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First principles chapter clearly explains the key concepts, processes and structures of the renal system. Clinical essentials chapter provides an overview of the symptoms and signs of renal disease, relevant history and examination techniques, investigations and management options. Disease-based chapters give concise descriptions of all major disorders, e.g. chronic kidney disease, each chapter introduced by engaging clinical cases that feature unique graphic narratives. Emergencies chapter covers the principles of immediate care in situations, such as hyperkalaemia and kidney stones. Integrated care chapter discusses strategies for the management of chronic conditions across primary and other care settings. Self-Assessment - 80 multiple choice questions clinical SBAs.
The aim of this guide is to provide clinicians with practical reference for the management of hypertensive patients with other cardiovascular risk factors, which originate from impaired metabolic functions. With the aid of carefully selected, paradigmatic case studies, the physician will find sound advice for the best approach to common but often under-recognized clinical situations, and answers to practical questions that arise when a specific condition is not directly addressed in the guidelines. Question-and-answer sections will help the reader to identify at a glance the most complex steps in the diagnostic and therapeutic process. In a "real world" clinical setting, the hypertensive patient rarely presents with hypertension as the only cardiovascular risk factor, and is more likely to be affected by other metabolic risk factors, such as impairment of lipid metabolism, glucose homeostasis, and purine metabolism, and by overweight or obesity. These cases will serve as a basis for analyzing best practice, highlighting problems in diagnosis and treatment, and selecting the most appropriate management of patients with metabolic risk factors in everyday practice.
This manual will meet the everyday needs of the wide range of medical professionals who play a role in the treatment of children referred to hospital because of renal disease. It is an easy-to-use, portable guide that will assist pediatricians, residents, and trainees in making prompt first-level management decisions. It will also prove invaluable for the adult nephrologists who care for children in many developing countries, and will serve as a teaching guide for experts when training non-subspecialists. Individual sections are devoted to the evaluation of renal disease; fluid, electrolyte, and acid-base disorders; glomerular diseases; tubular disorders; congenital, inherited, and urological disorders; consequences of renal disease; and miscellaneous topics. The text is in a bulleted format with tables and algorithms wherever possible, making it straightforward and easy to read. An appendix includes further important information such as normal values, drug dosages, and drug nephrotoxicity.
Kidney transplantation from a living donor provides the best chance for successful renal replacement therapy. However patient's safety remains of paramount importance and complications are unacceptable. Laparoscopic donor nephrectomy (LDN) has been proven to have a lower surgical mortality and morbidity as well as a lower blood loss, a shorter hospital stay, and a better cosmetic result compared to the open procedure. This has resulted in LDN being considered the standard in many centers. Robot-Assisted Laparoscopic Donor (RALD) nephrectomy is a new trend developed in the last decade. Robotic assistance is increasingly popular worldwide, because it offers optimal operative conditions to the urological surgeon and a shorter learning curve than the standard laparoscopy.
This book serves as a concise guide to urinary stone disease, providing simplified and complete information about the topic area. Various surgical techniques are provided and accompanied by first-hand accounts, to give insight into the operating room. The book is a quick reference guide and is relevant to both trainees and professionals. Written by a leading expert in the field, this book brings together years of experience and contains essential information on all aspects of lithology. The book covers all treatment options so that the best possible methods can be chosen for each patient. Urinary stone disease is a widespread ailment and updated information about it is permanently needed by trainees and professionals.
Vitamin D deficiency, circulating levels lower than 15 ng/ml, is an epidemic disease worldwide with more than a billion people suffering of it in the beginning of the 21-century. Besides its impact on mineral and bone metabolism, these low vitamin D levels are also associated with a diversity of non-skeletal complications, among them cardiovascular disease, diabetes mellitus, multiple sclerosis, cancer, tuberculosis, and immune system dysfunction. Chronic Kidney Disease is also a very common disease, affecting more than 10% of the world population, ranging from stage 1 to stage 5 before dialysis. Approximately 1% of the population in industrialized countries is affected by end-stage renal disease (ESRD), needing a renal replacement therapy either hemodialysis or peritoneal dialysis, and ultimately by renal transplantation. Those CKD patients are more susceptible to exhibit reduced vitamin D stocks. Consequently, more than eighty percent of CKD patients have either insufficient or deficient vitamin D levels for multiple reasons.
An overview of the diagnosis, treatment, and long-term management of diabetic-related kidney disease in clinical practice. Includes an evidence-based discussion of currently available and experimental drug therapies currently in development, guided by international consensus guidelines. Ideal for physicians, medical trainees, nurses and other medical professional that regularly screen and treat patients with all types of diabetes.
