It is increasingly recognized that various transporter proteins are expressed throughout the body and determine absorption, tissue distribution, biliary and renal elimination of endogenous compounds and drugs and drug effects. This book will give an overview on the transporter families which are most important for drug therapy. Most chapters will focus on one transporter family highlighting tissue expression, substrates, inhibitors, knock-out mouse models and clinical studies.

Well organized and highly readable, the National Kidney Foundation Primer on Kidney Diseases has offered clear, comprehensive coverage of adult and pediatric kidney diseases for more than 25 years. The thoroughly revised 8th Edition of this authoritative, practical reference covers every relevant topic in the field, making it an excellent resource for residency, fellowship, clinical practice, and board review. It brings you completely up to date with key topics in this fast-changing field, including ongoing clinical research and changing treatment protocols. This powerful learning tool and clinical reference is a joint publication of Elsevier and the National Kidney Foundation. Covers every relevant topic in nephrology-from anatomy, physiology, and pathophysiology to diagnosis and management of kidney disease, to fluid and electrolyte disorders, hypertension, dialysis, and renal transplantation. Presents complex material in a clear, easy-to-understand manner that is both accessible for residents and fellows and comprehensive enough for practicing nephrologists. Offers new guidance for management of COVID-19 in the Viral Nephropathies chapter. Contains two new chapters on Global Kidney Disease, and Conservative Kidney Management (CKM), a palliative care option for treating kidney failure without dialysis. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

We are pleased to present to our readers the Proceedings of the Sixth International Workshop on Phosphate and Other Minerals which was held in Verona, Italy, during June 24-26, 1983. It was hosted by Professor Giuseppe Maschio, Professor of Medicine and Chief, Department of Nephrology at the University of Verona. The Sixth Workshop maintained the tradition of the previous ones. It provided a unique and outstanding opportunity for close interaction between scientist involved in the research of the overall field of Mineral Metabolism. The current Workshop was attended by 250 scientists from 15 countries including Austria, Canada, Denmark, England, France, Germany, Holland, Israel, Italy, Japan, Spain, Sweden, Switzerland, and the United States of America. The topics discussed included the renal handling of phosphate, transport of other minerals, intestinal absorption of calcium and phosphate and phosphate homeostasis in health and disease. Two symposia dealing with the recent developments of the interactions between minerals, parathyroid hormone, and blood pressure and between minerals and myopathies were included. In addition to the 15 State-of-the-Art Lectures, there were 43 oral and 63 poster presentations selected from over 200 abstracts sub mitted to the Program Committee. The Seventh International Workshop on Phosphate and Other Minerals will be held during September, 1985, in Marseille, France. It will be hosted by Professor Michel almer, Chief of the Department of Nephrology at the University of Marseille. The theme of this coming Workshop will focus on the pathophysiology of phosphate homeostasis and the metabolism of other minerals."

We are pleased to present to our readers the proeeedings of the Seeond Bari Seminars in Nephrology. The topie of theses proeeedings deals with elinieal and experimental aspeets of aeute renal failure. The Bari Seminars in Nephrology were initiated in 1984 and will be held every two years. It is attended by a large number of international elinieal seientists in the diseiplines of nephrology and related fields. The next Bari Seminars in Nephrology will take plaee dur i n g Ap r i 1 2 0 - 2 4 i n 1 988 'a n d t he t he m e 0 f t he ga t her i n g w i 1 1 be Drugs, Systemie Diseases and the Kidney. \\e are indebted for the generous finaneial support of the Centro Nazionale delle Rieherehe, Italy. Alberto Amerio Pasquale Coratelli Vito M. Campese Shaul G. Massry vii CONTENTS I. PATHOPHYSIOLOGY AND STRUCTURAL CHANGES OF ACUTE RENAL FAlLURE Pathogenesis of Acute Renal Failure 3 M. Burnier and R. W. Schrier Structural-Functional Correlates in Acute Renal Failure . . . . . . 15 G. Eknoyan, D. C. Dobyan, and R. E. Bulger Long Term Clinical and Morphological Evaluation of Acute Renal Failure . . . . . . 27 V. Bonomini, A. Vangelista, G. Frasca, S. Stefoni, M. P. Scolari, and G. Feliciangeli The Role of Renal Biopsy in Acute Renal Failure . . . . . . . . . . 35 G. D'Amico, G. Colasanti Catabolism in Acute Renal Failure: Importance of Glucocorticoids and Lysosomal Enzymes . . . . . 41 A. Heidland, R. M. Schaefer, J. Weipert, E."

