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.

The breadth of the pharmaceutical medicine curriculum can be daunting, but this book is designed to navigate a path through the chaos. Providing a broad overview of all topics relevant to the discipline of pharmaceutical medicine, it gives you the facts in an accessible and user-friendlyformat.
With 136 chapters spread across 8 sections, the text offers a thorough grounding in all aspects of the field, from regulatory control to trial-building and data management. This makes it a useful revision aid for exams as well as giving the reader a taster of areas of pharmaceutical medicine adjacent to their current role. For healthcare professionals already working in the field, the book offers a guiding hand in difficult situations as well as supplying access to the latest recommendations and guidelines. Comparing regulatory bodies and guidelines from around the world, it provides a truly global perspective that allows readers to confidently apply knowledge internationally.
Produced in the style of the accessible Oxford Handbook series with plenty of space for notes, it details the facts in a concise and readable format, without the reader having to dive through page upon page of dense text. Written by authors with over 20 years of experience in the industry, this comprehensive and authoritative guide provides a shoulder to lean on throughout your pharmaceutical career.

When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.

In all varieties of organ transplants, early results have dramatically improved over the past two decades and failures due to acute rejection are becoming rarer. Efficient immunosuppressive regimens have been developed with the objective of very good results at 1, 3 and 5 years. Successful transplants, however, are significantly less frequent at 10 and 20 years, and many patients require retransplantation. Many factors are involved in late graft loss and it is now well recognized that, in addition to chronic rejection, a number of non-immunologic factors play a prominent role. In the case of renal transplantation, a reduced mass loss (transplantation of a single kidney, sometimes from an aged donor, ischemic injury and alteration of some nephrons in the case of early acute rejection) will result in slowly progressing chronic renal failure, even in the absence of any supplementary attack of an immunological nature. The new treatments must be analyzed in the light of their capacity to reduce these late failures. Several preventive measures can also limit both immunologic and non-immunologic factors of late transplant deterioration.

In recent years both doctors and patients have become increasingly aware that many essential drugs may induce unfortunate side-effects in susceptible individuals. The kidney is the principal route of excretion for many of these substances and may as a result become involved in pathological processes. Developments in haemodialysis and haemo perfusion may be of value in increasing the rate of excretion of potentially toxic substances but it is essential that the advantages and disadvantages of these techniques are fully appreciated by all with an interest in clinical practice. This book details the recent advances in understanding of analgesic nephropathy, interstitial nephritis, elimination of poisons and drug monitoring. Each chapter has been written by a recognized expert in the field and provides information of relevance and practical import ance to the average clinician. The developments of the last decade have emphasized that drug toxicity is a subject on which all clinicians, but perhaps especially nephrologists, should be fully informed. ABOUT TH E EDITOR Professor Graeme R. D. Catto is Professor in Medicine and Thera peutics at the University of Aberdeen and Honorary Consultant Phy sician/Nephrologist to the Grampian Health Board. His current interest in transplant immunology was stimulated as a Harkness Fellow at Harvard Medicial School and the Peter Bent Brighton Hospital, Boston, USA. He is a member of many medical societies including the Association of Physicians of Great Britain and Ireland, the Renal Association and the Transplantation Society."

This Open Access volume provides readers with an open access protocol collection and wide-ranging recommendations for preclinical renal MRI used in translational research. The chapters in this book are interdisciplinary in nature and bridge the gaps between physics, physiology, and medicine. They are designed to enhance training in renal MRI sciences and improve the reproducibility of renal imaging research. Chapters provide guidance for exploring, using and developing small animal renal MRI in your laboratory as a unique tool for advanced in vivo phenotyping, diagnostic imaging, and research into potential new therapies. 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. Cutting-edge and thorough, Preclinical MRI of the Kidney: Methods and Protocols is a valuable resource and will be of importance to anyone interested in the preclinical aspect of renal and cardiorenal diseases in the fields of physiology, nephrology, radiology, and cardiology. This publication is based upon work from COST Action PARENCHIMA, supported by European Cooperation in Science and Technology (COST). COST (www.cost.eu) is a funding agency for research and innovation networks. COST Actions help connect research initiatives across Europe and enable scientists to grow their ideas by sharing them with their peers. This boosts their research, career and innovation. PARENCHIMA (renalmri.org) is a community-driven Action in the COST program of the European Union, which unites more than 200 experts in renal MRI from 30 countries with the aim to improve the reproducibility and standardization of renal MRI biomarkers.

Though kidney transplantation is considered a routine procedure, there are still significant challenges in post-transplant management. "Core Concepts in Renal Transplantation" is a clinically focused authoritative guide to the management of kidney transplantation. This comprehensive, state-of-the-art reference summarizes the recent changes in the field of transplantation, offering the complete range of up-to-date information on all the various aspects of basic immunobiology and the medical care of the transplant recipient. Written by a team of renowned authorities in renal transplantation, this concise resource is intended for both the nephrologist and the non-specialist with an interest in kidney transplantation.

