Cardiovascular complications are not only responsible for more than half of our patients' mortality, they also represent the bulk of everyday problems in a dialysis unit. Yet, the space allocated to them in the major textbooks covers only 2-8% of their total content. The origins of this book lie in many years of day-to-day care of dialysis patients. It gradually became clear to the author that systematic application of well-known pathophysiological principles could improve patients' conditions beyond expectations. More importantly, it appeared that world literature was mainly concerned with evaluating risk factors and that efforts to improve prognosis were concentrated on urea removal. It is important, therefore, to notice that Volume Control', the central issue of this book, is not incorporated into the Adequacy' concept. While primarily intended for dialysis doctors, the author sincerely hopes that dialysis nurses, who carry the lion's share of day-to-day responsibility for dialysis patients, will also find this book a useful and practical guide to dialysis treatment.

In examining the preface of our first book, it is increases needed. The Deming philosophy empha apparent that the editorial comments made in sizes that quality is never fully achieved: process 1994 are even more pertinent in today's cost- improvement is never ending. constrained healthcare environment than when But, what is quality? Without defining, David first written. We repeat them in part. Garvin makes the point that "in its original form, This is a time in history when the concept of quality activities were reactive and inspecti- quality is reaching new highs in terms of public oriented; today, quality related activities have awareness. Articles describing quality, CQI, qual broadened and are seen as essential for strategic ity tools, critical success factors, failures, and success" 1]. How can the broad context of quality lessons learned appear in local newspapers, trade be applied to the diverse aspects of ESRD? journals, scientific periodicals, and professional Furthermore, although far from a new concept, publications on a daily basis, yet implementation Continuous Quality Improvement (CQI) has taken of a quality system in many hospital units is its place as a dominant theme in many industries. approached with caution and the basic tenants of CQI is more broadly applicable, both in concept quality systems and CQI continue to be misunder and execution, to service as well as manufacturi- stood. based operations."

This eighth volume in the series Recent Advances in Endourology brings together the latest clinical findings regarding various endourological treatment modalities and innovative materials. World-recognized experts outline their techniques clearly and concisely to provide an updated review of state-of-the-art endourological techniques. International management of urological diseases is focused in this latest issue.

The aquaporin field has matured at an exceptionally fast pace and we are at the verge to develop serious strategies to therapeutically modulate aquaporin function directly or via regulatory networks. Key prerequisites are available today: i. a considerable (and growing) number of aquaporin crystal structures for the rational design of inhibitory molecules, ii. elaborate molecular dynamics simulation techniques for theoretical analyses of selectivity mechanisms and docking experiments, iii. comprehensive data on aquaporin immunohistochemistry, iv. aquaporin knockout animals for physiological studies, and v. assay systems for compound library screenings. The structure of this volume on aquaporins follows the points laid out above and thus covers the developments from basic research to potential pharmacological use. Situated between pharmacology textbooks and recent scientific papers this book provides a timely overview for readers from the fundamental as well as the applied disciplines.

When the kidney fails its intended mission to manage the body 's waste products, physicians must perform multi-level and simultaneous adjustments to replicate kidney function. The management of the body 's absorption, reabsorption, utilization and excretion of calcium and phosphate requires constant fine tuning. This book provides an overview of the state-of-the-art clinical and basic science aspects of abnormal calcium and phosphate metabolism and its management.

Kidney Transplantation: A Guide to the Care of Transplant Recipients is an easy to read, up to date, clinical resource written by experts in the field of kidney transplantation. The book explains how donors and recipients are selected for transplantation, how the surgical procedure is performed, and how the experts recognize and treat rejection.

Clearly illustrated chapters show how the immune system works in the setting of transplantation and how immunosuppressive medications prevent rejection of the transplanted kidney; knowledge essential for the proper care of the transplant recipient.

The acute and long-term care of the patient is described from the perspective not only of proper immunosuppressive medication management, but also from the perspective of comorbidities most common to transplanted patients, including cardiovascular disease, diabetes mellitus, infectious diseases, malignancies, and bone disease. Special issues that impact the care of the transplant recipient, such as unusual donor sources, nonadherence and insurability are also addressed in separate chapters.