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.
This book is designed to assist physicians in choosing among diagnostic procedures and therapeutic options when caring for patients with hypertension and markers of organ damage. The comprehensive description of practical clinical cases sets this book apart from other publications and will help the reader to transfer general guideline recommendations to the clinical setting. With this purpose, the cases have been selected to reflect situations frequently encountered during clinical routine, rather than hypertensive crises or emergencies or the rare presentations that tend to be addressed in case reports in scientific journals. The scenarios considered include treated hypertension with uncontrolled blood pressure levels in patients with left ventricular hypertrophy, diastolic dysfunction, carotid atherosclerosis, microalbuminuria and renal impairment, proteinuria and renal disease, and abnormal pulse pressure. By representing clinical practice in a "real world" setting, these paradigmatic cases will enable the practitioner to select the diagnostic tools and form of treatment best suited to the individual patient and the particular cardiovascular risk profile, thereby optimizing outcomes.
This book presents a comprehensive and instructive management plan for physicians who care for CKD patients. Basic aspects of CKD, clinical assessment, evaluation and management of risk factors, cardiovascular disease in the context of CKD, assessment and management of CKD complications, special circumstances in CKD patients, and the path to renal replacement therapy are all thoroughly covered. Diagnostic and therapeutic approaches are presented according to the latest staging system for CKD, with patient care being discussed separately for each disease stage. The proposed management plan is both "best available evidence based" and "practice based." The book also recognizes the needs of busy clinicians by including helpful boxes summarizing the evidence on diagnostic and therapeutic issues and practice pearls based on guidelines. The authors are recognized experts from across the world, ensuring global coverage of the problem, and most have participated in writing guidelines on CKD.
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 number of dialysis patients, and their ages, continues to increase globally. This creates major issues such as rising medical costs in an aging population, how to best manage end-of-life care, and how to train the various practitioners involved in dialysis care. After the US and China, Japan occupies 3rd place with regard to the number of dialysis patients and is also widely regarded as a world leader in dialysis. This book contains selected articles - organized into 4 chapters - that discuss recent advances in dialysis therapy in Japan. Chapter 1 presents insights into causes, risk factors, disease associations, and possible implications for management of dialysis patients. Chapter 2 examines recent progress in hemodialysis treatment, and chapter 3 focuses on developments in peritoneal dialysis. The final chapter concentrates on recent advances in apheresis and current trends in practice, among other topics. This book is aimed at nephrologists, physicians, urologists, nurses, clinical engineers, pharmacists, and nutritionists. It is a significant contribution to furthering the progress of dialysis therapy worldwide.
This guide is structured to assist physicians in the management of those hypertensive patients who present with specific comorbidities, such as diabetes, systolic dysfunction, obesity, renal disease, or previous cardiac events, often associated with hypertension. The clinical cases contained in this book have been selected to provide a paradigmatic set of scenarios frequently encountered in daily clinical practice, and will serve as an easy-to-access tool in applying general guidelines to individual patients, particularly in the choice of the most appropriate antihypertensive therapy. Treatment of hypertension with associated clinical conditions require specific therapies and combinations of drugs, which are necessarily different from one comorbidity to another. By discussing exemplary cases that may better represent clinical practice in a "real world" setting, and analyzing step by step the diagnostic and therapeutic process, this book will assist cardiologists and physicians in selecting the diagnostic tools and forms of treatment best suited to the individual patient and the particular cardiovascular risk profile.
Approximately 14 million people in the UK live with some form of bladder complaint. This equates to over one in five people, so even if you don't personally experience the embarrassing and intrusive symptoms of bladder dysfunction, it is likely that you know someone who does. Bladder dysfunction does not discriminate as these problems affect all ages and genders. Despite the fact that these health issues are very common, it can be difficult to discuss them with family, friends and even a doctor. Many people suffer needlessly in silence even though there is now a wide range of investigations and treatments that can lead to effective and long-lasting symptom relief. This book guides you through the different conditions associated with bladder dysfunction, how you can help yourself, what to expect if you need to undergo investigations and the numerous evidence-based treatments that are available - both mainstream and complementary - so that you will no longer need to feel reluctant to broach the subject with your GP - meaning you can find your way back to good health.