Covering all aspects of the many rheumatologic disorders associated with renal disease, including pathogenesis, clinical features and treatment, Rheumatology and the Kidney brings together the available information in an accessible and practical way, with a particular focus on evidence-based patient management. Part of the Oxford Clinical Nephrology Series, and featuring chapters from a team of international experts, this new edition has been completely updated since publication of the first edition in 2001 and now contains more tables and figures to make the information more accessible. Completely updated since publication of the first edition in 2001, and with more illustrations, this book brings together the available information on the many rheumatologic disorders associated with renal disease in an accessible and practical way, with a particular focus on evidence-based patient management.

Kidney stone is a significant disease with a 12-15% prevalence in the United States. Patients with a history of stones have a 50% risk of making another stone in 5 years or 80% risk in their lifetime. The goal of this book is to educate the reader on the nuts and bolts of stone disease and to provide new and updated information to help them tackle this painful disease.

In Adrenal Disorders, a panel of distinguished physicians and researchers select the most relevant new findings and integrate them into the existing body of clinical knowledge on adrenal pathologies. The book includes important reviews of disturbances in cortisol homeostasis, and new concepts regarding adrenal tumors and hereditary adrenal diseases. Also discussed are mineralocorticoids and the syndromes of mineralocortoid excess and aldosterone synthase deficiency. Authoritative and insightful, Adrenal Disorders provides physicians and scientists with a comprehensive, state-of-the-art practical guide to the devastating diseases of the adrenals that are so often difficult to diagnose and treat.

Cancer and the Kidney covers the challenging overlap area of nephrology and oncology. Kidney problems in cancer patients, and cancer that affects kidney patients, are both very real clinical issues in medicine. For example, cancer is a common complication of kidney transplantation, and up to half of all survivors of bone marrow transplant may develop chronic kidney disease.
Since publication of the first edition in 2005, there have been many changes in this area. These include the recognition of chronic kidney disease after uninephrectomy for cancer, the occurrence of medication toxicities of the EGFR antagonists and of the VEGF antagonists, and changes in the approach to multiple myeloma. In this new edition, the primary authors cover diverse subjects in this area, ranging from assessment of kidney function, to paraneoplastic disorders, acquired cysts and native kidney cancers, and all points inbetween. Each chapter starts with a case study to ensure a practical focus, and there are numerous illustrations throughout. Specialists and trainees in nephrology and in oncology will find it a useful starting point and reference, as will physician assistants and nurse practitioners who work in these fields.

Chronic Kidney Disease (CKD) is rapidly becoming a global healthcare problem with an estimated 10% of the general population affected. As a result, it is becoming increasingly important that primary care physicians and general physic, as well as aspiring nephrologists, have a firm understanding of CKD as well as access to the key information.
Practical and highly-accessible, this book provides a comprehensive guide to the understanding and management of patients with CKD. It offers both primary care physicians and non-nephrology specialists an introduction to and insights into the disease. The emphasis is on practical guidance and a focused approach to a number of key topics in the field including epidemiology, diagnosis and management, and the impact of CKD on chronic, non-communicable disease.
This is a unique contribution by internationally renowned experts in the CKD field to update primary care physicians and non-specialists on major issues in this growing global healthcare problem.

The aim of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY is to publish every year a volume to keep nephrologists up to date on all the rapidly changing areas of nephrology. Each volume will be published by the end of each calendar year which corresponds with the annual meeting of the American Society of Nephrology. Each issue of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY will be divided into sections; each section will have different primary focus every year, depending upon what area is of greatest interest at the time. In other words, each annual volume will deal with what is truly current in nephrology. All the authors appointed for the chapters of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY are known experts in the field who will give an objective review of the topic up-dating the readers on the world-wide literature. A crucial point for the success of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY is the list of the references at the end of each chapter. We have asked all authors to provide a complete, accurate and up-to-date list of important references. In order to guarantee the most up-to-date yearbook, very rapid production is mandatory. Rapid publication can be obtained only with camera-ready manuscripts for direct photo-offset reproduction. Thus we have agreed to use photo-offset printing for the series. For the first issue of the series, the INTERNATIONAL YEARBOOK OF NEPHROLOGY 1989, the Editorial Board has focused attention on the latest and most important scientific and clinical advances in nephrology.