This comprehensive practical guide to transplant patient care is an essential source for the practicing community nephrologist that cares for transplanted patients, as well as medical and surgical residents and fellows in training.

Clear illustrations as well a therapeutic algorithms complement the text, making this an easy to read, up to date source on the clinical practice of kidney transplantation.

Increased recognition of the overlap between critical care and renal medicine, and recent advances in the understanding of acute renal failure and the application of renal replacement therapies, have brought increased attention to the nephrologist's role in the intensive care unit (ICU). This book is written to provide an approach for the resident in nephrology, at any level of training, with regards to critically ill patients. This text provides the information necessary to provide care for the nephrology patient in the ICU.

Comprehensive and clinically relevant, the 3rd Edition of Critical Care Nephrology provides authoritative coverage of the latest advances in critical care procedures for patients with renal diseases or disorders. Using common guidelines and standardized approaches to critically ill patients, this multidisciplinary reference facilitates better communication among all physicians who care for critically ill patients suffering from kidney disease, electrolyte and metabolic imbalances, poisoning, severe sepsis, major organ dysfunction, and other pathological events. Offers detailed discussions of different forms of organ support, artificial organs, infections, acute illness occurring in chronic hemodialysis patients, and much more. Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool. Presents information clearly, in a format designed for easy reference - from basic sciences to clinical syndromes to diagnostic tools. Covers special populations such as children, diabetic patients, and the elderly. An exceptional resource for nephrologists, intensivists, surgeons, or critical care physicians - anyone who treats critically ill renal patients. Shares a combined commitment to excellence lead by Drs. Claudio Ronco, Rinaldo Bellomo, John Kellum, and Zaccaria Ricci - unparalleled leaders in this field. Addresses key topics with expanded coverage of acute kidney injury, stress biomarkers, and sepsis, including the latest developments on mechanisms and management. Provides up-to-date information on extracorporeal therapies from new editor Dr. Zaccaria Ricci. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

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.

Der Dialyseshunt als moderne Form des permanenten Gefazugangs ist grundlegender Bestandteil der Betreuung des chronisch niereninsuffizienten Patienten.

In diesem Band wird das komplette Spektrum der Fragestellungen rund um Dialyseshunts fachkundig und umfassend abgehandelt: von der interdisziplinaren Vorbereitung der Gefauntersuchung durch Nephrologen und Gefachirurgen, uber die Diskussion unterschiedlicher chirurgischer Moglichkeiten der direkten Gefazugange bis hin zur Shuntpflege und Shuntpunktion. Daruber hinaus werden Diagnostik und Therapie bei Komplikationen sowie alternative Dialysezugange detailliert dargestellt.

Mit der 1. Auflage dieses Buches wurde vor 10 Jahren erstmals eine interdisziplinare, gefachirurgisch und nephrologisch angelegte Darstellung des groen Gebietes der Dialyseshunts in deutscher Sprache vorgelegt. Diese 2. Auflage belegt die weitere rasche Entwicklung dieses immens wichtigen Gebietes.

Seeing a patient die under his hands because there is no adequate treatment causes an emotion and a frustration in a doctor, which sometimes stimulates him to try to develop a new type of treatment. Seeing so many wounded young soldiers die due to renal failure in World War I incited the German doctor Georg Haas to try to develop an artificial kidney. He had to give up in despair in 1928. Ten years later doctor Willem Kolff saw a young man die in his ward in the University Hospital of Groningen due to renal failure. By that time two essential factors for an artificial kidney had become available: a drug to keep the blood from clotting outside of the body and an efficient dialysing membrane through which waste substances can pass from the blood into the dialysing fluid. Kolff succeeded in creating the rotating artificial kidney which he started using in the town hospital of Kampen in 1943. The rotation of this artificial kidney started a revolution that made it possible for thousands of kidney patients all over the world to keep on living - and sometimes to forget their disease for the time being. In addition it gave rise to the development of other artificial organs such as the heart-lung machine, the artificial heart and the artificial eye. Doctor Jacob van Noordwijk, the author of this book, was Kolff's first assistant in the treatment of the first 15 patients. How Kolff succeeded in spite of all the limitations imposed by the German occupation of the Netherlands and in spite of the absence of antibiotics and other medical tools which are common nowadays makes a story which may sound incredible. Yet it did happen and visitors to the town of Kampen can still see the hospital building where it all took place.