Peritoneal dialysis represents an internal technique for blood purification. In this dialyzer the blood path, the membrane, and the dialysate compartment are provided by nature. The developments of chronic peritoneal catheters, auto mated cycling equipment, solution preparation by reversed osmosis, manipula tions of transport with drugs, and the experiences with continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis have increased the interest in peritoneal dialysis. Publications related to peritoneal dialysis exceed 400 annually. The Peritoneal Dialysis Bulletin represents a new journal devoted to peritoneal dialysis developments. The Third International Symposium on Peri toneal Dialysis is to be held in Washington, D.C. in 1984. From this meeting it is likely that an International Society for Peritoneal Dialysis will emerge. This book is meant to provide an overview of the state of the art of peritoneal dialysis. Many clinicians are making extensive commitments to peritoneal dialysis for the first time. Nephrologists, physiologists, pharmacologists, biomedical engineers, and even physicists are involved in studies to better understand peritoneal dialysis. The complexities of peritoneal dialysis and the peritoneal membrane are becoming apparent. Studies of peritoneal dialysis increase under standing of the anatomy and physiology of biological membranes and of factors influencing the passive movement of solutes across the microcirculation and related structures. Peritoneal dialysis provides a 'window' to the visceral micro circulation in animals and humans. Peritoneal dialysis may be useful to treat problems other than renal failure."

We are pleased to present to our readers the Proceedings of the Fourth International Workshop on Phosphate and Other Minerals which was held in Strasbourg during June 22-24, 1979. It was hosted by Professor Henri Jahn, Professor of Medicine and Chief, Department of Nephrology at the University of Strasbourg. These Workshops have become a tradition in the scientific scene of mineral metabolism. The meetings have been providing a unique framework for close interaction between scientists from various disciplines, such as nephrologists, endocrinologists, bio chemists, nutritionists, and those dealing with bone metabolism. The Workshops also created a forum for the delivery of original information, as well as state-of-the-art presentations on exciting topics of current interest in this evergrowing field of phosphate and mineral homeostasis. The Fourth International Workshop was attended by three hundred scientists from 15 countries including Austria, Canada, Denmark, England, France, Germany, Holland, Israel, Italy, Japan, Sweden, Switzerland and the United States of America. The topics discussed included those dealing with the renal handling of phos phate, calcium and magnesium, intermediary phosphate metabolism and phosphate homeostasis in health and disease. Two symposia were also presented: one dealt with nephrolithiasis and its rela tion to phosphate and the other with bone metabolism. In addition to 22 presentations by invited speakers, the Workshop provided 46 oral and 93 poster presentations selected from over 250 abstracts submitted to the Organizing Committee."

We are pleased to present to our readers the Proceedings of the Fifth International Workshop on Phosphate and Other Minerals which was held in New York City, New York, U.S.A during September 23-27,1981. It was hosted by Joseph M. Letteri, M.D., Professor of Medicine at the State University of New York at Stonybrook School of Medicine, and Chief, Division of Nephrology, Nassau County Medical Center. As in the previous Workshops, this meeting provided an oppor tunity for interested scientists from interrelated fields, including nephrology, endocrinology, physiology, biochemistry and nutrition, to get together and discuss the recent advances in the field of phosphate and mineral metabolism. There were 29 invited presenta tions by leading scientists and 40 oral and 90 poster presentations selected from over 250 abstracts submitted to the Organizing Committee. The Workshop was attended by 250 scientists from 14 countries including Austria, Australia, Canada, Denmark, England, France, Germany, Holland, Israel, Italy, Japan, Sweden, and the United States of America. The Sixth International Workshop on Phosphate and Other Minerals will be held during June 24-26, 1983 in Verona, Italy. It will be hosted by Professor Giuseppe Maschio, Director, Division of Nephrology, Istituti Ospitalieri, Verona, Italy. The theme of this coming Workshop will continue to focus on the pathophysiology of phosphate homeostasis and the metabolism of other minerals."

