Organogenesis of the kidney has been intensely studied for over a century. In recent years advances in molecular techniques have not only made great inroads into exploring the genetic regulation of this complex process but also began to unravel the molecular basis of many forms of congenital kidney disease. This book is a comprehensive study on these findings and the only book available with such in depth coverage of the kidney.
Key Features
* Hundreds of color figures depicting key events in all aspects of kidney development
* Full coverage of the genetic and cellular basis of kidney development
* Analysis of the genetic basis of the major congenital kidney diseases

Death on Hemodialysis: Preventable or Inevitable? presents the transactions of the Brooklyn meeting, held in April 1993, including an analysis by Scribner and Schreiner and an introduction by Edmund Bourke. Authors include the heads of dialysis registries for Japan, Europe, and the United States, as well as protagonists of dialyser reuse and short dialysis times. Enthusiasts championed the determination of adequacy of dialysis by formulae or by clinical assessment. All chapters are direct and forceful. The reader will be able to judge the data on what are key controversies in planning dialysis protocols and schedules.

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.

Nocturia: Causes, Consequences and Clinical Approaches is the first volume exclusively on the topic of nocturia and is designed to be a comprehensive treatise on the subject. The volume is organized into 11 chapters first introducing and defining nocturia and its impact to patients and society, followed by chapters dealing with predictors and risk factors; relationship to sleep disorders; overactive bladder; and water homeostasis. Therapeutic areas addressing nocturia are covered in specific chapters and include pharmacotherapy affecting the bladder, prostate and kidneys as well as behavioral therapy and surgical intervention. Separate chapters are devoted to alternative therapies as well as the impact of nocturia in the elderly. The volume closes with a chapter presenting avenues for future investigation into the etiology and management of nocturia. Clinical case scenarios inclusive of figures and tables illuminate the evaluation and management of patients with nocturia. Nocturia: Causes, Consequences and Clinical Approaches will give physicians and related healthcare providers the background to understand the conditions causing nocturia, how nocturia affects society and the basis for its rational treatment. It will be used as a state of the art reference by urologists, urogynecologists, internists, nephrologists, pulmonologists, endocrinologists and sleep medicine specialists.

Kidney Development and Disease brings together established and young investigators who are leading authorities in nephrology to describe recent advances in three primary areas of research. The first section describes the use of animal models as powerful tools for the discovery of numerous molecular mechanisms regulating kidney development. The second section focuses on nephric cell renewal and differentiation, which lead to diverse cell fates within the developing kidney, and discusses diseases resulting from the aberrant regulation of the balance between cell fate decisions. The final section concentrates on morphogenesis of the developing kidney and its maintenance after formation as well as the diseases resulting from failures in these processes. Kidney form and function have been extensively studied for centuries, leading to discoveries related to their development and disease. Recent scientific advances in molecular and imaging techniques have broadened our understanding of nephron development and maintenance as well as the diseases related to these processes.

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. Calcium and Phosphate Metabolism Management in Chronic Renal Diseases provides an overview of the state-of-the-art clinical and basic science aspects of abnormal calcium and phosphate metabolism and its management.

The papers in this volume arose out of the workshop Membrane Transport and Renal Physiology, which was conducted as part of the IMA 1998-1999 program year, Mathematics in Biology. The workshop brought together physiologists, biophysicists, and applied mathematicians who share a common interest in solute and water transport in biological systems, especially in the integrated function of the kidney. Solute and water transport through cells involves fluxes across two cell membranes, usually via specialized proteins that are integral membrane components. By means of mathematical representations, transport fluxes can be related to transmembrane solute concentrations and electrochemical driving forces. At the next level of functional integration, these representations can serve as key components for models of renal transcellular transport. Ultimately, simulations can be developed for transport-dependent aspects of overall renal function. Workshop topics included solute fluxes through ion channels, cotransporters, and metabolically-driven ion pumps; transport across fiber-matrix and capillary membranes; coordinated transport by renal epithelia; the urine concetrating mechanism; and intra-renal hemodynamic control. This volume will be of interest to biological and mathematical scientists who would like a view of recent mathematical efforts to represent membrane transport and its role in renal function.

Conditions such as oxidative stress and hypoxia, which have a generalized impact on the oxygen metabolism, have been implicated in the genesis of kidney disease. This means that deepening our understanding of the pathobiology of oxygen metabolism in such diseases could be a fruitful path towards tangible clinical benefits. Studies in Renal Disorder collects reviews from leading researchers and clinical scientists working in exactly this field, providing an overview of the latest advances. The causal role of impaired oxygen metabolism in kidney disease has numerous clinical implications. It affects our understanding of the therapeutic benefits accruing from anti-hypertensive agents; the way we control hyperglycemia/hyperinsulinemia and hyperlipidemia; and our use of dietary approaches to the correction of obesity. The defensive mechanisms against oxidative stress, such as the Nrf2-Keap1 system, and hypoxia, such as the PHD-HIF system, have recently been explored in various cells, including kidney cells. These mechanisms include intracellular sensors for oxidative stress and hypoxia. This means that novel approaches targeting these sensors may offer clinical benefits in kidney disease in which oxidative stress and/or hypoxia is a final, common pathway.

