therapy for a wide range of health management issues such as morbid obesity and/or type 2 diabetes, and for lowering LDL-cholesterol (cholesterol apheresis) in patients unresponsive to medication or lifestyle modification.

In 1962, 30 years after the discovery by du Vigneaud have pathologic consequences. One potentially sig- of a new sulfur amino acid, homocysteine; Carson and nificant health outcome of such mild to moderate Neil reported two siblings with mental retardation in hyperhomocysteinemia is an increased risk of occlu- northern Ireland with elevated urinary homocystine. sive vascular disease. Homocysteine concentrations in Nearly simultaneously, Gerritsen and Waisman patients with vascular disease were, on average, 31 % greater than in normal controls. Prospective assess- identified increased homocystine in the urine of a mentally retarded infant in Wisconsin. Within two ment of vascular disease risk among men with higher years, Harvey Mudd, James Finkelstein, and their homocysteine concentrations indicated that plasma coworkers at the National Institutes of health (USA) homocysteine at only 12% above the upper limit of that the enzyme cystathionine ~- normal levels was associated with a 3. 4-fold increase had reported synthase was lacking in a liver biopsy specimen from in risk of acute myocardial infarction. Studies from another patient with homocystinuria. This was the original Framingham Heart Study cohort (USA) the first indication of a vitamin relationship to have shown strong, positive correlation between homocystinuria, because that enzyme has as its co- plasma homocysteine concentration and degree of factor vitamin B6 (pyridoxal phosphate). Thereafter, carotid stenosis.

The provision of optimal dialysis therapy to children requires a thorough understanding of the multi-disciplinary manner in which the pediatric patient is affected by renal insufficiency. Knowledge of the technical aspects of peritoneal dialysis, hemodialysis and continuous renal replacement therapy must be complemented by attention to issues such as anemia, renal osteodystrophy, hypertension, growth, cognitive development, nutrition, nursing care and the psychosocial adaptation of the child and family to chronic disease. The inaugural edition of Pediatric Dialysis provides a comprehensive review of these and other related topics with a singular emphasis on the unique aspects of their application to children. With authoritative, clinically relevant, well-referenced chapters written by a host of recognized international experts who emphasize key aspects of contemporary management, Pediatric Dialysis has been designed to serve as a primary resource to all clinicians involved in the care of the pediatric dialysis patient.

Part one of the book presents the gastrointestinal problems that commonly face the general practitioner. Emphasis is placed on analysis of clinical data and how this may provoke the most profitable lines of investigation. Many of the investigation and treatment protocols are within the scope of general practice, but hospital management is also included. It was possible to deal with common oesophageal diseases under the heading of oeso phageal problems in Part 1. In contrast, it proved impossible to discuss adequately all of the common diseases affecting other organs of the digestive system under the problem headings. For this reason, a fuller ac count of many common alimentary diseases is provided in Part two. M. L.-5. K. G. D. W. 9 Series Foreword This series of books is designed to help general practitioners. So are other books. What is unusual in this instance is their collec tive authorship; they are written by specialists working at district general hospitals. The writers derive their own experi ence from a range of cases less highly selected than those on which textbooks are traditionally based. They are also in a good position to pick out topics which they see creating difficulties for the practitioners of their district, whose personal capacities are familiar to them; and to concentrate on contexts where mistakes are most likely to occur. They are all well-accustomed to working in consultation."

The initial observations of dialytic support were brought from the laboratory and confined to patients with reversible acute renal failure. The thought at that time was one of short term maintenance. It was theorized that removal of waste products from the blood, albeit incomplete and inefficient, might allow these patients time to regenerate damaged tubules and regain renal function. After a dis appointing earlier experience in survival, greater sophisti cation and broader practice refined the dialysis skills and reduced mortality. It also became apparent that long periods of support were possible and successful attempts were then made in utilizing this technology in patients with chronic renal failure. These early young patients were a very select group who possessed only renal dysfunction and no other systemic involvement. Nonetheless, they demonstrated a one year survival of only 55-64%. There are presently over 80,000 patients on dialytic support in the United States and over 250,000 patients worldwide dependent on artificial replace ment. Mortality statistics vary but despite a 20-30% systemic disease involvement and a fifth decade average age in the North American experience, the one year survival has risen to apparently 90%."