In one golden age of medicine epitomized by William Osler, the physician also aspired to mastery of gross and microscopic pathologic anatomy. Now another such age has dawned in which ultrastructure and immunopathology provide insights into mysterious diseases of the kidney, connective tissues, joints, and muscles, among other sites. Dr. Anil K. MandaI has a background in clinical nephrology, experimental pathology, and diagnostic pathology of renal diseases that suits him well for his chosen task. This is to explain clearly the clinicopathologic entities seen by nephrologists, using the full range of available morphologic techniques. His ap- proach is brisk and incisive. To read his monograph as a pathologist is to make oneself a better clinician, and as a physician is to improve one's grasp of pa- thology. Such correlative knowledge seems at present the means most likely to lead to the ultimate control of some crippling chronic renal diseases. Sheldon C. Sommers, M.D.

Infectious and non-infectious tubulointerstitial nephropathies are old subjects but there is enough confusion and disagreement on terminology and etiopathogenesis to warrant a new look at these problems. We were fortunate in having at the Pediatric Nephrology Seminar 6 and as contributors to this volume, the representative- or shall I say "originators"? - of each of the three most identifi- able positions: Dr. Renee Habib - congenital anomalies, Dr. John Hodson - reflux, and Dr. Robert Heptinstall - infection. Although some tend to hold onto one position and exclude others, in this case there was overlapping of perception. Dr. Habib accepts a role for infection in reflux and for infection in the presence of obstruc- tion; Dr. Hodson accepts infection and congenital anomalies as modi- fiers; and Dr. Heptinstall takes an overall position whicm encompas- ses the three. Thus the first part of the book emphasizes the complexity of something as seemingly simple as UTI and demonstrates awareness of disagreement even among the pros about meanings, interpretations, and treatment. Drs. Gustavo Gordillo, Jorge de la Cruz and their associates emphasize the importance of predisposing factors for UTI; Dr. Materson focuses on the workup of the patient, Dr. Zillerueloon bacteriological aspects, and Dr. Gorman on treatment approaches. Dr. Vaamonde reviews nephrotoxic agents. Finally, Drs. Andres and Noble review the immunological aspects of various tubulointer- stitial nephritides.

We are pleased to present to our readers the Proceedings of the Third International Workshop on Phosphate and Other Minerals which was held in Madrid, during July 15-18, 1977. It was hosted by Dr. Aurelio Rapado, Head of the Metabolic Unit at the Fundacion Jimenez Diaz. The Third International Workshop was organized in the tradition of the previous two Workshops. Scientists from 15 countries attended the meeting which provided a forum for formal presentations and informal discussions of topics of current interest in the field of phosphate metabolism, and that of the homeostasis of other minerals. One day of the Workshop was devoted to the subject of Phosphate Depletion. The latest information on the various aspects of the metabolic consequences of phosphate depletion were brought into focus. In the preface of the Proceedings of the Second International Workshop on Phosphate, we indicated that the enthusiasm with which these Workshops were received generated the idea for the creation of a Journal which will publish research endeavors related to mineral and electrolyte metabolism. These efforts were brought into fruition, and the first issue of the new Journal, M). . neJLai. . and E-te. c. ;tJr. o-ty-te. Me. -taboWm has already appeared in November, 1977. It is published by Karger of Basel, Switzerland under the Editorship of Dr. Shaul G. Massry of Los Angeles, with Dr. Louis V. Avioli of St. Louis and Dr. Eberhard Ritz of Heidelberg, serving as Associate Editors.