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. "

Over the last decade the development of new molecular biology tools, advanced microscopy, live imaging and systems biology approaches have revolutionized our conception of how embryonic development proceeds. One fundamental aspect of development biology is the concept of morphogenesis: understanding how a group of multipotent cells organize and differentiate into a complex organ. In Kidney Development: Methods and Protocols, expert researchers in the field detail different approaches to tackle kidney development. These approaches include culture and live imaging aspects of kidney development, analyzing the 3-dimensional aspects of branching morphogenesis as well as nephrogenesis, manipulation of the gene/protein expression during kidney development as well as in the adult kidney, and how to assess kidney malformation and disease. Written in the highly successful Methods in Molecular Biology (TM) series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls. Authoritative and practical, Kidney Development: Methods and Protocols seeks to aid scientists in the further study of the process of morphogenesis which is fundamental important not only for studying developmental biology but also for regenerative medicine.

Is the nephrology community facilitating excess cardiovascular deaths in patients with kidney failure and anemia by treating to a subnormal hematocrit? Why have clinicians and nephrologists permitted health insurance companies and the government to decide when anemia therapy should begin in persons with progressive kidney failure? Is iron the only variable that can be manipulated to maximize response to recombinant erythropoietin? Are we using too much intravenous iron in kidney failure patients, and is oral iron supplementation worthless in sustaining iron stores during long-term erythropoietin treatment? When does left ventricular hypertrophy begin to emerge in patients with progressive renal disease and is there convincing evidence that anemia is a significant cause of LVH in this setting? Is darbepoetin alfa, a new novel, long-acting erythropoietin, really superior to recombinant erythropoietin? This book is a compilation of proceedings from a conference in Brooklyn convened to address these and other controversial and unresolved issues in renal anemia management.

Table 1 Comparison of MIDD and immunoglobulinic amyloidosis MIDD Amyloidosis Presentation Multivisceral or predominant involvement of an organ (kidney) Underlying disease Monoclonal immunoproliferative disorders, mostly myeloma. Monoclonal bone marrow plasma cell populations without overt malignancy. Possibility of 'non-secretory' forms. Deposits by EM (Granular) non-organized Fibrillar (13 pleated sheets) Spectrum LCDD : L chains, most K, either AL-amyloidosis : fragments (?)* of or apparently enlarged, normal-sized normal-sized or apparently enlarged or short. Frequent glycosylation L chains most A. Frequent and polymeration. glycosylation.Abnormal susceptibility to proteolysis. LHCDD : associated H chains Cases with associated short H chains (short by biosynthesis by biosynthesis experiments. experiments). HCDD: short H chains. AH-amyloidosis : short H chains. L chain isotypy V K IV predominance. VAVI C A3predominance. V region mutations Yes Yes *Found in necropsy material; whether they exist in vivo is doubtful. 3 After Preud'homme et al. AL-amyloidosis). Therefore, we believe' that the term MIDD should be restricted to this pathological entity, whatever the Ig content of the deposits, light 4 5 ) or both (LHCDD ). However, the chains (LCDD), heavy chains (HCDD New York group used the denomination MIDD for both Randall's disease and immunoglobulinic amyloidosis'S". The two processes have many features in common (Table I) and they can be associated in the same patients.

This conference and monograph were the result of many collective efforts. The whole concept was formulated one early Wednesday morning at our weekly research meeting at Children's Hospital in our division of urology. We have been most fortunate to have a close collaboration with Bob Levin, Ed Macarak, and Pam Howard who have helped steer the course of our division's growing interest in basic science. At our weekly meetings our laboratory fellow will summarize their current work. Other ongoing areas of investigation in our labs and elsewhere are discussed. We have always made an effort to try and understand what other groups are doing who are working in the area of bladder smooth muscle research. It occurred to us that the best way to really know what everyone working in this field was doing would be to sponsor a 2-day meeting where we could all gather to discuss our ongoing work. A major limitation of the annual meeting of the American Urologic Association or the urology section of the American Academy of Pediatrics is that the scientfic sessions are limited as these are meant to be primarily clinical meetings (as they should be). For this reason the idea of a meeting devoted solely to research about the urinary bladder had great appeal. In addition to allowing for longer presentations than the standard 5 to 7 minutes, every effort would be made to encourage a dialogue amongst the presenters and the audience.

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.

