Kidney cancer is the 10th most common cancer in Europe with overall mortality rates increasing until the late 1980s and early 1990s and thereafter, stabilised. Until recently, renal cell carcinoma (RCC) was thought to represent a monomorphic disease; however, modern genetic characterisation has demonstrated different subtypes with specific cell types and molecular metabolism. Imaging diagnostic methods are basic for staging and for new treatment strategies. Moreover, tumour biopsy has been reintroduced in the diagnostic armamentarium, mainly in patients with small masses but also when disseminated tumours need to be treated with new target therapies. Although TNM stage, Fuhrman grade and Eastern Oncology Group (ECOG) performance status are the most recognised prognostic factor in RCC, active research continues to determine new prognostic factors to classify different risks for death from RCC. Laparoscopy has gained widespread popularity because of a less morbidity and a faster post-operative convalescence. Partial laparoscopic nephrectomy is a demanding operation that can be made depending on the experience of the surgeon, the size or location of the tumour in the kidney. New robotic approaches are being introduced for nephron sparing surgery. Conversely, cardiac bypass can be necessary for resection of tumours with thrombus extending into the inferior vena cava above the level of hepatic veins. With the advent of modern ablative energies (cryotherapy or radiofrequency) for renal tumours in selected patients with percutaneous or laparoscopic techniques, it is now possible to achieve long cancer specific survival with decreased morbidity. A need for standardisation of follow-up after surgery with lifelong protocols has been recognised in last years. Finally, angiogenesis inhibitors have demonstrated a high probability of disease control in patients with metastatic renal carcinomas. Their indication as adjuvant in local advanced tumours as well as the role of nephrectomy in patients with metastatic disease is being evaluated in current clinical trials.

Nephrolithiasis is the third most common diagnosis involving the urinary tract, exceeded only by urinary tract infections and prostate conditions. Uric acid nephrolithiasis accounts for 5-10 % of all kidney stones in the general population in the United States (US) and is noted to be increasing in other parts of the world like Japan, previously known to have a low incidence of this condition. This increase is attributable, at least in part, to westernised eating habits. Other factors which influence development of kidney stones include age, sex and ethnicity. This book discusses in further details, the risk factors, treatment options and ways to prevent nephrolithiasis.

This multi-author book is an important contribution to the fields of nephrology and nephropathology, which is primarily focused on the discussion of the pathogenesis and pathology of nephrotic syndrome. A few primers are available on this subject, but those can be considered as reference works and not suitable for daily or bedside use. The present book has been written with a view to fill this void, at least partially. It is written by many practicing nephrologists and nephropathologists from different parts of the world, in particular, from developing countries. The book not only discusses the etiology and pathology of the disorder but also addresses the new developments and updates on the pathogenesis of nephrotic syndrome, which is the most common clinical manifestation of medical renal disorders in nephrological practice throughout the world. The book is handy and can be used in the office, classroom and by the patient bedside. It will prove very useful for the beginners in the field of nephrology and nephropathology. The book has been written in easy English, and is very well illustrated to enable easy comprehension and assimilation of the knowledge and information contained in it.

While patients with metastatic renal cell carcinoma (mRCC) are now living longer with improved quality of life, the success of novel therapies for mRCC has created challenges for practicing oncologists. Many patients who initially respond to targeted therapies ultimately develop progressive disease due to acquired resistance to these agents. Additionally, some patients do not respond at all to any of the currently approved targeted agents, underscoring the need for continued and concerted efforts to identify other relevant targets and pursue alternative therapeutic strategies. Part of the Oxford American Oncology Library, Renal Cell Carcinoma is a concise handbook that addresses the complex management of patients with mRCC. The book begins with a review of the epidemiology, pathology, and biology of renal cell carcinoma followed by chapters on specific targeted therapies and managing complications. The final chapters discuss supportive and integrative care and emerging therapies.

Vesicoureteral reflux (VUR) is defined as the retrograde flow of urine from the bladder to the upper urinary tract. It is a common urological entity among children and it is usually diagnosed in the prenatal period or after episodes of febrile urinary tract infection. Reflux can also be found in post-pubertal patients, but it is less common in this population. Pyelonephritis is an upper urinary tract infection involving the kidneys with an incidence in the USA as high as 250.000 cases per year. Most episodes of pyelonephritis are generally considered to be uncomplicated in healthy non pregnant adults. Different risk factors have been identified, such as diabetes, urinary tract obstruction, presence of an indwelling urethral catheter, stent or nephrostomy, functional or anatomic abnormalities of the urinary tract, renal transplantation, immunosuppressive therapy and pregnancy. This book discusses the causes, prevalence and treatment approaches of both VUR and pylonephritis.

