As the number of people aged 65 years and above rises, physicians are increasingly confronted by elderly patients with impaired renal function, altered drug metabolism and multiple comorbidities. This book examines in detail the nature of renal injury in the elderly and its optimal management. A wide range of key topics are covered, including end-stage renal disease, diabetic nephropathy, acute kidney injury, drug metabolism and renal toxicity, dialysis and its complications and the use of renal transplantation. In addition, the assessment of glomerular filtration rate in the elderly and the role of novel renal biomarkers are carefully examined. Quality of life issues, the significance of other age-related medical problems and end of life care are also discussed. This book will be of value not only to nephrologists but also to general practitioners, medical students, intensivists, cardiologists, pharmacologists and those working in related specialties.

The treatment of hypertension has become the most important intervention in the management of all forms of chronic kidney disease. Chronic Kidney Disease and Hypertension is a current, concise, and practical guide to the identification, treatment and management of hypertension in patients with chronic kidney disease. In depth chapters discuss many relevant clinical questions and the future of treatment through medications and or novel new devices. Written by expert authors, Chronic Kidney Disease and Hypertension provides an up-to-date perspective on management and treatment and how it may re-shape practice approaches tomorrow.

Nutrition in Kidney Disease, Second Edition addresses the relationships between nutrition and (1) normal kidney function and disease, (2) the progressiveness of chronic kidney disease (CKD) and strategies to prevent further compromise, and (3) the treatment and management of kidney failure especially during medical crises, such as acute kidney injury and its consequent nutritional therapies (e.g., enteral and parenteral nutrition). Demographic patterns, trends and outcomes in the current health care systems are explored in the United States and abroad. Disease prevention and management are presented over the entire lifespan, beginning with pregnancy, followed by infancy, childhood, adolescence, and adulthood, concluding with the elder years. Foundations for clinical practice are established by devoting a complete section towards conducting a comprehensive nutritional assessment, comprising of anthropometric, biochemical, clinical, physical parameters and psychosocial concerns unique to the kidney disease population. Nutritional therapy is also discussed across the spectrum of kidney disease, and pertinent aspects critical to successful management of disorders and conditions, such as bone disease, obesity, and nephrotic syndrome are explored. Nutrition in Kidney Disease, Second edition highlights cutting edge research in regards to exercise and functional outcomes, malnutrition and the inflammatory response, experimental therapies, and the use of complementary and alternative medicine, with a special emphasis on relevant preventative strategies.

This book systematically summarizes the ideas and technologies used in urine proteome analysis. It argues that change is the core of biomarker definition since the body uses its homeostatic mechanisms to correct changes in the blood. This means that urine is probably a better source of biomarkers than blood. A roadmap to the urinary biomarker era is proposed, and researchers are reminded of the potential opportunities and risks in their study design. Kidney diseases are emphasized as they produce the most significant changes in urine. This book tries to show researchers and graduate students, who are in or entering the field, "all things considered" rather than "the current affair".

Diabetes and Kidney Disease reviews the most up-to-date research on diabetic nephropathy, the current understanding of its pathophysiology, renal structural alterations and clinical features and summarizes recent evidence-based clinical treatment modalities for the prevention and management of diabetic kidney disease. General clinical aspects are covered, as well as an overview to the novel approaches being designed by leading researchers in the field. A convenient compendium for physicians involved in the care of diabetic patients with varying degrees of kidney involvement, Diabetes and Kidney Disease is also a handy resource for medical residents and students interested in the current status and future approaches to reducing the burden of diabetes and diabetic kidney disease.

Practical Controversies in Medical Management of Stone Disease addresses areas of controversy regarding the evaluation and management of recurrent stone formers and provides the best available evidence to support or refute common common drug and dietary recommendations. Aimed at dispelling common myths about preventative stone treatment, this book provides practical recommendations for the diagnositic evaluation and treatment and recurrent calcium calcium stone formers, but addresses uric acid and cystine stone formers. Written by experts in stone disease, Practical Controversies in Medical Management of Stone Disease is a concise yet comprehensive resource that provides the best, current evidence supporting medical practices regarding kidney stone prevention. The book will be of value to anyone involved in the medical care of patients with kidney stones, including urologists, nephrologists, primary care physicians, and dieticians.

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.

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.

This book is intended to provide up-to-date and emerging information in the field of diabetes mellitus with a focus on preventive, predictive and personalized medicine.

Through case presentations and a question and answer format, Clinical Decisions in Nephrology, Hypertension and Renal Transplantation provides a state of the art, updated reference for the optimal management of patients with diseases of the kidneys, and hypertension. This volume starts with the assessment of the patient, focusing on history and physical examination. Subsequently, cases depicting various clinical syndromes and/or diseases are presented, with questions centering on the appropriate diagnostic and treatment strategy. This sets the stage for a 'Socratic approach' to learning between the attending physician and the house staff or medical student. This is the only book featuring problem-oriented true to life clinical cases in this format to cover nephrology, hypertension and kidney transplantation. Written by renowned actively practicing clinicians, this unique reference is both comprehensive and concise and will be of great value to hospitalists and internists, as well as students, and interns/residents rotating in nephrology and internal medicine. Clinical practitioners, in the fields of critical care and hypertension specialists would also find this of value.

