Adel E. Berbari – författare

This book provides an in-depth and up-to-date review of the association between blood pressure disorders and diabetes mellitus. In addition, it discusses the specific role of hemodynamic alterations on the vasculature of various target organs (the retina, kidney, brain, and gravid uterus), topics that are infrequently considered and or acknowledged by clinicians.

Covering all aspects of the interaction between metabolic and hemodynamic factors, the book presents the diverse perspectives of the contributing authors and extensive discussions of issues including diabetic kidney disease, diabetic hypertensive phenotypes and postural hypotension.

This book is intended to be an in-depth and up-to-date guide to the various aspects of the association between blood pressure disorders and acute/chronic renal diseases. In addition, this work includes discussion of topics rarely considered and or acknowledged by in the clinical practice, namely hypertension in different kidney diseases, pathophysiologic mechanisms underlying blood pressure elevation in renal disorders, cardiorenal associations and therapeutic approaches in hypertensive renal disorders.

This book is divided in sections and chapters to cover various phenotypes of renal hypertension and their interactions to kidney disease.

This book aims to present a comprehensive classification of hypertensive phenotypes based on underlying target organ involvement. Particular emphasis is placed on review and assessment of clinical presentation, pathophysiologic mechanisms, and possible specific therapeutic options for each hypertension phenotype. Several of these phenotypes are well known and well described in the literature, such as prehypertension, white coat and masked hypertension, isolated systolic hypertension, renovascular hypertension, endocrine hypertension, pediatric hypertension, and gestational hypertension. Other hypertension phenotypes, however, are not widely recognized, being reported only in special reviews; examples include hypertension associated with renal calculus disease and other rarer causes such as Turner syndrome, herbal and medicinal compounds, and pharmacologic agents. A detailed account of the various causes of monogenic hypertension is also included. Finally, a section is devoted to general aspects of hypertension, including the significance of blood pressure indices, the natural course of untreated and treated hypertension, hypertension mechanisms, genetics, and guidelines for blood pressure control. 

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.