Oxford Clinical Nephrology Series – serie

A high proportion of adults with end-stage renal failure are suffering from an inherited disorder of the kidneys. This is the first book to present a practical approach to the investigation and management of people with inherited renal disorders. Taking an international perspective, it covers the dramatic clinical and scientific advances that have been made in the past decade.

Dialysis amyloidosis is a syndrome observed in dialysis patients characterized initially by joint pain, followed later by joint destruction. It is at present one of the few compliations in these patients.The factors involved in the genesis of this syndrome are not yet known with certainty and there is as yet no proven efficacious treatment otehr then renal transplantation. As a result, the interest in this topic among nephrologists remains very high.Dialysis amyloid gives general information on the pathophysiology, and the clinical aspects of all types of amyloidosis. It then goes on to discuss recently discovered B2, type of dialysis amyloidosis, from clinical and pathological features to physiological and pathophysiological aspects of this serious complication which effects patients suffering from chronic renal failure.This book will give nephrologists and rheumatologists a clear understanding of the dialysis amyloidosis syndrome as well as making a valuable contribution to identifying strategies for treatment and prevention.

Many inherited diseases and non-hereditary disorders have in common the development of renal cystic disease. The most common, autosonal dominant polycystic kidney disease, is responsible for 5-10% of end-stage renal failure treated by dialysis or transplantation.Since the publication six years ago of the last book on polycystic kidney disease, a number of genes causing the disease have been identified, mapped, or sequenced; new experimental models and the application of molecular biology techniques have provided new insights into the pathogenesis R polycystic kidney disease; novel clinical studies have provided valuable information for the prevention, evaluation, and treatment of the complications of this disease. This book provides an updated, state-of-the-art review of the genetics, pathophysiology, evaluation, and management of these diseases and will be of interest to both basic researchers and clinicians in nephrology.

Rapidly Progressive Glomerulonephritis is one of the most exciting areas in renal medicine. The disease usually presents acutely, and leads to end stage renal failure in weeks or months if untreated. However, appropriate immunosuppressive therapy can dramatically improve the prognosis in many cases, such that renal failure is avoided. It is now clear that various immunopathological processes are involved, and that an accurate diagnosis is of value in guiding management. This volume aims to bring together current knowledge of both scientific and clinical aspects of RPN. Recent advances in the immunology, inflammatory mechanisms and pathology of RPGN are discussed. This is followed by consideration of the major causes of RPGN, which include Goodpasture's disease, primary systemic vasculitis and systemic lupus erythematosus. RPGN secondary to other renal and systemic diseases, and RPGN in children are also described. Finally, new approaches to treatment are reviewed. Although certain of these areas are covered in the larger textbooks of renal medicine, our aim is to provide a current overview of RPGN, in a concise volume. This should be of particular interest to nephrologists and general physicians, including those in training, but may also be of value to pathologists, immunologists, and other studying the mechanisms of renal disease. We hope that this volume will help them in the management of patients with RPGN, or in planning their research into this condition.

Dialysis treatment for the management of end-stage renal failure is now an accepted treatment for all patients regardless of age. Mortality and morbidity of patients on dialysis, however, remain unacceptably high and it is most unusual for such patients to survive into the third decade. The aim of the book is to focus on the problems that develop in the second stage of dialysis treatment and discuss how to prevent, minimize and manage these complications.

This book describes the current status of vascular access for patients with end-stage renal failure who require dialysis. The book highlights controversial areas and problems and describes differences in practice in USA and Europe. Vascular Access is the Achilles heel of dialysis. In the United States and Europe in 1999 there were in access of 400,000 patients maintained on dialysis. The success of this life sustaining procedure is dependant on being able to successfully access the circulation and obtain blood flows of between two and five hundred mls per minute three times a week. In 1964 Cimino and Brescia described what remains today the premier form of vascular access. Not long after the development of the Cimino Brescia fistula it became apparent that there were patients in whom it was either impossible or extremely difficult to create an adequate fistula for dialysis. As dialysis technology has been applied to older and sicker patients this trend has continued, such that in the United States the majority of patients starting dialysis do not have a primary fistula. The maintenance of long-term vascular access in patients who do not have a primary fistula requires considerably increased effort. In recent years a number of innovations have considerably increased the success of long- term vascular access in these patients. This book brings together these developments, including strategies to prospectively detect impending vascular access failure, and strategies to pre-emptively prevent graft failure. Simultaneously with these developments there have been dramatic improvements in our understanding of the pathophysiology of graft failure, this improved understanding of the biology of access failure are beginning to bring to the clinical arena newer strategies to delay graft failure.