We are pleased to present to our readers the proceedings of th~ Third Bari Seminars in Nephrology. The tDpic ~f these proceedi~gs deals with effects of drugs and o:.yst el'll C ct i se;'Isc;- an the Id dney. Tho B?rj S~~jnar5 in Nephr~logy are bi-annual meetings ~tt~~~Dd k) D large international audience comprised of clinicians-scientist~ in the various displines of ~~phrnlDgy nnrl rQlated fi~ld$. The ne~t Bari S~mjnar5 of Nephrology will take place i" npril 19qn ~nd thp theme of the gathering will be Interstitial Nephritidies and Obstructive Uropathy. We are indc-bted for the goner-ells financial support of the Centro N::I~innalC' tiGBP:'llGBP'", Pichp.rche, Italy. Alberto Amerio Pasquale Coratelli Vito M. Campese Shaul G. Massry vii CONTENTS Lupus Nephritis: Pathogenesis, Course and Management .*..*...3 James E. Balow Prognostic Determinants in Lupus Nephritis ...*...* 17 P. Coratelli, R. Rizzi, G. Pannarale, A. Ramunni M. Giannattasio, and G. Passavanti Thrombotic Microangiopathy in Lupus Nephritis . * * . . 35 . M.T. Porri, M.I. Quarenghi, F. Ferrario G. Colasanti, R. Rossi, E. Schiaffino, G. Toia, and G. D'Amico Vasculitis and the Kidney . * ...* ...* * * 41 .

Over the last few years, transplantation knowledge and techniques, as well as insights into pharmacology, have improved, thus enabling greater access to transplantation for patients. The pool of organs for transplantation is stable, and therefore insufficient to cope with the growing demand. To adjust demand and resources in the most equitable way, organ procurement and allocation have been organized nationally and often across borders. The national and international organ exchange programs were studied and discussed during the Congress on Organ Allocation, from which this book is derived. This book describes the state of the art in the management of waiting lists and the allocation of organs in transplantation. It includes chapters on the possibilities of expanding the pool of available cadaver organs. It also analyzes the results of transplantation of cadaver organs from older donors and marginal, non-heart beating donors. Transplantation policies based on the offering of organs by living donors are also described, as is the impact of delayed graft function on organ allocation.

Many groups of biologically important compounds experience cycles of furious research activity and near oblivion. The purines however seem not to be falling into such a pattern. Interest seems to be continuing almost exponentially with no sign of diminution. The result is a frighteningly extensive literature and an increas ing demand for international conferences and symposia. Unfortunately meetings such as these also spawn increasingly voluminous proceedings and it becomes more and more difficult for a newcomer to the area, or a non specialist, to obtain the general introductory survey he needs. This volume therefore is not intended to be comprehensive - far from it. We have tried to be selective in the material presented and the references quoted. They should provide a quick guide and access to key works in the literature which can be expanded by library or computerised searching. We hope that our efforts will widen the appreciation of purines as biologically important substances and will herald the day when more purine related drugs than the handful currently available are used for the selective treatment of disease. We are grateful to the many authors and publishers who have given permission to reproduce figures or quote unpublished results, and to Anne Stone for her patient typing of the manuscript."

The first International Symposium on Urolithiasis Research was held in Leeds, England, in 1968. The meeting was the first in what was to become a series of symposia intended to gather together a diverse group of biochemists and physicians, urologists and engineers, with a common interest in factors affecting the formation of human urinary stones. Since its inception the series has threaded a peripatetic course back and forth across the Atlantic Ocean, from Madrid in Spain, to Davos in Switzerland, to Williamsburg in the USA, to Garmisch-Partenkirchen in Germany and Vancouver in Canada, under the guardianship of Drs Nordin, Cifuentes Delatte, Fleisch, Smith, Schwille, Dirks and Sutton, and their colleagues. In 1992, for the first time, the meeting moved to the southern hemisphere, to Cairns in Northeastern Australia. Unlike most previous symposia, there were no invited papers. Instead, the submitted abstracts were allowed to dictate the content of the meeting so that the conference programme would reflect the flavour of current research in the field. To achieve this, all abstracts were graded anonymously by three referees to determine their categorization as oral, theme poster, or general poster presentations. The 300 or so accepted absracts were then allocated to seven plenary sessions, nine theme poster discus sion groups and three large general poster sessions."