The successful series of International Meetings on "Current Therapy in Nephrology" (now known around the world as "Sorrento Meeting") has continued this year with the third meeting of the series, updating on new therapeutic strategies in Nephrology. This time the meeting was held at the Cocumella Hotel of Sorrento, Italy, on May 27-30, 1990, in a wonderful atmosphere, with the participation of outstanding scientists, such as Drs. H. Auchincloss (Boston, USA), E. Bartoli (Udine, Italy), V. Bonomini (Bologna, Italy), M. Broyer (Paris, France), V. Cambi (Parma, Italy), G. Camussi (Naples, Italy), J.M. Dubemard (Lyon, France), G. Haycock (London, U.K.), G. Jacobs (Paris, France), C. Kjellstrand (Minneapolis, USA), R. Maiorca (Brescia, Italy), G. Maschio (Verona, Italy). As many as five hundred nephrologists from all over the world (European Countries, Israel, U.S.A., Taiwan, Corea, Japan) attended the meeting, actively participating in the discussion of a great number of good papers and posters. Important lectures by invited speakers have dealed with mediators of inflammation, cellular immunity in glomerular pathology, immunosuppressive therapy in autoimmune nephropathies, treatment of hypertension in chronic renal failure, dialysis compatibility, xenogenic transplantation. Very interesting controversies have been included in the programme: "Extracorporeal or peritoneal dialysis for uremic children?" (M. Broyer against G. Haycock) and "Extracorporeal or peritoneal dialysis for diabetic uremic patients?" (c. Kjellstrand against C. Jacobs). Their presentation has been quite successful with a great participation in the discussion by Congress members.

During the past quarter century there has been a renaissance of interest in the use of peritoneal dialysis as the primary dialytic modality for the treatment of children with end-stage renal disease (ESRD). The development of continuous ambulatory peritoneal dialysis (APD) has facilitated the provision of prolonged dialysis to infants, children and adolescents and has provided pediatric nephrologists worldwide with a real opportunity to administer effective dialysis therapy to all patients afflicted with ESRD. It has been more than a decade since the initial publication of CAPD/CCPD in Children. In the interim, a great deal of clinical experience with patients receiving peritoneal dialysis has been accumulated and research efforts have substantially increased our understanding of the technique. Therefore, we felt that a second edition of CAPD/CCPD in Children was propitious to update the advances of the past decade.

Designed for daily use by professionals responsible for caring for patients with renal disease, this long-awaited primer provides a simplified, up-to-date review of peritoneal dialysis. Dealing concisely with all aspects of PD, it is written in such a style that even beginners with elementary knowledge of the subject could benefit from its use, and thus it is the perfect text for trainees or new and junior staff members. It is also an ideal text for nurses, a virtual how-to guide on PD. A book like this one, crafted specifically as a bench text and a learning tool, is hard to find. Emphasis is placed on the plentiful illustrations and tables that immediately clarify and expand upon the text. The illustrations, many in full color, are deftly drawn by one of the foremost medical artists in the world, Bernard Tardieu. Few texts can boast such a cast of distinguished authors. Ramesh Khanna, Karl Nolph, and Dimitrios Oreopoulos are among the most respected practitioners of dialysis.