Having kidney failure is not a unique experience. Neither is receiving a kidney transplant or undergoing dialysis. Adopting to irreversible uremia - a devastating illness- by assisting others to cope with their own life trial represents the best of human traits. Bonded by marriage for 42 years, I was privileged to love and live with a marvelous and unique individual whose approach to life with this horrific disease taught me to regard every moment of our existence as precious. Preparation of this volume had two main objectives: 1) To honor the author for all of efforts in behalf of kidney patients. 2) To disseminate her insights and wisdom to those who may derive comfort and benefit from her words. Mildred (Barry) Friedman was a medical writer and patient advocate devoted to the American Association of Kidney Patients, who died at University Hospital of Brooklyn on September 21 st 1997 at the age of 61 of complications of type 1 diabetes. Barry, the second child of Leontine and Hardinge Barrett-Lennard, was born on October 17,1935 in Manhattan and attended Brooklyn College as a New York State Scholarship Awardee earning a Bachelor of Arts degree in 1953. She subsequently began teaching in the New York City elementary schools gaining a Master's degree in education. Following the birth of her third child, Barry developed both diabetes and Addison's disease forcing her retirement from teaching.

International illicit trade in human organs is on the increase, fueled by growing demand and unscrupulous traffickers. In order to truly understand the problem of organ trafficking, an analysis should take into account the various perspectives that come into play in this multifaceted issue. With contributions from international scholars and experts, The International Trafficking of Human Organs: A Multidisciplinary Perspective provides a broad-based exploration of this controversial phenomenon. Divided into four parts, the book examines the issue of human organ trafficking from the perspectives of criminal justice, business, medicine, ethics, philosophy, and theology. The book begins by presenting case studies of the trafficking of body parts occurring in the U.S. and Mexico. It examines the increase in organ harvesting from Chinese prisoners and describes widespread instances of trafficking in Europe. Diverse perspectives Next, it examines the economic ramifications of possible legislation of the sale of body parts and discusses other proposals for increasing the supply of kidneys and other organs. It explores ethical issues surrounding the kidney shortage and incentives to promote donation. It also offers arguments for and against compensation for transplant organs from Kantian, Dworkinian, and other perspectives. Lastly, theologians discuss opposing Catholic and Protestant perspectives on the sale of human organs. Learning tools Each chapter provides discussion questions to provoke vigorous debate and references to facilitate further study. The wide-ranging analysis provided by this volume is certain to enhance further inquiry into a disturbing and increasingly prevalent issue.

This classification is based primarily on the microscopic charac- teristics of tumours and, therefore, is concerned with morpho- logically identifiable cell types and histological patterns, as seen with conventional light microscopy. The term tumours is used synonymously with neoplasm. The phrase tumour-like is applied to lesions which resemble neo- plasms, clinically or morphologically, but do not behave biologi- cally in a neoplastic manner. They are included in this classifica- tion because they give rise to problems in differential diagnosis and because of the unclear borderline between neoplasms and certain non-neoplastic lesions. Synonyms are listed only if they have been used widely, or if they are considered to be helpful to the understanding of the lesion. In such cases, the preferred term is given first, followed by the synonym. Although the emphasis of this classification is on histological typing, in the examination of kidney tumours, consideration should be given to the degree of cellular anaplasia, the extent of local spread, vascular and lymphatic invasion, and the occur- rence of metastasis. The scheme of histological grading suggested here is as fol- lows: Grade I applies to the tumours that have the least degree of cellular anaplasia compatible with a diagnosis of malignancy; . grade II! applies to tumours with the most severe degrees of cel- lular anaplasia; and grade I! applies to those tumours in be- tween. This scheme is applicable to the carcinomas of the renal parenchyma and pelvis.