This book explains how hypertension affects 20-50% of the adult population in developed countries. Heart failure is the result of the hypertension's effects on the heart and it represents a growing public health problem. In this context the international scientific community is continuously struggling to develop better strategies in screening, diagnosing and treating hypertension and its deleterious effects. Thus, this field is continuously changing, with new important information being added constantly. This volume will offer both insights into the intimate mechanisms of transition from hypertension to heart failure and clinical practice advice on the prevention and treatment of heart failure in hypertensive population. The mechanisms which explain the progression from hypertension to heart failure will be also covered exhaustively by offering two chapters referring to the diagnosis of heart failure in hypertensive population and one regarding echocardiography which is the most frequently used imaging method in clinical practice. The reader will be also provided with information on cardiovascular magnetic resonance which has the unique advantage of differentiating hypertensive heart failure from other pathologies associated with increased myocardial thickness. This book is a useful tool for clinicians but also to the research community interested in heart failure and consequences of hypertension on heart who want to be up-to-date with the new developments in the field.
"Renal Neoplasms: An Integrative Approach to Cytopathologic Diagnosis" provides a comprehensive review of cytology and all the morphologic correlates, including their respective limitations, related to a broad spectrum of renal neoplasms with special emphasis on cyto-histo correlation. The book also discusses related usual radiologic appearances, gross features and possible targeted therapies where appropriate. The volume features an integrated approach that provides step-by-step guidance in the morphologic evaluation of renal neoplasms. Furthermore, all chapters are written by experts who deal with this type of specimen in their daily practice and have insights into the pathology as well as the clinical aspects of these tumors.
Illustrated with high quality color microphotographs and formatted for ease of use in the lab, R"enal Neoplasms: An Integrative Approach to Cytopathologic Diagnosis"is a helpful guide to everyday pathology practice, especially for pathologists who rarely encounter this type of specimen."
This volume, written by well-known experts in the field, covers all aspects of Anti-Neutrophil Cytoplasmic Antibody (ANCA) Associated Vasculitis (AAV). The expression refers to a group of diseases, characterized by destruction and inflammation of small vessels. The clinical signs vary and affect several organs, such as the kidney, lung, skin, nervous system and others. The opening chapters give some historical hints, explain the genetic basis of the disease and provide insights into the pathogenesis derived from recent experimental studies and guides the reader through classification and nomenclature. A large part of the book is then devoted to a detailed description of the specific related diseases and their clinical presentations, the disease course, and potential complications. The advice regarding treatment is based on the best currently available evidence in this constantly evolving area. The book is part of Springer's series Rare Diseases of the Immune System, which presents recently acquired knowledge on pathogenesis, diagnosis, and therapy with the aim of promoting a more holistic approach to these conditions. AAVs are systemic autoimmune diseases of unknown cause that affect small (to medium) sized blood vessels. They include granulomatosis with polyangiitis (formerly Wegener's granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome). This volume will be an invaluable source of up-to-date information for all practitioners involved in the care of patients with these diseases.
This practical guide provides the reader with answers to important clinically relevant questions regarding the evaluation and management of acute kidney injury (AKI). All aspects of critical care nephrology are covered, from pathophysiology and diagnosis to prevention and treatment. The questions considered relate to a wide range of issues, such as: How do I diagnose AKI? How can I protect the kidney in clinical practice? How do I manage patients with AKI? When should I initiate and how do I perform renal replacement therapy (RTT)? Which type of RTT is most appropriate for my patient? Should I give specific nutrients? In addition to providing practical guidelines and treatment algorithms, the book includes calculators for continuous RRT and anticoagulant dosing. The authors are internationally renowned experts in the fields of Intensive Care Medicine and Nephrology and all contributions are written in a clear and concise style and have been peer reviewed. Acute Nephrology for the Critical Care Physician will serve as a very useful source for intensivist internists, anesthesiologists and nephrologists involved in the management and treatment of critically ill patients at risk of or affected by AKI.
