V.E. Andreucci - Böcker

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.

When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.

The 1991 International Yearbook of Nephrology is the third in a sueeessful .eries whieh has, as its principal aim, thc presentation of a eomprehensive list of topfes of the greatest current relevanee to elinieal nephrologists. We believe that, by following the subjeets eovered by the Yearbook in the broad field of nephrology, the praetieing nephrologist and nephrologist-in-training ean stay abreast of a number of rapidly advaneing fields. To improve the quality of the Yearbook, we have appointed an Editorial Board to provfde suggestions for topies and authors. Thus, we have invited 58 outstanding nephrologists from around the world (the list of them is included in this issue of the Yearbook) to identify annually potential topies for the Yearbook. The reply was exeel- lent and the contribution quite outstanding. Thus, for the 1992 Yearbook, we reeeived more than 150 suggestions. A number of them will be included in the next issue if they continue to be viewed as eurrent and important. We also invite readers to suggest topies for upeoming issues of the Yearbook. The present issue, the 1991 Yearbook, represents an improvement over previous volumes.We expeet this trend to be maintained in future years. As in previous issues, all ehapters provide a eomplete, aeeurate and up-to-date list of important references. We are grateful to all the authors for their exeellent eontributions and for having fulfilled the deadline in forwarding their manuseript. Our special thanks to Kluwer Aeademie Publishers for the timely publieation of this volume.

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.

The behavior of the kidney in normal pregnancy, as well as in complicated pregnancy, is a very interesting, but still in many ways an unknown topic in renal medicine. It is undoubtedly difficult to determine, even in normal women, the behavior of renal hemodynamics throughout gestation, since the fear of impairing a new life (i.e., the fetus's life) will limit, for ethical reasons, the use or the frequent repetition of diagnostic tests on the mother. On the other hand, the study of complicated pregnancy even for diagnostic purposes (for planning adequate treatment), except in a few countries that are known for the advanced health education of the population, has to face serious difficulties. First of all, pregnant women usually seek the help of an obstetrician when gestation is already in an advanced stage. This makes it difficult to determine when and how asymptomatic signs of any disease discovered during pregnancy have first occurred. A second difficulty is that frequently the patient does not know whether a given disease has preceded pregnancy. Pregnancy is a condition of young women, and a young woman frequently has never seen a physician; thus, no urine analysis or blood tests have been performed before the gestation. Not infrequently, even blood pressure has never been measured. This will make it difficult to classify hypertension discovered in late pregnancy as pregnancy-induced hypertension or as chronic hypertension in pregnancy.

The need for adequate means by which to improve urine output is very old. Even in the "Scuola Salernitana", the oldest medieval medical school in Western Europe, about 1000 years ago it was taught how to improve urine output. The list of known "diuretica" included herbs, plants, roots, vegetables, in particular asparagus, fennel and carrot. The first diuretic drugs, however, were mercurial compounds. Thus, calomel, mercurous chloride, was initially used as a diuretic in the sixteenth century by Paracelsus, being one of the ingredients of the so-called "Guy's Hospital pill". But calomel had a cathartic effect so that it was replaced by organic mercurial compounds. These diuretics were clearly toxic. After the discovery of the car­ bonic anhydrase, in the early 1930s, and the introduction of sulfanilamide as a chemotherapeutic agent, it was observed that this drug was inhibiting carbonic anhydrase in vitro and urinary acidification in vivo thereby causing metabolic acidosis; urine output, however, appeared to increase. Subsequent studies led to the synthesis of more potent analogs, in particular acetazolamide. Studies on car­ bonic anhydrase inhibitors led to the synthesis of benzothiadiazides which disclosed much less inactivating action on carbonic anhydrase and much more diuretic effect through an inhibition of tubular transport of sodium and chloride. Chlorothiazide was the first member of this class of diuretics. Thiazides are still used in clinical practice.

When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.

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.

The need for adequate means by which to improve urine output is very old. Even in the "Scuola Salernitana", the oldest medieval medical school in Western Europe, about 1000 years ago it was taught how to improve urine output. The list of known "diuretica" included herbs, plants, roots, vegetables, in particular asparagus, fennel and carrot. The first diuretic drugs, however, were mercurial compounds. Thus, calomel, mercurous chloride, was initially used as a diuretic in the sixteenth century by Paracelsus, being one of the ingredients of the so-called "Guy's Hospital pill". But calomel had a cathartic effect so that it was replaced by organic mercurial compounds. These diuretics were clearly toxic. After the discovery of the car­ bonic anhydrase, in the early 1930s, and the introduction of sulfanilamide as a chemotherapeutic agent, it was observed that this drug was inhibiting carbonic anhydrase in vitro and urinary acidification in vivo thereby causing metabolic acidosis; urine output, however, appeared to increase. Subsequent studies led to the synthesis of more potent analogs, in particular acetazolamide. Studies on car­ bonic anhydrase inhibitors led to the synthesis of benzothiadiazides which disclosed much less inactivating action on carbonic anhydrase and much more diuretic effect through an inhibition of tubular transport of sodium and chloride. Chlorothiazide was the first member of this class of diuretics. Thiazides are still used in clinical practice.

The behavior of the kidney in normal pregnancy, as well as in complicated pregnancy, is a very interesting, but still in many ways an unknown topic in renal medicine. It is undoubtedly difficult to determine, even in normal women, the behavior of renal hemodynamics throughout gestation, since the fear of impairing a new life (i.e., the fetus's life) will limit, for ethical reasons, the use or the frequent repetition of diagnostic tests on the mother. On the other hand, the study of complicated pregnancy even for diagnostic purposes (for planning adequate treatment), except in a few countries that are known for the advanced health education of the population, has to face serious difficulties. First of all, pregnant women usually seek the help of an obstetrician when gestation is already in an advanced stage. This makes it difficult to determine when and how asymptomatic signs of any disease discovered during pregnancy have first occurred. A second difficulty is that frequently the patient does not know whether a given disease has preceded pregnancy. Pregnancy is a condition of young women, and a young woman frequently has never seen a physician; thus, no urine analysis or blood tests have been performed before the gestation. Not infrequently, even blood pressure has never been measured. This will make it difficult to classify hypertension discovered in late pregnancy as pregnancy-induced hypertension or as chronic hypertension in pregnancy.

Acute renal failure is undoubtedly one of the marize in one volume the recent advances on patho- most interesting and frequent syndromes observed physiology of acute renal failure, the clinical aspects by clinicians. A great number of factors may of the various forms (even those which have been acutely impair renal function, but the pathoge- disregarded in other surveys), the diagnostic tests netic mechanism by which this occurs is fre- available today in our clinical practice, the general quently unknown. Even the pathophysiology of and specific therapeutic measures and (very impor- ischaemic!toxic forms of acute renal failure re- tant, indeed), some useful suggestions for preven- mains controversial despite the huge number of tion. experimental and clinical studies. The contributors have provided clear, complete Medical management of patients with acute renal and up-to-date chapters. I am deeply grateful to failure has greatly improved in recent years, partic- them all. ularly with the use of different types of dialytic I like to express my sincere thanks to Dr. A.J.

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.