Continuous Renal Replacement Therapy (CRRT) is the standard of care for management of critically ill patients with acute renal failure. Part of the Pittsburgh Critical Care series, Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice. Organized into sections on theory, practice, special situations, and organizational issues, this volume provides a complete view of CRRT theory and practice. Tables summarize and highlight key points, and key studies and trials are included in each chapter. The second edition has been updated to include a new chapter on the use of biomarkers to aid in patient selection and timing, extensive revisions on terminology and nomenclature to match current standards, and the most up-to-date information on newly developed CRRT machines.

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.

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.

Over the last 10 years the syndrome of severe acute renal failure has progressively changed in its epidemiology. It is now most frequently seen in critically ill patients, typically in the context of sepsis and multiorgan failure. This epidemiologic change has meant that intensive care physicians and nephrologists must now work in close cooperation at all times and must take many com plex issues of prevention, pathogenesis, and management into account that they did not previously have to tackle. Simultaneously, the last 10 years have seen the development of major technical and conceptual changes in the field of renal replacement therapy. There are now previously unavailable therapeutic options that provide physicians with a flexible and rapidly evolving armamentarium. The nutrition of these patients, previously limited by the par tial efficacy of renal replacement therapies, has also become more aggressive and more in tune with the needs of critically ill patients. Increased understanding of the pathogenesis of the multi organ failure syndrome has focused on the role of many soluble "mediators of injury" (cytokines, leukotrienes, prostanoids etc.). These molecules are likely to participate in the pathogenesis of acute renal failure. Their generation and disposal is also affected by different techniques of artificial renal support."

This book presents contributions from leading international experts in the field of nephrology. Each chapter is independent and discusses nephrology in the author's country, including the history of nephrology development, kidney disease epidemiology, clinical nephrology, dialysis practice in acute and chronic renal failure settings (hemodialysis, hemodiafiltration, peritoneal dialysis), pediatric nephrology, and kidney transplantation. In addition, the book covers topics such as the job market for nephrologists, reimbursement, nephrology education, and the number of professionals in the private and public sectors. With 53 chapters and more than 300 authors from all continents offering a unique perspective on nephrology practice, it provides a much-needed information source for nephrologists around the globe. The reader will be able to travel through "Nephrology Worldwide", a pleasant reading experience with not only relevant information and updated data, but also a comprehensive look at the history, countries' peculiarities, and a critical analysis of the scenario of nephrology and renal replacement therapy. A valuable resource for healthcare professionals and other stakeholders interested in learning about the status quo of Nephrology Worldwide. "Both the failings and the successes are outlined in a way that should make this book a compelling read, not just for the well-informed renal physician, but also for planners and policy makers whose thinking and actions are integral to the way we practice medicine." - Sir Peter J. Ratcliffe, Nephrologist and 2019 Nobel Prize Winner More information on the Nephrology Worldwide initiative can be found at www.nephrologyworldwide.com.

Hyperuricemia is often associated with life-style related disorders such as diabetes mellitus, hypertension, and dyslipidemia, which, in turn, are major causes of CKD. Improved management of hyperuricemia is thus expected to be beneficial for both the general population and CKD patients. This book presents new information on uric acid in tubular transport, early recognition of renal lesions, genetic predisposition, preeclampsia, metabolic syndrome, diabetes, high blood pressure in the young, and the relationship with vitamin D. Moreover, the relationship between AKI and uric acid, as well as the rejection of renal transplants due to hyperuricemia, are discussed. This publication will be of interest to both general practitioners and researchers working in the field of CKD. It provides new insights into renal damage caused by hyperuricemia and into prevention and treatment possibilities.

The cerebro-renal interaction - a neglected entity Chronic kidney disease (CKD) is an established risk factor for cardiovascular diseases. Stroke, on the other hand, is not only a major player in cardiovascular disease, but it also has strong two-way relationships with CKD. Moreover, subclinical cerebral abnormalities are also associated with CKD. But despite all these connections, the cerebro-renal interaction has so far not received much attention. This book includes easily understandable reviews on brain, stroke and kidney by both experts in nephrology and neurology. Examined are underlying concepts for cerebro-renal interaction, risk of clinical and subclinical brain damage in CKD patients, primary prevention and acute/chronic management for stroke patients with CKD and end-stage kidney disease. This book promotes not only further understanding and a multidisciplinary collaboration between nephrologists and neurologists, but it is also of interest for neurosurgeons and cardiologists.

Acute organ damage and the ensuing multiple organ failure are the result of a pathophysiological process involving various cytokines. Once activated, these proteins cannot be eliminated even when the kidneys function at their maximum capacity. To counteract this mechanism, researchers in Japan have developed an innovative concept employing blood purification to remove the overwhelming cytokines. This book describes the use of hemodiafiltration to inhibit the cytokine storms which cause serious organ damage in patients with septic shock. Moreover, the technical construction of the blood purification system, which includes various machines, devices, membranes, fluids, etc., is explained in detail. Finally, leading experts discuss the concept of continuous renal replacement therapy as the standard care in critically ill patients with severe acute kidney injury. Describing the current state of acute blood purification, this publication provides new impulses and opens new avenues in the treatment of acute organ damage.