Clinical nephrology is confronted with an emerging medical catastrophe of international proportions: endstage renal failure in patients with type 2 diabetes. From a number of recent studies it has become apparent that nephropathy in type 2 diabetes is a preventable condition, at least in principle. It is for this reason that it appeared timely to summarize the current state of knowledge concerning nephropathy in type 2 diabetes, giving an update on the predisposing factors on which interventions are of proven benefit and on the accepted standards of management of such patients. This concise monograph is addressed not only to nephrologists, but also to diabetologists and general practitioners. It is hoped that it will help to improve clinical outcomes in the future.

A better understanding of the pathophysiology of renal failure coupled with technological advances in dialysis techniques and renal transplantation have greatly improved the prognosis and survival for patients with end-stage renal disease (ESRD). Unfortunately, the advances and success of treatment are limited by a number of extrarenal complications that can cause significant morbidity and mortality. Of these, cardiovascular abnormalities are the most common, with cardiac complications alone accounting for more than 40% of deaths in international registries. The importance of cardiovascular complications has become more apparent in recent years with the increased prevalence of diabetes mellitus and vascular nephropathy and with the general ageing of patients with ESRD. The past decade has witnessed enormous advances in understanding the causes and pathophysiology of cardiovascular disease, and their diagnosis, treatment, and prevention. It is, therefore, of importance for physicians caring for patients with end- stage renal failure to understand the pathogenesis of cardiovascular complications, to become familiar with modern diagnostic tools and techniques, and to recognise and treat these complications. The goal of this text is to provide a comprehensive review of the pathophysiology and clinical manifestations of the principal cardiovascular complications in patients with chronic renal failure. The text is intended to assist nephrologists, cardiologists, and internists who care for these patients. The book includes nineteen chapters and is organised in three parts. The first includes three chapters dealing with the epidemiology of cardiovascular disease in patients with end-sage renal failure. The second comprises eight chapters on the basic pathophysiology and pathobiology of cardiovascular diseases in the setting of end- stage renal failure. The third includes eight chapters focusing on clinical manifestations and diagnosis of cardiovascular disease in patients with end-stage renal failure and their management.

This is the second edition of a full colour reference atlas published first to excellent reviews in 1994. Every renal unit needs to have a reference text of this kind and urine microscopy is an important diagnostic aid in nephrology. After the 'Historical Introduction' by J Stewart Cameron, chapter 1 descibes the methods used to prepare and analyse the urine samples. Chapter 2, which is the most important section of the book, describes with the help of 249 illustrations (over 200 in full colour) the elements of the urinary sediment. Chapter 3 deals with the urinary sediment of the normal subject, while chapter 4 deals with the urinary changes which are observed in the main diseases of the kidney and urinary tract. Chapter 5 describes the changes of the urinary sediment caused by drugs. Chapter 6 is about the interpretation of the urinary findings shown in the previous chapters. Chapter 7 covers the new systems to analyse the urinary sediments. An appendix shows how to adjust the microscope to analyse the urine specimens. The primary audience is practising nephrologists and nephrologists in training, and also those in internal medicine rotating through the renal unit who perform routinely the analysis of the urinary sediment. Clinical pathologists would also find this an attractive and useful book. The illustrations are outstanding and additional clinical information has been added in this new edition. From review from the Lancet of the first edition in comparison with a competing title: 'Every nephrologist knows and teaches that urine microscopy is an important diagnostic aid. What has been urgently needed is a colour guide to the subject.....I preferred the pictures in the European book. They were of high quality, not repetitive and with clear legends...if I wanted to teach myself.. then the European book was well ahead. The latter is also accompanied by an elegant introductory essay by JS Cameron on the history of urine analysis. Every renal unit needs at least one of these books.' The Lancet

