|
Books > Medicine > Clinical & internal medicine > Renal medicine
A complete guide to caring for your kidneys and maximizing your
health. Kidney disease occurs when your kidneys are damaged and no
longer function as well as they should. In the past, it was fatal,
but thanks to new treatments, including dialysis and
transplantation, people can live long and healthy lives. This book
provides everything you need to know to help you cope with your
kidney disease and maximize your health. Walter A. Hunt, a medical
researcher who had kidney disease and received a kidney transplant,
walks you through what science says about how you can take care of
your kidneys, including what foods to avoid and what treatment
options may be best for you. Also included are recommendations to
help you sleep and feel better along with overall health advice. In
this latest edition, Hunt adds new sections on emerging subjects,
including * coping skills for caregivers * kidney disease in
children * environmental causes of chronic kidney failure *
conservative care for those who wish to decline treatment * related
conditions like gout, depression, and sleep disturbances * diet
after transplantation * how best to work with your care team *
insurance issues * potential new treatments A useful guide for the
healthcare professionals who work with individuals with kidney
problems.
The kidney is innervated with efferent sympathetic nerve fibers
reaching the renal vasculature, the tubules, the juxtaglomerular
granular cells, and the renal pelvic wall. The renal sensory nerves
are mainly found in the renal pelvic wall. Increases in efferent
renal sympathetic nerve activity reduce renal blood flow and
urinary sodium excretion by activation of 1-adrenoceptors and
increase renin secretion rate by activation of 1-adrenoceptors. In
response to normal physiological stimulation, changes in efferent
renal sympathetic nerve activity contribute importantly to
homeostatic regulation of sodium and water balance. The renal
mechanosensory nerves are activated by stretch of the renal pelvic
tissue produced by increases in renal pelvic tissue of a magnitude
that may occur during increased urine flow rate. Under normal
conditions, the renal mechanosensory nerves activated by stretch of
the sensory nerves elicits an inhibitory renorenal reflex response
consisting of decreases in efferent renal sympathetic nerve
activity leading to natriuresis. Increasing efferent sympathetic
nerve activity increases afferent renal nerve activity which, in
turn, decreases efferent renal sympathetic nerve activity by
activation of the renorenal reflexes. Thus, activation of the
afferent renal nerves buffers changes in efferent renal sympathetic
nerve activity in the overall goal of maintaining sodium balance.
In pathological conditions of sodium retention, impairment of the
inhibitory renorenal reflexes contributes to an inappropriately
increased efferent renal sympathetic nerve activity in the presence
of sodium retention. In states of renal disease or injury, there is
a shift from inhibitory to excitatory reflexes originating in the
kidney. Studies in essential hypertensive patients have shown that
renal denervation results in long-term reduction in arterial
pressure, suggesting an important role for the efferent and
afferent renal nerves in hypertension.
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.
|
|