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.

Supportive Care for the Renal Patient Second Edition provides a comprehensive, evidence-based overview of supportive care for the nephrology patient. An international group of contributors emphasise the continuum of palliative care from the time of diagnosis through to end-of-life care and the issues surrounding withdrawal of dialysis. The book addresses the psychological impact of the disease, the importance of involving the patient in making decisions about their care, ethical considerations, the role of the family and the multidisciplinary team. This new edition includes two new chapters on conservative management of advanced kidney disease (AKD) and dialysis in the very elderly. The chapters covering non pain symptoms, advance care planning, quality of life, psychological and psychiatric consideration and end-of-life care have also be completely revised to include new evidence and current thinking. This book will be of particular interest to palliative care practitioners; nephrologists, who increasingly need to know more about palliative care; nurse practitioners, dialysis nurses, social workers, dieticians, and psychiatric consultants. ABOUT THE SUPPORTIVE CARE SERIES Supportive care is the multidisciplinary holistic care of patients with chronic and life-limiting illnesses and their families - from the time around diagnosis, through treatments aimed at cure or prolonging life, and into the phase currently acknowledged as palliative care. It involves recognising and caring for the side-effects of active therapies as well as patients' symptoms, co-morbidities, psychological, social and spiritual concerns. It also values the role of family carers and helps them in supporting the patient, as well as attending to their own special needs. Unlike traditional palliative care, which grew from the terminal care of cancer patients, supportive care is not restricted to dying patients nor to cancer. This series covers the support of patients with a variety of long-term conditions, who are currently largely managed by specialist medical teams in hospital and by primary care teams in community settings. Each volume therefore provides a practical guide to the supportive care of patients at all stages of illness. Series Editor: Sam H. Ahmedzai

The book focuses on pharmacological and non-pharmacological approaches of psychiatric syndromes that commonly occur in patients with kidney disease. It specifically reviews principles of psychotherapy and psychopharmacology with an emphasis on organ impairment and drug-drug interactions specific to nephrology. This book also covers issues with medication nonadherence in patients with chronic kidney disease and psychiatric comorbidity, as well as the associated issues in dialysis and renal transplantation. Additionally, chapters cover various other topics addressing an active stance towards health promotion in chronically ill patients, including the critical role of the diet and physical activity. Such advice is often complex and changing depending on the stage of chronic kidney disease and the individual needs of the patient. Written by specialists in the field, Psychonephrology: A Guide to Principles and Practice serves as a valuable reference and teaching tool that provides an opportunity for learning across a rapidly evolving medical field.

The third edition of a bestseller, this book provides insight from a wide array of international contributors in the field of pediatric nephrology. Copiously illustrated with photomicrographs and clinical diagrams, the third edition reflects current advances in the field. Each chapter contains a set of questions, directed at helping fellows succeed at the American Pediatric Nephrology Board examination. New information for this edition includes changes in treatment options for hyponatremia, and updates on hyperparathyroidism and transplantation. Text boxes highlight important "take home points" throughout the chapters. Clinical Pediatric Nephrology, Third Edition will be a valuable reference for clinicians in nephrology, pediatrics and urology, and any professional involved in the care of children with renal diseases seeking a reliable contemporary text.

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.

Immunosuppression in solid organ transplantation is experiencing a worldwide revival since new drugs are now available in the late-1990s 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 analyzed, 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.

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.

This is the story of a boy raised up in a village in Poland during World War II, with his father deported to concentration camps throughout the war. Some years after he graduated from medical school, he serendipitously entered the then developing field of dialysis, and he eventually embarked on a career-long practice in the field, where he contributed to the development of a number of new inventions and therapeutic methods. The book contains 13 chapters covering the author's childhood, education, and his career-long contributions to the field of nephrology. The book includes inspirational stories of his patients; the struggles he faced in the course of getting his numerous inventions patented; his research work in the 1990s; his work of teaching and consulting; and not the least, his travels to interesting places unrelated to business. The book concludes with an epilogue summarizing his life, as well as his predictions regarding treatment of chronic renal failure in the future.

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.

Explores the latest findings for both selective and efficient separation devices in the field of kidney research. It is divided into three major sections. Part one deals with the biochemistry'' part of the problem, including how to identify ligands of interest, how to link them to synthetic membranes, and some kinetic limitations of frontal elution chromatography. The second part comprehensively discusses the various substrata used in affinity separations and the formation processes of semi-permeable membranes. The final section explores the filtration processes using membranes and the kinetics of separations based on affinity membranes.

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.

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.

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.

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 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

Medical Semiology Guide of the Renal System provides a comprehensive understanding of medical semiology in the renal system. Highly illustrated with many original images from the author's daily medical practice, the book highlights all signs of diseases and important semiological maneuvers in the field. Each chapter incorporates a specific questionnaire with important questions that should be asked to patients in different situations to obtain valuable information that helps identify rare and unusual diseases. This unique feature of the book aims to facilitate the learning process among medical students, while also acting as a quick reference guide for clinicians in practice.

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.

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.

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.

Membrane Transport Processes in Organized Systems is a softcover book containing portions of Physiology of Membrane Disorders (Second Edition). The parent volume contains six major sections. This text encompasses the fourth and fifth sections: Transport Events in Single Cells and Transport in Epithelia: Vectorial Transport through Parallel Arrays. We hope that this smaller volume, which deals with transport processes in single cells and in organized epithelia, will be helpful to individuals interested in general physiology, transport in single cells and epithelia, and the methods for studying those 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 ofthe 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 play a 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.

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.

In many ways this book is a team effort. Many people have helped me in writing it. Firstly, I thank my wife who read the manuscript twice correcting grammatical errors and spelling and clarifying many sentences. Secondly, I thank friends and colleagues at St. Mary's Hospital, including Mrs Jean Emerson, Renal Unit Social Worker and Mrs June Morgan, Senior Dietician, both of whom contributed technical information; Sisters Christine Holmes and Malinie Polpitiye who read and criticized some chapters; Miss Mary Williams, Mr Robert Minor and Mr Richard Viner who as patients read some sections and made useful suggestions. My thanks are due to Miss Veronica Adams who typed most of the manuscript and also to Mrs June Marshall and Miss Joyce Meadows who helped with typing and much photocopying. I must thank Travenol Laboratories Limited whose generous financial support enabled this book to be published. The editorial staff of MTP Press have been very helpful, rapid and efficient in publishing the text. If any reader wants to know more about renal disease, there 7 PREFACE are several good introductory books on renal medicine available. I am sure that the local public library will be pleased to help. Any parts of this book that are wrong or misleading are my responsibility. If anyone has the energy to point out errors to me I will try to correct them in any subsequent edition.

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.