Anti-native DNA antibodies and DNA are present in cryopreClpItates from patients with systemic lupus erythematosus and some other cryoglob ulinemic states. The data suggest that these antibodies may be bound in immune complexes. The demonstration of native DNA in these precipitates raises the likelihood that they represent specific antigen in these complexes. Whether or not these complexes play a pathogenetic role in nonlupus inflammatory diseases remains to be demonstrated. References Aarden, L. A., de Groot, E. R., and Feltkamp, T. E. W., 1975, Immunology of DNA. III. Crithidia luciliae, a simple substrate for the determination of anti-dsDNA with the immu nofluorescence technique, Ann. N.Y. A cad. Sci. 254:505. Agnello, V., Winchester, R. J. and Kunkel, H. G., 1970, Precipitin reactions of the Clq component of complement with aggregated 'Y-globulin and immune complexes in gel diffusion, Immunology 19:909. Anker, P., Stroun, M., and Maurice, P. A., 1975, Spontaneous release of DNA by human blood lymphocytes as shown in an in vitro system, Cancer Res. 35:2375. Bankhurst, A. D., and Williams, R. C., 1975, Identification of DNA-binding lymphocytes in patients with systemic lupus erythematosus, ]. Clin. Invest. 56:1378. Bluestone, R., Goldberg, L. S., Cracchiolo, A., and Barrett, E. V., 1970, Detection and characterization of DNA in mixed (IgG-IgM) cryoglobulins, Int. Arch. Allergy Appl. Immunol. 39:16."

Therapeutic immunosuppression has very broad applications in clinical medicine, ranging from prevention and treatment of organ and bone marrow transplant rejection, management of various autoimmune disorders (e.g., rheumatoid arthritis), skin disease, and asthma. Whereas traditionally only a small repertoire of immunosuppressive agents was available for clinical use, recent discoveries have significantly increased the number of approved agents, resulting in numerous trials to further evaluate their potential. In addition, products of the biotechnology industry - monoclonal antibodies, cytokines, cytokine antagonists, and other products of genetic engineering that target key molecular pathways in disease pathogenesis - have either already made, or are on the verge of making an important impact on treatment. There is also considerable interest in the potential of cell-based therapies (particularly hematopoietic stem and dendritic cell therapy) of allo- and autoimmunity. Important recent advances in the immunotherapy of allergic diseases are also covered in this book. Gene therapy offers considerable promise for suppressing pathogenic processes in either transplantation or autoimmune disorders. The possibility of combining these important new advances to maximize benefit to the patient, and to minimize possible untoward effects (which are also given extensive coverage in this book), is one of the most exciting challenges of contemporary medicine. This volume is intended both for practising physicians and surgeons and for biomedical scientists at the graduate/postdoctoral levels, and is designed to provide the theory behind these various approaches to immunosuppression, and to provide state-of-the-art reviews of current developments in each area. Each chapter is contributed by one or more experts in the field. There was a need to bring this information together in a single volume, as much of the key recent developments have been dispersed throughout the biomedical literature, largely in specialized journals. Since, as in the past, important developments in immunosuppressive therapy in one branch of medicine (i.e. transplantation) are likely to benefit another (e.g., dermatology, rheumatology, gastroenterology), cross-disciplinary coverage of the mechanistic basis of the various therapeutic strategies in a single volume is likely to convey the potential of advances in therapy in the most coherent manner possible.

This book contains 55 chapters that summarize referred to the special issue of Drug Development lectures given during the Fifth International Research (Volume 31, Number 4, April 1994). Symposium on Adenosine and Adenine Measured by the number and quality of presenta- Nucleotides held in Philadelphia, Pennsylvania, tions, and by the record number of participants, U. S. A. , May 9-13, 1994. The symposium and the Fifth International Symposium on Adenosine its proceedings follow four previous symposia and Adenine Nucleotides was clearly an intel- and their published proceedings. Previous sym- lectually stimulating meeting. It is safe to posia were held in Banfff, Canada (1978), conclude that the purine research field is vibrant Charlottesville, Virginia (1982), Munich, and still growing. Adenosine has rapidly become Germany (1986), and Lake Yamanaka, Japan the drug of choice for the acute management (1990). of supraventricular tachyarrhythmias and was The program included a wide range of sub- recently approved for use in combination with jects from molecular and cellular biology to cardiac imaging for detection of ischemic heart clinical applications. Great emphasis was placed disease. Additional clinical applications of on cutting edge information derived from studies adenosine and adenosine-related drugs and ATP using molecular and cellular biology techniques seem closer than ever before. The editors would like to express their grati- applied to the field of adenosine and adenine nucleotide research. Likewise, the program tude to the distinguished contributors for their included a number of presentations on poten- excellent chapters and to all participants.