Few complications of systemic diseases are better understood than diabetic nephropathy. In large part, progress in this area is due to Carl Erik Mogensen's steadfast preoccupation over more than three decades with the disorder's epidemiology, pathogenesis, pathophysiology, clinical diagnosis and evolving strategies of management. Though he sparked progress in each of these areas, he generously opens the forum of discussion to many expert contributors to this latest and most comprehensive edition of this exemplary textbook. In eliciting all relevant and up-to-date views, the reader, whether internist, pediatrician or specialist in endocrinology or nephrology, is assured a thorough review of the entire subject and in a format which is exceptionally well-written, well-illustrated and easy to read. Each of the prior editions have been an essential resource for my own work in this field and the 5th edition will no doubt continue to provide the information I and others will require to move forward in the years ahead. If only the other renal diseases were as masterfully synthesized, how much easier our task would be of achieving a comprehensive vision of all else in clinical nephrology. Barry M. Brenner, M.D., Samuel A. Levine Professor of Medicine, Harvard Medical School

During the past decade, there has been a renaissance of interest in the use of peritoneal dialysis as a primary dialytic modality for the treatment of children with end stage renal disease (ESRD). The development of the technique of continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) has markedly changed the approach to children requiring dialytic therapy. The availability of these techniques has facilitated prolonged dialysis in infants and has for the first time given pediatric nephro logists in many areas of the world an opportunity to consider dialysis in chil dren afflicted with ESRD. I have enlisted the collaboration of colleagues from Europe, South America, Canada, and the United States in compiling this multidisciplinary text, which hopefully contains the most up-to-date, comprehensive information regarding the use of CAPD/CCPD in children. It is my hope that every nephrologist (pediatric and adult); nephrology nurse (pediatric and adult); nephrology tech nician, or allied health professional dealing with children who require these therapeutic modalities will be able to resolve immediately any confounding clinical or technical issues that arise by using the information contained in this text. Demographic data on the use of CAPD/CCPD in children in Europe is provided from the EDTA Registry and in the United States from the National Peritoneal Dialysis Registry. The particular problems encountered in the use xiii xiv Preface of CAPD in children in developing countries is detailed by Dr. Grunberg and his colleagues in Uruguay."

Peritoneal dialysis represents an internal technique for membrane are becoming apparent. Studies of peritoneal blood purification. In this dialyzer the blood path, the dialysis increase understanding of the anatomy and phy membrane and the dialysate compartment are provided by siology of biological membranes and the factors influencing nature. The developments of chronic peritoneal catheters, the passive movement of solutes across the microcirculation and related structures. Peritoneal dialysis provides a 'win automated cycling equipment, solution preparation by reversed osmosis, manipulations of transport with drugs dow' to the visceral microcirculation in animals and hu and the experiences with continuous ambulatory peritoneal mans. dialysis and continuous cycling peritoneal dialysis have Peritoneal dialysis may be useful to treat problems other increased the interest in peritoneal dialysis. Publications than renal failure. Beneficial effects in the treatment of related to peritoneal dialysis probably exceed 400 annually. dysproteinemias, psoriasis, hypothermia, and many meta Peritoneal Dialysis International (formally Peritoneal Dialy bolic problems have been reported. The intraperitoneal sis Bulletin) the official journal of the International Society administration of chemotherapeutic agents draws upon and for Peritoneal Dialysis is a journal solely devoted to contributes to our understanding of peritoneal dialysis."

After the great success of the fIrst issue of the series, the International Yearbook of Nephrology 1989, we were encouraged to proceed in our editorial venture to update nephrologists yearly, on all rapidly-changing areas of nephrology. Thus we have chosen new topics and appointed experts in the fIeld, asking them to give an objective review of the topic, up-dating the readers on the world-wide literature and providing them with a complete, accurate and up-to-date list of important, recent references. We have decided to maintain the successful format of the International Yearbook of Nephrology 1989. Thus each annual issue will be devided into sections; each section will have a different primary focus every year, depending upon what area is of greatest interest at the time. In other words, the Yearbook will remain different from the numerous books which appear every year covering all aspects of nephrology. In the Yearbooks you will fInd topics usually anavailable in nephrology textbooks. In this issue we have improved the printing quality of the book, with a more uniform format throughout the volume, despite the use of camera-ready manuscripts for direct photo-offset reproduction (a procedure mandatory for a rapid publication).