Dyslipidemia in chronic kidney disease is a common clinical problem and growing in prevalence. With the recent publication of clinical practice guidelines on the management of lipid related disorders in patients affected by chronic kidney disease, an up-to-date and comprehensive resource of evidence-based literature is needed. Dyslipidemias in Kidney Disease captures the growing body of information on this subject matter. This book presents the latest clinical evidence and management guidance for patients of various demographics and stages of chronic kidney disease. Written for the nephrologist community, as well as cardiologists and general practitioners, this guide will provide practical knowledge and fill a much needed void in the literature.

Post-transplant lymphoproliferative disorders are a group of conditions that straddle the borders between infection and malignancy. They were very rare prior to the mid-1980s but now can be expected to develop in 1-10% of transplant recipients. While some cases are reversible with reduction in immunosuppression, more severe forms are indistinguishable from frank lymphomas. This book sets out to cover in depth every aspect of these disorders, including both basic science and clinical topics. The epidemiology is reviewed, and careful attention is paid to the role of Epstein-Barr virus in their development. Clinical features are documented and clear guidance is provided on diagnosis, with thorough description of pathologic and imaging findings. Further chapters are devoted to treatment, prognosis, preventive and pre-emptive strategies, and organ-specific considerations. The state-of-the-art information contained in this book will aid researchers as well as the many different professionals involved in caring for patients with post-transplant lymphoproliferative disorders. The comprehensive and detailed coverage will appeal to those who already have some expertise in the field, yet the book will also serve as an invaluable resource for beginners in transplantation.

In the 6 years since the publication of the first volume of Recent Advances in Endourology by the Japanese Society of Endourology and ESWL, data on long-term oncological or functional outcomes have been collected in several related fields, and advances in surgical techniques and improved instrumentation have led to further development of such complex surgery as laparoscopic partial nephrectomy and radical prostatectomy. This seventh volume in the series focuses on the treatment of urogenital malignancies by endourological procedures, including laparoscopic surgery with robotic assistance. The standard procedures and their relatively long-term outcomes as well as new techniques have been clearly described with detailed references. This book provides a better understanding of the present status of endourological management for urogenital carcinoma and sets the stage for future improvements in both oncological and functional outcomes.

Chronic kidney disease with a worldwide prevalence of 10% in the general population is emerging as a major public health priority. Renal dysfunction is associated with a high risk for cardiovascular complications. The relationship between renal insufficiency and cardiovascular disease, termed the cardiorenal syndrome exists whether impairment of renal function is a consequence of primary renal parenchymal disease or primary heart disease. Several pathophysiologic mechanisms have been postulated to explain the relationship between renal dysfunction and cardiovascular disease. Recent studies indicate an integrated response of the vascular smooth muscles and glomerular mesangial cells to traditional and uremia related cardiovascular risk factors. Traditional risk factors can incite renal impairment and cardiac damage. As renal function deteriorates, uremia-related risk factors play an increasing role both in reduction in glomerular filtration rate and cardiovascular damage. Several uremia related factors such as uncontrolled hypertension, disturbed glucose insulin metabolism, microalbuminuria, phosphate retention, secondary hyperparathyroidism, myocardial and vascular calcification, hypertensive-uremic cardiomyopathy, inflammation, oxidant injury, and neurohormonal dysregulation have been implicated in the pathogenesis of the cardiorenal syndrome. Recent data suggest that management of the cardiorenal syndrome requires aggressive control of traditional risk factors as well novel approaches to prevent or reverse uremia -related processes. This book provides a comprehensive update analysis of our current understanding of the cardiorenal syndrome including epidemiology, pathophysiologic mechanisms, and therapeutic approaches.

The prevalence of hypertension is almost three times as high as that of diabetes mellitus type 2, with both conditions being major risk factors for stroke, ischemic heart disease, cardiac arrhythmias, and heart failure. The exact prevalence of hypertension related to hormonal derangements (endocrine hypertension) is not known but estimated to affect less than 15% of hypertensive patients. Recent scientific discoveries have increased the understanding of the pathophysiologic mechanisms of hypertension. In Endocrine Hypertension, a renowned panel of experts provides a comprehensive, state-of-the-art overview of this disorder, discussing when to assign an endocrine cause in one of many conditions that may present with hypertension. The first part of Endocrine Hypertension is dedicated to adrenal causes. The second part of the volume concerns potential nonadrenal causes of hypertension, such as growth hormone excess or deficiency, primary hyperparathyroidism, vitamin D deficiency, testosterone deficiency, insulin resistance, obesity-associated hypertension, and the role of central mineralocorticoid receptors and cardiovascular disease. An important contribution to the literature, Endocrine Hypertension is an indispensable reference not only for endocrinologists, diabetologists, and adrenal investigators, but also for translational scientists and clinicians from cardiology, internal medicine, pediatrics, family medicine, geriatrics, urology, and reproductive medicine / gynecology.