Urolithiasis is one of the oldest documented medical ailments with archeological evidence showing that humans have suffered from kidney and bladder stones for centuries. Urolithiasis is a common multifactorial problem with multi-effect on the patients' quality of life and an economic burden on the individual and the health system of the country. Various intrinsic and extrinsic factors are associated with the risk for stone formation. Among intrinsic factors are race, sex, and genetics. Finding the cause of urolithiasis or establishing it early in life will reduce the consequence and complications of kidney stone disease and hence reduction of the cost in the treatment by establishing preventative measures in addition to patient education. Genetic factors play an important role in the etiology of urolithiasis as a polygenic (common) or monogenic (rare) forms, however its knowledge and early diagnosis is important for achieving the goals of reducing patient suffering as well as economic burdens that inevitably follow a diagnosis. This book discusses the symptoms, management and prevention strategies of urolithiasis.

Glomerulonephritis is a term referring to direct injury of the glomeruli with resulting disturbances of normal glomerular function, progressively leading to renal failure. Glomerular diseases are classified as primary, where glomerular damage is the prime disturbance, with extrarenal manifestations as a result of renal impairment, and secondary, following systemic disorders, infections or exposure to certain drugs. Although noteworthy progress has been made in the past years in the symptomatic and specific treatment, therapy of both primary and secondary glomerulonephritis can be challenging. Management of these patients requires early diagnosis, expert knowledge of the immunosuppressive agents and other drugs currently available for the treatment of each glomerulonephritis, consideration of possible adverse reactions to these drugs, alternative therapeutic strategies in cases of hyporesponsiveness or non-responsiveness of the patient to the treatment, and possible relapses of the disease. This book reviews knowledge of the main primary and secondary glomerulonephritis, with emphasis on current therapeutic strategies and practical recommendations. Glomerulonephritis are grouped according the presence or absence of proliferative histological alternations into primary and secondary proliferative and non-proliferative types. Each chapter deals with etiopathogenesis, epidemiology, pathology, clinical manifestations, natural history and therapeutic options of the commonest primary and secondary glomerular diseases, with exception the last chapter that covers inherited diseases with renal involvement. An atlas of the pathology of the glomerular diseases discussed completes this work.

Hemolytic uremic syndrome (HUS) is characterized by the triad non-immune micro-angiopathic hemolytic anaemia, thrombocytopenia and acute renal failure. The disease mainly affects children one to ten years of age. It begins after an incubation period of 4 to 7 days with abrupt onset of bloody diarrhoea and abdominal pain. Two to ten days later, microangiopathy, haemolytic anaemia, thrombocytopenia, and acute renal failure develop. HUS microangiopathy can involve almost any organ, but damage to kidneys and central nervous system cause the most severe clinical problems. This book discusses the symptoms, the treatment options and prognosis of HUS.

Kathleen and 24 of her fellow patients provide easy-to-read helpful tips and share their personal experience, that is both useful and informative. This book will certainly assist those who are currently on dialysis or about to start it. Dialysis is not easy, but this information may give you a much better understanding and change the way you feel about it. Attitude is most important. Staying positive and finding some new ways to combat the negatives just might make it a whole lot easier.

Acute kidney injury (AKI), defined as an abrupt decrease in renal function over a period of hours to days, is a common complication among hospitalised patients with different acute diseases. Its incidence has been increasing in recent years and is reported to be very high especially in the acute settings. Since clinical signs and symptoms of acute renal damage are not specific, it is difficult to promptly distinguish AKI at the time of patient presentation. Currently the diagnosis of AKI requires serial assessment of laboratory tests over a period of several days, and is based mainly on the evaluation of serum creatinine (sCr) and decrease in urine output as supported by Risk, Injury, Failure, Loss, and End-Stage Kidney Disease (RIFLE) criteria, Acute Kidney Injury Network (AKIN) criteria, and the recent Kidney Disease: Improving Global Outcomes (KDIGO) practice guidelines for AKI. Such a need for repeated sCr evaluations and monitoring of urinary output for too long time after admission could therefore result in a diagnostic delay. With delays in diagnosis, clinicians miss opportunities to start appropriate treatment to minimise damage, and patients incur more severe AKI with subsequent greater risk of developing progression of renal damage leading to chronic kidney disease (CKD), dialysis and increased risk of severe cardiovascular diseases and death.

