Nefrologi

This practical book covers the basic principles and practice of dialysis access management, a crucial part of the care of patients undergoing hemodialysis. It has been written in an easy-to-read, step-by-step format to help facilitate learning and understanding of the procedures and has been supplemented with numerous operative photographs and diagrams demonstrating the commonly performed dialysis access exams, interventions, procedures and surgeries.Dialysis access management is an essential text for residents, fellows and physicians who are learning or practicing in dialysis and/or dialysis access management, especially in the fields of nephrology, radiology, surgery and vascular medicine.

Written in a succinct question and answer format, this comprehensive book is a resource on all areas of nephrology and common clinical scenarios. The updated volume covers the basic physiology of fluids, electrolytes and acid-base problems, renal disorders and management, chronic kidney disease, hypertension, and other essential subjects. The nearly 1000 detailed questions and answers prepare readers for nephrology and internal medicine boards and provide a better understanding of nephrology as a whole. This new edition of Absolute Nephrology Review features the latest evidence and guidelines needed by nephrology fellows, practicing nephrologists, and clinicians.

This comprehensive guide to polycystic kidney disease captures the growing knowledge of this common, potentially-fatal and hereditary disease. The first two sections of the book provide an overview of PKD gene structures, mutations and pathophysiologic mechanisms. This is followed by chapters focused on PKD¿s clinical features, including renal and extrarenal manifestations, and appropriate management of patients. The final section covers current clinical trials and emerging therapies in PKD. Authored by experts in the field, this book provides the clinician and researcher with critical information on basic and translational science and clinical approaches in one concise resource.

During the past decade, there has been a renaissance of interest in the use of peritoneal dialysis as a primary dialytic modality for the treatment of children with end stage renal disease (ESRD). The development of the technique of continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) has markedly changed the approach to children requiring dialytic therapy. The availability of these techniques has facilitated prolonged dialysis in infants and has for the first time given pediatric nephro­ logists in many areas of the world an opportunity to consider dialysis in chil­ dren afflicted with ESRD. I have enlisted the collaboration of colleagues from Europe, South America, Canada, and the United States in compiling this multidisciplinary text, which hopefully contains the most up-to-date, comprehensive information regarding the use of CAPD/CCPD in children. It is my hope that every nephrologist (pediatric and adult); nephrology nurse (pediatric and adult); nephrology tech­ nician, or allied health professional dealing with children who require these therapeutic modalities will be able to resolve immediately any confounding clinical or technical issues that arise by using the information contained in this text. Demographic data on the use of CAPD/CCPD in children in Europe is provided from the EDTA Registry and in the United States from the National Peritoneal Dialysis Registry. The particular problems encountered in the use xiii xiv Preface of CAPD in children in developing countries is detailed by Dr. Grunberg and his colleagues in Uruguay.

CHARLES Y. c. PAK Major progress has been made in the pathophysiologic elucidation and management of nephrolithiasis during the past two decades. It is now possible to detect the cause of stone disease in more than 95% of patients, to prevent recurrent formation of stones in the majority of patients, and to remove most existing stones less invasively. The assumption of editorship of this book permits me to indulge in the discussion of this progress from my personal perspective. Three somewhat fortuitous events in my academic career dictated my directing major efforts in stone research. The first event occurred in 1963 when, after having completed medical training, I was faced with two years of military service as a participant of the Berry plan. Choices were limited and disconcerting for someone interested in a research career: a staff physician at a military installation or an indian reservation, or a member of a research team in a state penitentiary. An interesting article by Norman Gershfeld on phospholi­ pid monolayers prompted me to write him seeking a position in his laboratory of Health (NIH) in Bethesda, MD. Partly because of at the National Institutes my rudimentary exposure and publication in surface chemistry, I was offered a position as a staff scientist and a position in the Public Health Service which satisfied the requirements of a military service.

The aim of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY is to publish every year a volume to keep nephrologists up to date on all the rapidly changing areas of nephrology. Each volume will be published by the end of each calendar year which corresponds with the annual meeting of the American Society of Nephrology. Each issue of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY will be divided into sections; each section will have different primary focus every year, depending upon what area is of greatest interest at the time. In other words, each annual volume will deal with what is truly current in nephrology. All the authors appointed for the chapters of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY are known experts in the field who will give an objective review of the topic up-dating the readers on the world-wide literature. A crucial point for the success of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY is the list of the references at the end of each chapter. We have asked all authors to provide a complete, accurate and up-to-date list of important references. In order to guarantee the most up-to-date yearbook, very rapid production is mandatory. Rapid publication can be obtained only with camera-ready manuscripts for direct photo-offset reproduction. Thus we have agreed to use photo-offset printing for the series. For the first issue of the series, the INTERNATIONAL YEARBOOK OF NEPHROLOGY 1989, the Editorial Board has focused attention on the latest and most important scientific and clinical advances in nephrology.

This manual provides practical and accessible information on all aspects of general nephrology, dialysis, and transplantation. It outlines current therapies in straightforward language to help readers understand the treatment rationale, and does not assume extensive knowledge of anatomy, biochemistry, or pathophysiology. Consisting of 33 chapters written by 31 experts from four continents, this volume covers all the practical tips in the emergency and long-term management of patients with electrolyte disturbance, acid-base disturbance, acute renal failure, common glomerular diseases, hypertension, pregnancy-related renal disorders, chronic renal failure, and renal replacement therapy. It is thus an essential source of quick reference for nephrologists, internists, renal fellows, and renal nursing specialists, and is also suitable for graduate students and research scientists in the field of kidney diseases.

Proceedings of the 4th Bari Seminar in Nephrology, April 25-28, 1990

Dieses Buch informiert umfassend uber physiologische, psycho- logische, soziale, technische und organisatorische Fragen, die im Zusammenhang mit der Dialyse auftreten. Es unterrichtet dar- uber hinaus uber die komplexen Probleme, welche eine chroni- sche Krankheit, die fur den Kranken eine standige, nur durch unausgesetzte medizinische Betreuung und Uberwachung ab- wendbare Todesdrohung bedeutet, fur die Interaktion zwischen Kranken, Arzten, Pflegepersonal und Angehorigen aufwirft. Da- mit wird das Buch zum Dokument fur eine bemerkenswerte Etappe in der Entwicklung der modernen Medizin, die zwei fur sie vitale Probleme losen mu: Die Einfuhrung des Kranken als Subjekt in die Heilkunde, die Viktor von Weizsacker forderte, und die Integration der sich standig vermehrenden Spezialdiszi- plinen zu einem einheitlichen System. Zu dem ersten Problem dokumentiert das Buch die schein- bar paradoxe Tatsache, da die Einfuhrung des Kranken als Subjekt, die der Psychologie bisher trotz aller Anstrengungen nicht gelungen ist, von der Perfektion der Technik - gegen deren eigentliche Intention - erzwungen wird. Der Grund dafur ist die Erfahrung, da die Subjektivitat des Kranken zu einem Hinder- nis fur den technischen Fortschritt in der Medizin wird, das durch weitere Perfektionierung der Technik nicht uberwunden werden kann.

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.