This book systemically presents the latest research on renal fibrosis, covering all the major topics in the field, including the possible mechanisms, biomarkers, and strategies for prevention and treatment of chronic kidney disease (CKD). Due to its high prevalence, CKD represents a huge global economic and social burden. Irrespective of the initial causes, CKD progresses to end stage kidney disease (ESKD) due to renal fibrosis, which is characterized by glomerulosclerosis, tubule atrophy and atresia, and the excessive accumulation of extracellular matrix (ECM) in the kidney. Unfortunately, an estimated 1%-2% of the adult population living with CKD will need renal replacement therapy at some point as a result of ESKD. As such, strategies for preventing or slowing CKD progression to ESKD are of utmost importance, and studies aiming to understand the mechanisms of renal fibrosis have been the focus of intensive research. Recently, novel insights into the pathophysiological processes have furthered our understanding of the pathogenesis of renal fibrosis, and more importantly, promoted studies on the early diagnosis and treatment of CKD. This book draws lessons from the extensive, state-of-the-art research in this field, elaborating the new theories and new techniques to offer readers a detailed and comprehensive understanding of renal fibrosis and as well as inspiration for future research directions.

This book considers the aetiological factors that render renal patients at risk of infection and covers the infectious complications of the major modalities of renal replacement therapy. The book has been written by a combination of microbiologists, clinical scientists and clinicians active in the care of kidney patients at all stages in their treatment from chronic renal insufficiency through dialysis and on to transplantation. It brings together a large body of clinical and scientific material to help clinicians manage infectious complications of kidney disease. As far as is possible a clinical chapter is balanced by a chapter dealing with pathophysiology.

The book is divided in to three sections: Basic Mechanisms, Infectious Complications of Common Renal Conditions, Renal Failure and Transplantation, and Prevention and Management.

The uraemic condition as a state of immunosupression is discussed to set the scene for why renal patients are prone to so many diverse infections. Increasingly potent immunosuppressive drugs are being deployed in a variety of primary conditions and also to prevent renal allograft rejection. The mechanisms by which these drugs predispose to infection are discussed. A chapter deals specifically with peritoneal defence mechanisms of critical importance in the management of infection complicating continuous ambulatory peritoneal dialysis.

The second section of the book deals specifically with infectious complications in defined situations. For example, diabetes mellitus is discussed in detail as this is now the major cause of endstage chronic renal failure. Infectious complications of glomerulonephritis and vasculitis are discussed, and this relates to the effects of the potent immunosuppressive agents now deployed. Specific chapters are devoted to infectious complications of peritoneal dialysis and haemodialysis including a chapter on mucormycosis. Hepatitis B and Hepatitis C have each been given a chapter and the impact of these hepatitis viruses on the renal patient from chronic renal failure through dialysis to transplantation is described. Infectious complications of transplantation follows and reviews the common infections as well as presenting some new data on viral induced tumours.

In the final section of the book, prevention of infection is discussed with particular emphasis to vascular access and the care of the uraemic ischaemic/diabetic foot. The general principles relating to limiting the spread of infection within the Renal Unit are discussed in detail. Increasing patient mobility and travel requires that travel and vaccination in renal patients are discussed. The book ends with a practical chapter on prescribing advice for the use of common anti-microbial agents.

This book will be of value to all those involved in the care of this vulnerable group, specifically nephrologists, renal transplant surgeons and physicians and diabetologists.

During the past 4O years there have been major conceptual and technical advances in the domain of dialysis methods and renal/organ transplantation for long-term treatment of patients with End-Stage Renal Failure (ESRF). This now enables better defined, more selective strategies of treatment to be undertaken, according to patient-specific criteria such as age or underlying renal disease also taking into account the lifetime duration of these treatments. For many patients this implies necessary successive changes of mode of therapy depending on their availability, occurrence of medical/technical complications or failure and social-environmental and economic factors.

This rationale has inspired the structure of this volume which is divided into four sections: 1/ A descriptive overview of the various modes of renal replacement therapy (RRT): Extracorporeal dialysis/filtration, peritoneal dialysis, kidney and multi-organ transplantation.2/ Most appropriate indications and use of these methods, respective advantages, drawbacks and outcome in children, pregnant women and elderly patients 3/ In diabetic patients and in patients with hereditary/congenital diseases. 4/ The ethical issues generated by this new domain in Medicine by limitations in treatment facilities or medical dilemmas for acceptance, best technical choices, withdrawal or termination of RRT in individual patients.

Finally, contributors form Eastern European Countries, Africa and Far Eastern Countries analyse the current status of RRT in their respective geographical area and the ways and means required for a wider implementation of RRT in thus far lesser economically developed countries where the great majority of the populations still have no access to these life-saving therapeutic procedures.

Anemia in the elderly has been properly defined as the silent epidemic, representing 3 million people in the United States aged 65 years and older. Incidence and prevalence of this condition increase with age. It differs in its etiology, pathogenesis and treatment from anemia in children and younger adults. Anemia is associated with reduced survival, increased risk of functional dependence and hospitalization, increased risk of congestive heart failure and stage renal disease and cognitive disorders. Approximately 70% of anemia in older individuals is reversible.