This volume will be a reliable source on the management of the elderly with renal disease. There is an ever-increasing proportion of the aging population affected by renal disease and hypertension, and physicians are faced with atypical clinical presentations of renal disease in the aged as compared to younger people. This volume combines the fields of nephrology and geriatrics and presents a multidisciplinary approach to the topic.

Knowledge of the juxtaglomerular apparatus (JGA) of the kidney and of the synthesis and secretion of renin has increased to such an extent over the past few years that it is now appropriate to summarize this knowledge in a monograph on the JGA, the first of its kind. It was the authors' special concern to demonstrate the association between structure and function for renin secretion, not only within the juxtaglomerular region, but also in the region of the renal cortex beyond the JGA. The description of the pathology of the human JGA, studded with references to experimental findings but nevertheless fully self-contained, should help to make this monograph also useful for clinicians.

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.

This new edition of Vascular Interventional Radiology: Current Evidence in Endovascular Surgery provides a thorough yet succinct and accessible review of the latest knowledge in the field of endovascular surgery. All chapters have been updated to reflect the advances that have occurred during the past five years, and new chapters are included on carotid artery stenting and day case intervention. The chapter on lower limb veno-occlusive disease has been expanded to include management of deep venous thrombosis. Among the other topics considered are the endovascular treatment options in different arterial territories, aneurysm repair techniques, and the management of venous stenosis and venous insufficiency. The aim throughout is to tackle issues of evidence-based practice in order to assist trainees and experienced practitioners in making and implementing treatment decisions. This book will be an invaluable source of information for both interventional radiologists and vascular surgeons with an interest in endovascular techniques.

This book does not pretend to be a comprehensive textbook of nephrology, nor is it a guide to the management of renal disease, as space does not allow the description or discus sion of investigation and treatment. Its intention is to illustrate the diverse diseases which present to nephrologists. Since the key to understanding the effects and progression of a disease are to know and com prehend its pathology, I have approached the subject not by discussing presenting symptoms of single diseases in different sections, which would lead to much repetition, but by describing the disorders according to the mechanisms which cause them. To illustrate the text I have chosen the most immediate clue which usually appears in a given dis ease, which may therefore be a clinical sign, a radiograph or the histological appearance of a renal biopsy. D. Gwyn Williams Guy's Hospital, London 1. Trauma Trauma is a common cause of acute renal failure. This may arise directly from injuries to the kidneys themselves despite their protected position (Figure 1). Trauma can also cause acute renal failure by damaging the renal arteries, which may be actually avulsed from the kidneys, or stretched at the time of impact, with tearing of the arterial wall and secondary thrombosis. Figure 2 shows the renal arteriogram of a young man who presented with anuric acute renal failure after a motorbike accident. Only the upper pole of the right kidney is Figure 1.

This book provides a comprehensive look at renal cell carcinoma, exploring its biology as well as current and future molecular targets for renal cancer carcinoma.

A year or so after Dr. Robert Popovieh arrived in Seattle in 1965 to begin working on his doctoral thesis under Dr. A.L. Babb, we had just begun work to try to prove the prediction that the peritoneum had a higher permeability to 'middle molecules' than hemodialysis membranes [I]. Several years later, when Dr. Popovieh accepted a position at the University of Texas in Austin, he decided to concentrate his research efforts in the area of peritoneal dialysis and everyone knows how successful that effort has become [2]. Indeed, because of continuous ambulatory peritoneal dialysis (CAPD), long-term per itoneal dialysis after a two-decade incubation period is finally becoming an equal option to hemodialysis and transplantation in the management of chronic renal failure. For me this development represents final vindication of a twenty-year effort to help promote peritoneal dialysis, often in the face of enormaus opposition. I particularly remember a policy meeting at the NIH a few years back in which it was decided by my colleagues on the committee that long term peritoneal dialysis had no future and therefore no funds for projects in this area would be forthcoming. Based on the excellent results that Boen and later Tenckhoff had been getting in our Seattle program, I knew the committee was wrong and tried to convince them otherwise. Naturally, being the only favorable vote, I failed. I often wonder how many years this decision and others like it set back peritoneal dialysis.

Therapeutic regimens for visceral leishmaniasis (also Kala-azar, Dum-dum fever or black fever), caused by parasitic protozoa of the Leishmania genus, evolve at a pace never seen before. Spread by tiny and abundant sand flies, the parasite infects internal organs and bone marrow and if left untreated will almost always result in the death of the host. In developing countries successful diagnosis and treatment are complicated by asymptomatic cases, undernutrition and Kala-azar/HIV co-infections. This book brings together world-renown experts writing state-of-arts review on the progress in diagnosis and treatment of visceral leishmaniasis, ultimately leading to the complete elimination of this fatal disease from South Asia. The chapters provide valuable information for disease control as well as therapy and the diagnostic improvements necessary for early treatment, subclinical detection and drug-resistant cases. The presented methods allow for points-of-care testing in the endemic area, enabling rapid detection in resource-poor settings with easy handling and low costs. This book provides essential information for scientists, medical practitioners and policy makers involved in the diagnosis, treatment and elimination of Kala-azar.