This invaluable guide, endorsed by the UKMi and reflecting the extensive experience of the UK Renal Pharmacy Group, features drug monographs guiding physicians in how to prescribe, prepare, and administer drugs to patients with different levels of kidney function and when undergoing renal replacement therapy. It has been fully updated for this fifth edition to include up to 100 additional drugs, while maintaining the clear structure and format that is easy to use and simple to follow in the busy clinical setting. It continues to offer support and guidance to health care professionals enabling them to prescribe medications to their renal patients appropriately and safely.

This volume focuses on the investigatory methods applied to autosomal dominant polycystic kidney disease (ADPKD), one of the most common human genetic diseases. ADPKD is caused by mutations in PKD1 and TRPP2, two integral membrane proteins that function as receptor/ion channels in primary cilia of tubular epithelial cells. Thus, ADPKD belongs to ciliopathies, a group of disorders caused by abnormal cilia formation or function. This proposed book will cover the state-of-the-art methods ranging from molecular biology, biochemistry, electrophysiology, to tools in model animal studies. Key Features Explores the role of cilia in polycystic kidney disease Focuses on myriad state-of-the-art methods and techniques Reviews specific mutations integral to this autosomal genetic disease Includes discussions of model systems

A practical primer for physicians wanting to learn about simple and complex urodynamic testing. The clear, concise workbook structure allows for quick reference to multichannel urodynamic tracings and their interpretation. Brief but thorough discussion of the underlying theory and concepts behind urodynamic testing enable readers to gain a firm grasp of the implications of test results in individual patients. It provides an understanding of all the techniques used for the evaluation and treatment of the incontinent or lower urinary tract dysfunctional female patient, and also includes a quick reference guide to outpatient treatment. In contrast to other didactic texts, this book allows readers to initiate testing programs and will thus be of practical benefit to all those interested in improving patient care.

The Renal System at a Glance is a highly illustrated and practical guide to the structure and function of the kidney, renal, and urinary system. It also covers related disorders and abnormalities and their treatment. Fully updated to reflect the many exciting new developments in the understanding of nephrology, this new edition has been restructured to better integrate basic science and clinical examples to the medical school curricula. New chapters on glomerular filtration and global kidney medicine are included, while the latest guidance and approaches to acute kidney injury, chronic kidney diseases, and renal replacement therapy have also been incorporated. The Renal System at a Glance: * Offers clear explanations on tricky topics such as electrolytes, fluid balance and acid-base handling * Features new sections on glomerular filtration, and a new chapter on the global differences in kidney problems * Includes cross-referencing between basic science and related clinical content * Focuses on clinical disorders and investigations ideal for those embarking on medicine rotations * Illustrates each topic in a double page spread, complete with charts, graphs, and photographs * An updated companion website is available at www.ataglanceseries.com/renalsystem featuring animations and MCQs This new edition is the perfect guide for medical students, junior doctors, and allied health professionals, including specialist nurses, who wish to learn, or refresh their knowledge, on the kidney and renal system in health and disease.

Bladder Cancer is designed for researchers and clinicians involved in urologic practice, including urologists, medical oncologists, pathologists and radiologists. It provides comprehensive guidance for treating and understanding bladder cancer and serves as an up-to-date reference reflecting evidence-based research. The biological behavior of this disease entity shows a heterogeneous pattern with diverse morbidity and mortality depending on a variety of factors, such as tumor characteristics (tumor stage, grade, size, number, shape, and histologic subtypes) and applied treatment modalities (surgery or non-surgical management). This book presents the substantial academic developments in the field of bladder cancer in one convenient reference.

In about 5% of all organ (kidney, liver) transplant recipients, malignancies occur as a late complication of the massive immunosuppression. The malignancies are mainly skin cancers, lymphomas and renal carcinomas. The present book discusses the possible mechanisms of this type of tumorigenesis and inquires into possibilities of prevention. In particular, the described malignancies might be of viral origin. The book informs about a completely new type of carcinogenesis. Apart from the scientific aspects, it is of great practical value.