Handbook of Peritoneal Dialysis Second Edition Steven Guest M.D. This book is a guide to the clinical practice of Peritoneal Dialysis. Chapters provide the core curriculum for expertise in PD therapy and address relevant clinical challenges faced by caregivers. Contained in this Handbook: Peritoneal Membrane Physiology, PET, Modified PET, DATT, Acute and Chronic PD Prescription, Catheters and Placement Techniques, PD Solutions, Infectious and Non-infectious Complications, Fluid Management in PD, PD in the Diabetic and Morbidly Obese Patient, Nutritional and Metabolic Issues in PD, Survival in the PD Population, Setting Up a PD Program / Infrastructure.

This book with its most comprehensive and illuminating chapters covers all the relevant areas of hemodialysis practice including access for hemodialysis, hemodialysis modeling and membranes, timing of hemodialysis, infections in hemodialysis, the application of hemodialysis in extra-renal disease, the various formats of hemodialysis from nocturnal through SLED to apheresis and the wearable artificial kidney, convective hemodialysis methodologies, and various clinical aspects of hemodialysis including protein-calorie-malnutrition, inflammation, haemoglobin stability and sleep disorders in ESRD patients and so on. Furthermore, the inclusion of such new topics as the syndrome of rapid-onset end stage renal disease (SORO-ESRD), and the place of reduced HBV testing among ESRD patients in regions with less de novo HBV incidence to cut down on costs of delivery of hemodialysis care without loss of quality of care, are new paradigms that would play stronger roles in hemodialysis care, well into the 21st century.

Written by experienced educators and renal nurses with extensive experience of clinical practice the Oxford Handbook of Renal Nursing is a concise, current and evidence-based guide to the care of patients with renal disease. This practical and thorough resource ensures that expert and relevant information is always accessible, whatever the circumstances.
Assisting both practising and student nurses with decision-making skills from the patient assessment stage through to post procedure/operation nursing care, this handbook provides a wealth of useful information on the aetiology of kidney disease, assessment and diagnostic processes, and the available treatments.
An indispensable resource, it covers caring for patients with a wide range of conditions, including chronic kidney disease and established renal failure. Additional information on treating patients waiting for, or undergoing dialysis or transplant surgery, and those requiring end of life care is also included.
Taking a multi-professional approach to the care and management of renal patients, the Oxford Handbook of Renal Nursing is an essential tool for all renal nurses, studying and practising, as well as dieticians, pharmacists, social workers, counsellors and researchers who specialise in renal care.

Metabolic and electrolyte disorders can pose special challenges to physicians caring for the critically ill patients. Constrained by time and circumstances, clinicians require rapid access to information to help assess and manage these often life-threatening conditions. In this book, a readily useable road map is presented, emphasizing the interactions among problems and suggesting clear lines of action. Keeping the physiopathological mechanisms to the essential, and maintaining an uncluttered format, each chapter provides guidelines to understanding "how did we get here" and "what should we do now," as quickly and safely as possible. Chapters describe clinical presentation and management of the most common renal, electrolyte, acid-base, metabolic and endocrine disorders, complicating the course of critically ill patients.
Contributing authors are all experts in their respective fields, who regularly engage in the day-to-day management of critically ill patients. In a rapidly changing field, the authors have endeavored to maintain an updated approach, emphasizing the most recent evidence on diagnosis and management. Although controversy in the interpretation and management of some problems is inevitable, the editors see it as a desirable way to depict differing interpretations and solutions for each problem. Each chapter ends with a selected list of key references to facilitate in-depth review of each subject.
As with other titles in the Pittsburgh Critical Care Medicine series, this book is intended for frequent use by both "budding experts" as well as by seasoned practitioners in need for of quick and effective reference.