We are currently facing an alarming obesity epidemic, with its well-known health consequences such as metabolic syndrome / type 2 diabetes, cardiovascular diseases, an increased incidence of certain types of cancer, musculoskeletal disorders and pulmonary diseases. Experimental and clinical evidence accumulated in recent years now suggests that obesity has also a major effect on renal structure and function. Since the adipocyte is considered a source of many hormones and cytokines, obesity has much more direct influences on renal function besides mediating hypertension: It can by itself induce renal disease such as focal segmental glomerulosclerosis, but also, more commonly, bring about progression of chronic renal diseases. The present volume is the first comprehensive compilation dedicated to this important topic, featuring discussions of pathophysiological as well as clinical aspects written by the leaders in this emerging field of research. It brings together pathophysiological concepts on how obesity influences renal structure and function, reviews the epidemiology of the problem and provides therapeutic suggestions. This publication is recommended for internists, nephrologists, hypertensiologists, cardiologists, and urologists treating patients with obesity and renal diseases. Furthermore, basic scientists such as renal physiologists, renal pathologists, pharmacologists, biochemists, and epidemiologists who want a comprehensive overview of the topic will also profit from this book.

A compendium of consensus papers, guidelines and research summaries Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and organ death? Even if we have a positive biomarker pattern and we can identify patients at risk or patients with early or even subclinical AKI, how is this information affecting our clinical behavior and practice? The second part is dedicated to the appraisal of the current knowledge about the pathophysiological mechanisms involved in different forms of CRS: it contains contributions on the state-of-the-art knowledge and practice of CRS, particularly focusing on the pathophysiology of the five subtypes. Acute and chronic mechanisms of damage are explored in depth, with particular attention to the primacy of organ involvement and the subsequent pathways of organ crosstalk. Presenting the most recent research in the field of biomarkers, AKI and CRS, this publication is an important educational tool for advanced investigators and clinical experts, but also for students and fellows.

Acute kidney injury (AKI) is a serious disorder in which sudden impairment of kidney function occurs secondary to one or more of a variety of underlying conditions and exposures. It is very common in (elderly) ICU patients and associated with very high mortality. Many of those who survive suffer from permanent kidney failure and other long-term morbidities. Renowned experts from around the world have contributed to this new publication, creating a succinct yet complete review of the most controversial aspects of AKI. The topics range from epidemiology and basic science to pathophysiology and clinical issues. It is intended as a concise reference work for physicians and nurses who deal with AKI in clinical nephrology and intensive care wards on a daily basis.

Acute kidney injury (AKI) is a serious and as yet incompletely understood disorder in which sudden impairment of kidney function occurs secondary to one or more of a variety of underlying conditions. This disorder is very common in (elderly) ICU patients and is associated with very high mortality. Many of those who survive suffer from permanent kidney failure and other long-term morbidities, which may include cardiovascular disease and immune dysfunction. Epidemiologic evidence suggests that AKI is not a single disease, but a syndrome comprised of multiple, often coexisting, etiologies. Being usually part of multiorgan failure syndrome, it calls for multiple organ support therapy. The publication at hand contains sections on prerenal azotemia syndromes, dying 'of' or 'with' AKI, pathophysiology of sepsis-induced acute kidney injury, developments in prevention / treatment / rehabilitation, and renal support. Reporting the latest recommendations from experts, it provides valuable information for those that are interested in understanding the disorder and its treatment options.

This publication contains the most recent findings in the field as presented by the outstanding faculty of the 2012 International Vicenza Course on Peritoneal Dialysis. After 30 years, this course is still one of the main educational events in the field of peritoneal dialysis as well as other disciplines including CKD, hemodialysis and critical care nephrology. The publication of the book in time for the course represents another success of the Vicenza team. The experts of the world and the related industry met in Vicenza for this important anniversary which is celebrated by this book representing not only a milestone in the history of the Department of Nephrology and the International Renal Research Institute of Vicenza, but also and above all an extraordinary educational tool for all physicians and nurses interested in peritoneal dialysis today.

Uric acid disorders are involved in both nephrological and hematological diseases. One of these crystal-associated diseases which has been known since antiquity is gout. More recently, tumor Lysis syndromes have been identified which affect patients with cancer, especially in the phase of cellular destruction after chemotherapy. The detection of these hyperuricemic syndromes, together with the improved understanding of urate handling by the kidney, have spurred new interest in the pathophysiology of hyperuricemic states, their clinical consequences and management. Moreover, the recent development of a recombinant form of urate oxidase transforming uric acid into allantoin (Rasburicase) has caused new interest in the pathophysiology of hyperuricemia and the potential applications of this new drug. The multidisciplinary approach of this book offers new insights into the metabolic syndromes in question by uniting authors from the fields of biochemistry, pharmacology, rheumatology, onco-hematology, and nephrology. The result is a compendium of the present knowledge in the field, which will also be very useful as a reference tool for professionals and students who want to expand their knowledge on this topic.

Critical care nephrology is an emerging multidisciplinary science in which the competences of different specialists are merged to provide a unified diagnostic and therapeutic approach to the critically ill patient. The volume at hand places great emphasis on cardiorenal syndromes and the multidisciplinary collaboration between cardiology and nephrology. Several contributions describe the cardiorenal syndrome in its different varieties and subtypes and report the results from the most recent Acute Dialysis Quality Initiative Consensus Conference, as well as proposing new diagnostic approaches based on early biomarkers of AKI. Other papers discuss advances in technology for renal replacement therapy and multiple organ support therapy. Moreover, special emphasis is placed on the potential role of extracorporeal therapies in patients affected by H1N1 influenza, and a summary of the most recent trials in the field is included. Containing the proceedings of the 2010 International Vicenza Course on Critical Care Nephrology, this publication is a state-of-the-art appraisal of today's technology and current issues related to cardiorenal syndromes.