In modern medicine, the aging population is prone to many simultaneous cardiovascular (CV) risk factors which often produce co-incident pathology. Nowhere is this more obvious than in the interaction between Chronic Kidney Disease (CKD), Diabetes and diverse CV diseases (CVD). This is a complex and challenging area, as the presence of CKD/diabetes promotes CVD while also complicating its treatment. The emergence of CKD as a public health priority is one of the most challenging problems of modern medicine. It is now solidly established that renal dysfunction portends a high risk for cardiovascular disease. Cardiovascular diseases remains the main cause of death in western societies and the amplification of the death risk conveyed by coexisting CKD, even though still poorly understood, appears considerable. The bidirectional link that associates renal and cardiovascular diseases, the high risk of the death signalled by their coexistence and the considerable epidemiological burden imposed by this link is at the basis of the emergence of a new discipline aiming at making the borders between nephrology and cardiovascular medicine even more permeable than before. The term Cardio-Renal Syndrome was coined around 5 years ago to try to formalize this link, and act as a stimulus to interaction between clinical teams, researchers and others to achieve better management and outcomes for all. This book takes clinical presentations and clinical problems as its base, and then discuss the evidence for best management of common clinical problems as well as the reasons for the complex interplay between the cardiac and renal systems. Moreover, it addresses the issue of organizing healthcare to maximize the opportunities for prevention and best healthcare economic returns, building on cutting edge initiatives at the Karolinska, Stockholm. The book will be of immediate value and interest to all cardiologists and renal physicians.
Surgical Techniques for Kidney Cancer provides a comprehensive review and detailed description of surgical techniques for kidney and adrenal cancer. Through a step by step approach various surgical techniques are covered including radical nephrectomy, partial nephrectomy, and thermal ablation for renal cortical tumors. Each step by step approach is followed by the latest data on outcomes. Furthermore, limitations as well as tips and tricks are detailed in addition to management of common complications. Kidney Surgery for Urologists will be a valuable resource for Urologists, Urological Surgeons, Fellows in Urologic Oncology and Minimally Invasive/Robotic Surgery as well as upper level residents training in Urology.
Primary glomerulonephritis is one of the most frequent renal diseases, and a main cause of end-stage kidney disease. Glomerulonephritis has multiple subtypes, each with different physiopathologies, clinical presentations, and management requirements, which makes treatment difficult. As a complex set of diseases, the choice of symptomatic and specific treatment is critical to ameliorating the relentless course of glomerulonephritis. Focusing on all aspects of primary glomerulonephritis, from their epidemiologies and classification, to their pathogenesis and treatment, this third edition of Treatment of Primary Glomerulonephritis has been fully updated to include the latest research and evidence-based practice. With a strong emphasis on drugs used for both symptomatic and specific treatments, mechanisms of action, effectiveness, and potential toxicity are considered for therapeutic strategies in the different subtypes of primary glomerulonephritis. Each chapter follows a clear and logical format, allowing easy access to key information. Featuring over 20 full-colour histological images of different diseases to aid diagnosis, and with commentary from internationally recognised experts in the field, this new edition is an essential resource for all practising or academic clinical nephrologists.
This thoughtful new book presents strategies for helping end-stage renal disease patients and their families deal with the psychosocial aspects of the chronic long-term illness. Technological advances in the treatment of this disease have offered much hope for improved quality in living which has led caregivers to have a greater concern for preserving the quality of life of their patients. In Psychosocial Aspects of End-Stage Renal Disease leaders in the field of many disciplines share knowledge and reveal problems that are still evident to them in the confrontation with this potentially fatal illness.Five comprehensive sections devote special attention to the different areas of concern for the psychosocial well-being of end-stage renal disease patients. The impact of renal disease on family relationships is covered by examining issues of family responses and coping measures such as marital and family reactions to home and hospital dialysis treatment. Ethical issues in treatment are explored, including the ethics of treatment refusal and a Jewish perspective on kidney transplants. Relations between staff and patients and a timely section on renal disease and special populations, particularly the elderly and AIDS patients, make up the final two sections of this informative volume. Professionals in all allied health disciplines will benefit from this important volume as it demonstrates a model approach, if not the definitive one, for the treatment of the psychosocial aspects of end-stage renal disease as well as other chronic illnesses.
The Oxford Handbook of Epidemiology for Clinicians provides all the information required by students and junior doctors who need to understand and translate key epidemiological concepts into medical practice. Unlike standard textbooks in this area, the focus throughout is on clinical applications of epidemiological knowledge. Divided into four sections, the handbook begins with the basics of epidemiology in the clinic, moving on to the theories behind evidence-based practice, discussions of optimum methods and studies, and then ends by looking at the epidemiology of common diseases. The material is presented in a logical manner, from problems to the most appropriate solutions or tools to be applied. Interesting topics such as controversies in prevention intervention encourage discussion and thought, and the authors pose sensible and important questions throughout. This handbook is a must for all junior doctors, medical students, and clinicians who need to apply epidemiological concepts to day-to-day practice or who want a practical step-by-step guide to undertaking research, conducting reviews of evidence, or writing up publications.
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