Cardiac disease is the major cause of death in dialysis patients, accounting for over one third of deaths. This book focuses on myocardial function and dysfunction in chronic uremia. It is aimed at practicing and training nephrologists, cardiologists, and internists, and at research workers in the field. We have tried to produce an up-to-date, in-depth review of the subject by inviting experts in clinical epidemiology, pathophysiology, and thera peutics to write the 18 chapters. The book is divided into three sections. The first section comprises five chapters that provide an overview of the burden of illness associated with cardiac disease in end-stage renal disease and a review of clinical epidemi ological aspects of various cardiac diseases that occur in renal patients. The second section discusses abnormalities of left ventricular contractility and mass, and the factors that predispose to both systolic and diastolic disorders. The importance of hypertension, anemia, hyperparathyroidism, hyper lipidemia, and diabetes mellitus in predisposing to these abnormalities is reviewed splendidly by researchers active in these areas. The final section concentrates on therapeutics. Data and opinion on management of congestive heart failure, cardiomyopathy, coronary artery disease, hypertension, and arrhythmias are provided. In editing this book, we have reviewed an extensive literature, but un fortunately we have become more aware that substantial gaps in our knowl edge exist. Insufficient high-quality clinical research has been undertaken xiii xiv Preface regarding the various cardiac diseases that occur in end-stage renal disease."

Drug dosage in renal insufficiency has become an toxication. In 1975, his Poison Index was pub important facet of nephrology, a subspeciality of lished, first in German, and two years later in internal medicine which is only 30 years young but English, with supplements in 1979 and 1983. This constantly growing in scope and importance. Two volume has become an obligatory reference in more thirds of all drugs are partially, mainly, or exclu than 2500 dialysis units. sively excreted by the kidneys. In the presence of Based on GOnter Seyffart's experience and renal insufficiency, dose adjustments are therefore knowledge in this field, the plans for this book obligatory. In patients on dialysis, drug elimination matured in 1984, a logical step in view of his by this route must also be considered. untiring effort and diligence. In order to deal with As the reader of this book will discover, 20 more than 1200 different drugs and almost 4000 percent of currently used drugs are contraindicated references, 21 contributors were sollicited, while it where there is any degree of renal insufficiency, took six years to complete the work. The major and for at least another 60 percent a dose reduc share of the effort was thus left to the main author tion is required. It is obvious, therefore, that the and editor and he has produced a concise work of detailed knowledge required can never be com impressive clarity.

These proceedings of the 5th Prouts Neck Meeting on Prostate Cancer, held in October, 1989, highlight the many advances in the understanding of prostatic growth and function at the cellular and molecular levels which have been registered since the first Prouts Neck Meeting in 1985, a meeting which also focused on the then current concepts and basic approaches to understanding prostate cancer. Inter vening Prouts Neck Meetings in 1986, 1987 and 1988 were devoted to treatment, image cytometry and clinical markers. As before, the Prouts Neck tradition of bringing together an international, multidiscipli nary group of experts for 3 days to exchange ideas and new data, in the relaxed atmosphere of an old iun on the scenic Maine coast, proved to be an ideal combination for a highly successful conference. Accordingly, the Organ System Program of the National Cancer Institute plans to use the Prouts Neck model for future conferences on other solid tumors (bladder in 1990 and kidney in 1991) and will return to the prostate in 1992. A new dimension was added to the current program through the inclusion of a poster session to recognize the research of pre-and postdoctoral investigators. The posters were judged by Drs. Collette Freeman, Frank French, Shutsung Liao, Robert Matusik and Henry Sun. The three winners, in alphabeti cal order, were John Fabian, Robert Getzenberg and Ming Fong-Lin."