Lecture Notes: Nephrology is a concise introduction to the fundamental principles of nephrology. An ideal study guide for medical trainees, this accessible resource combines the depth of a textbook with the accessibility of a handbook. Succinct chapters describe the clinical implications of renal physiology, examine major renal disorders and diseases, and explain a wide range of management and treatment options. A new addition to the popular Lecture Notes series, this handbook provides trainees in nephrology with core subject knowledge and enables medical students to gain a more comprehensive understanding of this complex specialty. Offers clear, easy-to-understand coverage of all relevant nephrology topics Includes MCQs and discussion around the answers, ideal for those preparing for written Internal Medicine examinations, including the certification examination of the American Board of Internal Medicine, the UK-based MRCP and the Australia and New Zealand-based FRACP examinations Features chapter summaries and numerous infographics, tables and figures Emphasises core management skills needed by medical students and junior doctors Is presented in the consistent and well-recognised Lecture Notes format

This book provides a comprehensive review of ethical issues in clinical nephrology. With the advent of dialysis and kidney transplantation midway through the 20 Century, clinical nephrology was one of the first areas of medicine to deal with complex ethical issues such as rationing of health care and discontinuation of life-sustaining therapy. In the first section of the book this historical perspective is reviewed, followed by a consideration of legal issues. Specific ethical issues in nephrology are discussed in detail in the next section. These include problems in the allocation of chronic dialysis and in termination of that treatment. Also reviewed are issues in kidney transplantation, such as proposals for enhanced acquisition of kidneys, including a number of controversial proposals such as payment to donors and xenotransplantation; and equity in allocation of the supply of kidneys. Other chapters consider ethical issues in genetics; special problems in the care of children with kidney disease; and broad societal issues such as allocation of national resources for expensive therapies and economic issues in clinical practice. In the final part of the book ethical issues in the care of patients with kidney disease are discussed from an Asian and African perspective.

A better understanding of the pathophysiology of renal failure coupled with technological advances in dialysis techniques and renal transplantation have greatly improved the prognosis and survival for patients with end-stage renal disease (ESRD). Unfortunately, the advances and success of treatment are limited by a number of extrarenal complications that can cause significant morbidity and mortality. Of these, cardiovascular abnormalities are the most common, with cardiac complications alone accounting for more than 40% of deaths in international registries. The importance of cardiovascular complications has become more apparent in recent years with the increased prevalence of diabetes mellitus and vascular nephropathy and with the general ageing of patients with ESRD. The past decade has witnessed enormous advances in understanding the causes and pathophysiology of cardiovascular disease, and their diagnosis, treatment, and prevention. It is, therefore, of importance for physicians caring for patients with end- stage renal failure to understand the pathogenesis of cardiovascular complications, to become familiar with modern diagnostic tools and techniques, and to recognise and treat these complications. The goal of this text is to provide a comprehensive review of the pathophysiology and clinical manifestations of the principal cardiovascular complications in patients with chronic renal failure. The text is intended to assist nephrologists, cardiologists, and internists who care for these patients. The book includes nineteen chapters and is organised in three parts. The first includes three chapters dealing with the epidemiology of cardiovascular disease in patients with end-sage renal failure. The second comprises eight chapters on the basic pathophysiology and pathobiology of cardiovascular diseases in the setting of end- stage renal failure. The third includes eight chapters focussing on clinical manifestations and diagnosis of cardiovascular disease in patients with end-stage renal failure and their management.

Clinical nephrology is confronted with an emerging medical catastrophy of international proportions; endstage renal failure in patients with type 2 diabetes. Based on a number of recent studies it has become apparent, that nephrology in type 2 diabetes is a preventable condition, at least in principle. It is for this reason that it appeared timely to summarize the current state of knowledge concerning nephropathy in type 2 diabetes giving an update on the predisposing factors on which interventions are of proven benefit and on the accepted standards of management of such patients. This concise monograph is addressed not only to nephrologists, but also diabetologists and general practitioners. It is hoped that it will help to improve clinical outcomes in the future.

This book presents up-to-date information on how to assess early preclinical alterations in the heart, the small and large arteries and the kidney using the most sensitive, specific and cost-effective techniques. A wide variety of techniques are discussed, with careful attention to the latest developments. For each organ, evidence is documented regarding the prevalence of organ damage in the general and the hypertensive population. Information is provided on the potential induction of regression of organ damage by treatment, the criteria for establishing significant changes and the clinical prognostic significance of regression. The manual will be invaluable for all practitioners responsible for the clinical management of hypertensive patients, given that the assessment of early preclinical cardiovascular and renal damage permits more accurate risk stratification at baseline and facilitates evaluation of cardiovascular protection when regression of structural changes is achieved during treatment.