Primary glomerulonephritis is one of the most frequent renal diseases, and a main cause of end-stage kidney disease. Glomerulonephritis has multiple subtypes, each with different physiopathologies, clinical presentations, and management requirements, which makes treatment difficult. As a complex set of diseases, the choice of symptomatic and specific treatment is critical to ameliorating the relentless course of glomerulonephritis. Focusing on all aspects of primary glomerulonephritis, from their epidemiologies and classification, to their pathogenesis and treatment, this third edition of Treatment of Primary Glomerulonephritis has been fully updated to include the latest research and evidence-based practice. With a strong emphasis on drugs used for both symptomatic and specific treatments, mechanisms of action, effectiveness, and potential toxicity are considered for therapeutic strategies in the different subtypes of primary glomerulonephritis. Each chapter follows a clear and logical format, allowing easy access to key information. Featuring over 20 full-colour histological images of different diseases to aid diagnosis, and with commentary from internationally recognised experts in the field, this new edition is an essential resource for all practising or academic clinical nephrologists.

Chronic kidney disease (CKD) is rapidly becoming a global healthcare problem, with an estimated 10% of the general population affected. As a result, it is becoming increasingly important that primary care physicians and general physicians as well as aspiring nephrologists, have a firm understanding of CKD as well as access to the key information. Practical and highly-accessible, this book provides a comprehensive guide to the understanding and management of patients with CKD. It offers both primary care physicians and non-nephrology specialists an introduction to and insights into the disease. The emphasis is on practical guidance and a focused approach to a number of key topics in the field including epidemiology, diagnosis and management, and the impact of CKD on chronic, non-communicable disease.This is a unique contribution by internationally-renowned experts in the CKD field to update primary care physicians and non-specialists on major issues in this growing global healthcare problem.

Despite significant improvement in the management of patients with chronic kidney disease, the morbidity and mortality remain high. However more is now understood about the hormonal influence on bone and vascular structures, and there have been major advances in the field of bone and mineral metabolism. This has lead to the development of new treatment strategies and agents. This new second edition reflects the most current thinking and understanding in this fascinating field, as presented by world basic and clinical experts.

Severe inflammation of the kidney can indicate the serious, negative prognosis of lupus nephritis when present in conjunction with systemic lupus erythematosus (SLE), a chronic autoimmune connective tissue disease that can affect any part of the body, most often harming the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. This book pulls together in one comprehensive reference the current knowledge regarding the inherited and immunologic abnormalities that have been identified in SLE, with specific reference to the development of renal disease and the way in which these factors may impact upon the chronic care of these patients. Since publication of the first edition in 1999, the discipline of medicine has experienced some revolutionary changes in the way drugs are used to treat to immune system diseases. On the basis of careful analysis of physical make-up, the immune system, and microscopic features of the human body, it has become clear that multiple components of the immune system are responsible for renal injury and that any given patient can experience a combination of these mechanisms. With this in mind, specific therapies can be tested, and drugs that interrupt the immune response in highly specific ways are being scrutinized for their value in lupus nephritis. This new edition reflects the updated methods of classification and advances in treatment options for SLE, and covers recent clinical trials to help treat patients using the most up-to-date knowledge available. It takes a practical approach throughout, and will be of interest to those working with patients with lupus nephritis, and those who manage their everyday care.

Covering all aspects of the many rheumatologic disorders associated with renal disease, including pathogenesis, clinical features and treatment, Rheumatology and the Kidney brings together the available information in an accessible and practical way, with a particular focus on evidence-based patient management. Part of the Oxford Clinical Nephrology Series, and featuring chapters from a team of international experts, this new edition has been completely updated since publication of the first edition in 2001 and now contains more tables and figures to make the information more accessible.Completely updated since publication of the first edition in 2001, and with more illustrations, this book brings together the available information on the many rheumatologic disorders associated with renal disease in an accessible and practical way, with a particular focus on evidence-based patient management.