Despite our efforts at creating clinical performance measures, clinical practice guidelines and intense government regulations, we still have disparities in care, poor outcomes and quality that is inferior to many other nations. Bundling and payment reform challenge the ability to deliver good care to patients even further. Chronic dialysis is at a crossroads. Physicians and providers must incorporate new approaches, reinventing the paradigm of how to plot the course of patient therapy. This book offers new ideas. It is refreshing, timely and engaging, with a wide range of topics by leading authors, each designed to help meet the challenges yet to come.

Gabriel of Urantia asked the question, in the beginning of his struggle with dialysis, "God, why is this happening to me?" Throughout his 8-month dialysis experience, 3 days a week, 4 hours a day, being tied down to a chair while his blood flowed from his body through a machine and back, he realizes-from the people he meets also on dialysis and in the hospitals after post-kidney-transplant-that very bad things happen to very good people. He met young and old alike, tied down to the machines just like he was, and the young people were the hardest for him to resolve in his mind with God and also to try to give them hope. As a minister, he felt obligated to do so. Being a Pastor of a church (Global Community Communications Alliance-a very social, environmental, and spiritual activist church), he knew that bad things happened to good people who try to change the world. But this disease is personal, between him and God you might say. So he had to discover for himself why God allowed this to happen to him and to the other very good people he met with various traumatic illnesses in the hospitals and dialysis centers. Gabriel of Urantia tries to explain how he felt along the path, from the beginning to the receiving of his new kidney from his 22-year-old daughter and gaining the hope and health to continue not only his spiritual work, but his work as a musician, guitar player, and singer (in which he was planning a tour around the country with his 11-piece Bright & Morning Star Band), while now taking immunosuppressant drugs to keep him alive. He had all the fears that a new transplant patient has. How long will the kidney last? What other affects do these drugs have on my body? He writes about his experience with the medical world, the services he experienced from both very qualified people and those not so qualified (experienced and inexperienced care givers), as well as the bureaucracy of the medical field and insurance companies (both private and governmental). He realized that often in the medical field, the right hand didn't know what the left hand was doing and the patient suffered the results. Beyond that, Gabriel of Urantia tries to give hope to people with life-threatening illnesses by sharing his faith in the Creator to all who may read his book. A must-read for anyone on dialysis or with any life-threatening illness, from a writer who went through this and can identify with what they are going through and give them hope through this trauma in their lives.

This book is intended for use by nephrologists, internists, hospitals, trainees in these specialties and indeed anyone interested in renal medicine. It contains top-class authoritative and up-to-date reviews by internationally renowned experts coming from some of the best nephrology centres in the world. It covers the diagnosis, causes and management of acute kidney injury. It also includes a discussion of the diagnosis of chronic kidney disease, including the use of simple clinical and laboratory data, imaging, proteinomics and renal biopsy. It reviews the general management of chronic kidney disease, including an in-depth analysis of kidney transplant immunology. This book is therefore a comprehensive, authoritative text with clear explanation of even the most complex topics.

In this book, the authors present topical research in the study of the indications, procedures and complications of hemodialysis. Topics discussed in this compilation include cardiovascular involvement in chronic kidney disease; nutritional therapy during hemodialysis; vascular access and common complications in patients undergoing hemodialysis treatment; prevention of hemodialysis catheter-related infections; antiplatelet medication and the risk of bleeding in hemodialysis; and vascular calcifications in end stage renal disease.

Pathology of the Kidney in Dysproteinemia is an academic monograph describing in detail the causes and development of structural and functional changes in the human kidney resulting from the deposition of abnormal circulating serum proteins. The material presented was obtained from 147 cases of renal involvement associated with Dysproteinemia encountered in university and community hospital settings. The described entities account for 4.5% of 3.260 biopsies of native kidneys examined over a period of approximately 25 years. While some of the lesions are quite rare, others are relatively common and seen fairly frequently in a reasonably busy renal biopsy service. Together they constitute a group of extremely interesting lesions in terms of immunology, morphology, and pathogenesis.This book should be of interest to pathologists- especially renal pathologists, immunologists, and internists. Both general internists and sub-specialists in nephrology and hematology will find this volume useful, as will medical residents and medical technologists in these various specialties. As a monograph it is user-friendly, since the subject matter is sufficiently circumscribed to permit expanded or detailed visual and textual treatment of specific lesions in a single easy-to-wield volume.