Major advances in both the technology and the medical knowledge of maintenance hemodialysis have been made since the early stages of such treatment in the 60s. Hemodialysis is now an established therapeutic method. and the time has come to present an up-to-date approach to all its technical and medical aspects. We adopted a simple and concise style with a clear design and a large number of tables and illustrations. so that not only health professionals but patients themselves can easily understand the essentials of hemodialysis. In addition to the most recent technical developments of hemodialysis. particular attention is given to biocompatibility. adequacy of dialysis and patient nutrition. The many clinical problems encountered in the dialysis patient have been especially emphasized. since proper management may prevent most uremia-related complications. Indeed. chronic hemodialysis consists not only of providing the patient with safe and well-tolerated dialysis sessions but also of maintaining good general condition, adequate nutritional status and well-being in the long term. All of us have worked in the field of nephrology and hemodialysis at Necker Hospital for more than 25 years, and several of our very first patients are still enjoying life thanks to hemodialysis. We hope that our experience will be of help to nephrologists. renal nurses and technicians in training so that they can offer their patients, through optimal dialysis, long survival with the best possible quality of life and rehabilitation.

The first edition of this book was well received by updated. The two of us have made further collab orative efforts to present a better understanding of medical students, graduate students, and clinicians interested in furthering their understanding of basic the function of the kidney in conjunction with the principles of renal physiology. Most of the reviews most recent anatomical findings. of the first edition and comments from the various The second edition consists of 13 Chapters and 3 instructors who used the book were very positive Appendices. As in the first edition, the anatomical and complimentary with regard to the presentation description of the kidney is incorporated into the of the physiological information and the use of the various chapters dealing with kidney functions. Most system analysis approach to describe renal function. of the anatomical information was written by Wil These positive and encouraging comments over the helm Kriz. The physiological information was writ past nine years, since the publication of the first ten by Esmail Koushanpour, except for Chapter 12 edition, gave us the impetus to consider the prepa which was jointly written. Chapters 1 through 3 were ration of a second edition."

Volume 2 of Contnnporary Xephrology updates the major developments which ha\'e occurred during the past 2 years in 15 major areas of both basic and clinical nephrology. In addition, this volume has a section, Chapter 8, \uitten by Drs. Pederson, Llach, and Papper, from the Med- ical School at the Universitv of Oklahoma, which reviews the recent developments on nonilwasive diagnostic techniques in nephrology. The other chapters are presented in such a way as to emphasize the major advances that have occurred in the different areas in the last 2 years. In Chapter 1, Dr. Schafer analyzes in detail the new information available regarding the action of aldosterone both in anuran membranes and in the mammalian kidney. Drs. Knox and Romero, in Chapter 2, update the information accrued du ring the last 2 years in the area of renal hemodynamics and sodium chloride excretion. In the area of renal me- tabolism (Chapter 3), Schoolwerth, Little, and Idell-Wenger review in detail the metabolism of lipids in the kidney and its potential relation to renal function. This is, to the best of our knowledge, the first compre- hensive review of this subject in any textbook of nephrology. Dr. Dunn provides an authoritative review of the major advances in the rapidly expanding field of prostaglandins with particular emphasis on renal prostaglandins (Chapter 4). Drs. Batlle and Kurtzman update new con- cepts of acid-base phvsiology and pathophysiology, and Dr.

This volume is based on a very successful meeting on organ transplantation that was held in Kuwait in 1990 under the auspices of the Middle East Society for Organ Transplantation. An international group of organ transplant experts attended this conference and their contributions and deliberations have been recent1y updated to produce this definitive and authoritative summary of current clinic al practice in organ transplantation. The initial chapters appropriately focus on the immunology of organ trans plantation with special emphasis on the initial events in the induction of alloreactivity, the mechanisms of rejection, and the potential for tolerance induction. A strong emphasis is placed on the diagnosis of rejection by cellular analysis. The section on immunosuppression deals with several new areas of clinical therapy. The section on renal transplantation is unique in several respects, the long-term results from various countries, including the Middle East, are summarized, the use of living unrelated donors and of ABO incom patible donors - all strategies to maximize organ availability - are presented."

Immunosuppression in solid organ transplantation is currently experiencing a worldwide revival since new drugs are now available and others are under development. In order to contribute to the design of future strategies, a critical approach of surrogate endpoints is given and long-term side effects are analysed, together with the impact of non-compliance, quality-of-life and economical parameters. In this book, international specialists have set up the scientific rationale and provided new bases for further immunosuppressive strategies.