Advanced renal cell carcinoma is refractory to nearly forms of systemic therapy. For this reason the last decade has seen numerous research groups working on immunotherapeutic s trategies against it. Immunotherapy of Renal Cell Carcinoma reports the contributions of most of the world's leading re- search groups to two international conferences on the immu- nobiology of this illness. Sixteen chapters divided in expe- rimental and clinical studies provide an overview of immuno- therapy in renal cell carcinoma and a discussion of new la- boratory approaches to this topic.

This is the first book to summarize experimental results from the new, rapidly expanding field of research into the calcium channel in cell membrane. Calcium is an ubiquitous messenger of various cellular functions. Its fundamental role in the regulation of cardiac contractions has long been recognized. Drugs counteracting some actions of calcium ions, namely calcium antagonists, have since become essential to research. In the last decade it has been established that calcium ions reach their target intracellular system by passing through specialized calcium channels in the membrane. Recently improved experimental techniques combined with the discovery of highly specific Ca channel ligands have dramatically enlarged our knowledge of the molecular structure and function of such channels. The contributions by leading world specialists shed new light on both basic science and possible clinical implications for cardiovascular pharmacology, endocrinology and neuropharmacology.

The association of diabetes mellitus and hypertension has been well known for a long time. However, the important impact of hypertension on the development of chronic complications of diabetes and on the prognosis of the diabetic patient has only recently been realized. The increasing number of patients with endstage diabetic nephropathy who need regular dialysis or renal transplantation reflects only one important aspect of this problem. As new targets for the treatment of hypertension were considered, it became evident, that drug treatment of hypertension in diabetics must take side effects into account which may be negligible in the nondiabetic patient. Basic research has granted much new insight into the mechanisms which function to link diabetes, kidney function, hypertension, and vascular disease. As a result of the high specialisation in research, such new information diffuses only slowly out of the circles of experts into clinical practice. Therefore, it was a most rewarding initiative of the Bayer Company to sponsor a conference which aimed at a mutual exchange of ideas between clinicians and researchers who are experts in either hypertension or diabetes.

Peritoneal dialysis (PD) is in widespread use for the treatment of acute and chronic renal failure. A considerable amount of knowledge about the various procedures and problems associated with this form of treatment has accumulated over recent years, particularly since the introduction of continuous ambulatory peritoneal dialysis (CAPD). However to date the information regarding the more technical or practical aspects of PD has been largely scattered in various books and journals. There appears to be no straightforward text concerned with these points suitable for recommending to junior doctors or nurses dealing with patients receiving this therapy. Though in-house-training is of considerable value it takes time and I have noticed that on a number of occasions in our own unit, technical problems with PD have not been dealt with quickly because of lack of knowledge in the staff on duty. There thus appeared to me to be a need for a short book giving firm advice on how to perform the various procedures and how to deal with problems as they arose. This manual is an attempt to fulfil that aim. Initially it was tried and tested on the renal unit in the Cardiff Royal Infirmary for 3 years. Prior to publishing it has been extensively revised and updated.

Clinical Disorders of Membrane Transport Processes is a softcover book containing a portion of Physiology of Membrane Disorders (Second Edition). The parent volume contains six major sections that deal with general aspects of the physiology of transport processes and specific aspects of transport processes in cells and in organized cellular systems, namely epithelia. This text contains the last section, which deals with the application of the physiology of transport processes to the understanding of clinical disorders. We hope that this smaller volume will be helpful to individuals particularly interested in clinical derangements of membrane transport processes. THOMAS E. ANDREOLI JOSEPH F. HOFFMAN DARRELL D. FANESTIL STANLEY G. SCHULTZ Vll Preface to the Second Edition The second edition of Physiology of Membrane Disorders represents an extensive revision and a considerable expansion of the fIrst edition. Yet the purpose of the second edition is identical to that of its predecessor, namely, to provide a rational analysis of membrane transport processes in individual membranes, cells, tissues, and organs, which in tum serves as a frame of reference for rationalizing disorders in which derangements of membrane transport processes playa cardinal role in the clinical expression of disease. As in the fIrst edition, this book is divided into a number of individual, but closely related, sections. Part V represents a new section where the problem of transport across epithelia is treated in some detail. Finally, Part VI, which analyzes clinical derangements, has been enlarged appreciably.