Because of many advances in medicine and biotechnology, an increasing number of individuals are surviving into old age, and we are now challenged to apply sophisticated medical knowledge to the care of the elderly citizen. In nephrology, individuals older than 65 are the fastest-growing group of patients requiring dialysis. Similarly, in increasing numbers, elderly persons present themselves with renal complaints to their family doctor, the geriatrician or the nephrologist. In August 1998, with the financial support of the John A. Hartford Foundation, leaders in geriatrics, nephrology and urology met in Jasper, Alberta, for one week to discuss their areas of special knowledge and to learn from each other. Geriatricians learned from nephrologists, nephrologists learned from geriatricians, and both came to see that they had much in common. All participants discovered a common interest, challenge and commitment, namely, to provide the best renal care to a progressively aging population and to teach their fellows the principles of the other collaborating specialties. This book contains all the papers presented at this meeting and also the text of group discussions on Training and Education, Special Clinical Problems in Geriatric Patients, and Recommendations in Basic and Clinical Research. Nephrology and Geriatrics Integrated will prove useful to both nephrologists and geriatricians in their efforts to manage the renal complaints of the elderly, who come to them in increasing numbers.

Ethical rational, facts, and center techniques for choosing kidney donors all in one volume. This is the first book of its kind, devoted solely to preoperative issues for living kidney donors and those who counsel them. The eight chapters are devoted to vital areas that are comprehensively addressed by experienced professionals. The book presents a unified ethical and factual approach that is essential for all transplant centers to understand. It is a readable and understandable ethical foundation for living kidney donation that is free of jargon. It includes balanced, hard to find factual summaries that are essential for acceptable kidney donor counseling. As transplant centers increasingly turn to living kidney donors, this book is an essential step forward in the field.
The book will appeal to transplant physicians and surgeons, transplant coordinators and social workers, nephrologists who have patients on dialysis or who evaluate potential living kidney donors and to potential living kidney donors and their recipients. As a practical application of medical ethics to an important field, it will be of interest to medical ethicists as well.

The understanding how complement relates to glomerular diseases has evolved considerably during the last years. Substantial evidence has accumulated that explain how a defective or deregulated complement system results in kidney diseases. The combination and close interaction of basic research with clinical medicine has demonstrated an important role of complement effector and regulatory proteins in pathological settings of the kidney. A large panel of distinct human kidney diseases such as hemolytic uremic syndrome (HUS), membrano proliferative glomerulonephritis (MPGN), systemic lupus erythematosus (SLE) and in ischemic reperfusions injury and transplantation are caused by defective complement control. Genetic analyses have identified mutations in complement regulators that are associated with these diseases. Mutations have been identified in the fluid phase alternative pathway regulator Factor H and the membrane regulator Membrane Cofactor Protein MCP (CD46). The functional characterization of the mutant proteins allows to define the pathophysiological events on a molecular level. These new concepts and data on disease mechanisms already allowed to establish new diagnostic and novel promising therapeutic approaches for several human kidney diseases.

The successful series of International Meetings on "Current Therapy in Nephrology" (now known around the world as "Sorrento Meeting") has continued this year with the third meeting of the series, updating on new therapeutic strategies in Nephrology. This time the meeting was held at the Cocumella Hotel of Sorrento, Italy, on May 27-30, 1990, in a wonderful atmosphere, with the participation of outstanding scientists, such as Drs. H. Auchincloss (Boston, USA), E. Bartoli (Udine, Italy), V. Bonomini (Bologna, Italy), M. Broyer (Paris, France), V. Cambi (Parma, Italy), G. Camussi (Naples, Italy), J.M. Dubemard (Lyon, France), G. Haycock (London, U.K.), G. Jacobs (Paris, France), C. Kjellstrand (Minneapolis, USA), R. Maiorca (Brescia, Italy), G. Maschio (Verona, Italy). As many as five hundred nephrologists from all over the world (European Countries, Israel, U.S.A., Taiwan, Corea, Japan) attended the meeting, actively participating in the discussion of a great number of good papers and posters. Important lectures by invited speakers have dealed with mediators of inflammation, cellular immunity in glomerular pathology, immunosuppressive therapy in autoimmune nephropathies, treatment of hypertension in chronic renal failure, dialysis compatibility, xenogenic transplantation. Very interesting controversies have been included in the programme: "Extracorporeal or peritoneal dialysis for uremic children?" (M. Broyer against G. Haycock) and "Extracorporeal or peritoneal dialysis for diabetic uremic patients?" (c. Kjellstrand against C. Jacobs). Their presentation has been quite successful with a great participation in the discussion by Congress members.

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.

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 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.

This text covers the basic principles of mitochondrial dynamics in cardiovascular medicine, with particular emphasis on their functional roles in physiology and disease. The book will include articles pertaining to mitochondrial fitness on a global basis, providing therefore an update on the progress made in several aspects in the field. Thus, it will assist scientists and clinicians alike in furthering basic and translational research. Organized in sections focusing on: basic science, mitochondrial dysfunction in cardiac disorders, in vascular disorders, in metabolic disorders, in kidney disease, therapeutic challenges and options, this essential volume fills imperative gaps in understanding and potentially treating several cardiovascular disorders.