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First principles chapter clearly explains the key concepts, processes and structures of the renal system. Clinical essentials chapter provides an overview of the symptoms and signs of renal disease, relevant history and examination techniques, investigations and management options. Disease-based chapters give concise descriptions of all major disorders, e.g. chronic kidney disease, each chapter introduced by engaging clinical cases that feature unique graphic narratives. Emergencies chapter covers the principles of immediate care in situations, such as hyperkalaemia and kidney stones. Integrated care chapter discusses strategies for the management of chronic conditions across primary and other care settings. Self-Assessment - 80 multiple choice questions clinical SBAs.
This book serves as a concise guide to urinary stone disease, providing simplified and complete information about the topic area. Various surgical techniques are provided and accompanied by first-hand accounts, to give insight into the operating room. The book is a quick reference guide and is relevant to both trainees and professionals. Written by a leading expert in the field, this book brings together years of experience and contains essential information on all aspects of lithology. The book covers all treatment options so that the best possible methods can be chosen for each patient. Urinary stone disease is a widespread ailment and updated information about it is permanently needed by trainees and professionals.
Vitamin D deficiency, circulating levels lower than 15 ng/ml, is an epidemic disease worldwide with more than a billion people suffering of it in the beginning of the 21-century. Besides its impact on mineral and bone metabolism, these low vitamin D levels are also associated with a diversity of non-skeletal complications, among them cardiovascular disease, diabetes mellitus, multiple sclerosis, cancer, tuberculosis, and immune system dysfunction. Chronic Kidney Disease is also a very common disease, affecting more than 10% of the world population, ranging from stage 1 to stage 5 before dialysis. Approximately 1% of the population in industrialized countries is affected by end-stage renal disease (ESRD), needing a renal replacement therapy either hemodialysis or peritoneal dialysis, and ultimately by renal transplantation. Those CKD patients are more susceptible to exhibit reduced vitamin D stocks. Consequently, more than eighty percent of CKD patients have either insufficient or deficient vitamin D levels for multiple reasons.
The aim of this guide is to provide clinicians with practical reference for the management of hypertensive patients with other cardiovascular risk factors, which originate from impaired metabolic functions. With the aid of carefully selected, paradigmatic case studies, the physician will find sound advice for the best approach to common but often under-recognized clinical situations, and answers to practical questions that arise when a specific condition is not directly addressed in the guidelines. Question-and-answer sections will help the reader to identify at a glance the most complex steps in the diagnostic and therapeutic process. In a "real world" clinical setting, the hypertensive patient rarely presents with hypertension as the only cardiovascular risk factor, and is more likely to be affected by other metabolic risk factors, such as impairment of lipid metabolism, glucose homeostasis, and purine metabolism, and by overweight or obesity. These cases will serve as a basis for analyzing best practice, highlighting problems in diagnosis and treatment, and selecting the most appropriate management of patients with metabolic risk factors in everyday practice.
This guide is structured to assist physicians in the management of those hypertensive patients who present with specific comorbidities, such as diabetes, systolic dysfunction, obesity, renal disease, or previous cardiac events, often associated with hypertension. The clinical cases contained in this book have been selected to provide a paradigmatic set of scenarios frequently encountered in daily clinical practice, and will serve as an easy-to-access tool in applying general guidelines to individual patients, particularly in the choice of the most appropriate antihypertensive therapy. Treatment of hypertension with associated clinical conditions require specific therapies and combinations of drugs, which are necessarily different from one comorbidity to another. By discussing exemplary cases that may better represent clinical practice in a "real world" setting, and analyzing step by step the diagnostic and therapeutic process, this book will assist cardiologists and physicians in selecting the diagnostic tools and forms of treatment best suited to the individual patient and the particular cardiovascular risk profile.
An overview of the diagnosis, treatment, and long-term management of diabetic-related kidney disease in clinical practice. Includes an evidence-based discussion of currently available and experimental drug therapies currently in development, guided by international consensus guidelines. Ideal for physicians, medical trainees, nurses and other medical professional that regularly screen and treat patients with all types of diabetes.
This book discusses the latest findings on the pathogenesis and treatment of IgA nephropathy. It particularly focuses on recently recognized initiation and progression factors and the varying treatment strategies in different regions, such as Asia, Europe, and the United States. More than 40 years have passed since Dr. Jean Berger first described primary IgA nephropathy ("Nephropathy with mesangial IgA-IgG deposits") as a new disease entity. Immunohistopathologically, IgA nephropathy is characterized by the granular deposition of IgA (IgA1) and C3 in the glomerular mesangial areas with mesangial cell proliferation and the expansion of mesangial matrices. It is clear that IgA nephropathy is one of the most common types of chronic glomerulonephritis in the world. This disease may lead to end-stage kidney disease, with its enormous economic impact on healthcare everywhere. Efforts by many investigators around the world have gradually clarified various aspects of the pathogenesis and treatment of IgA nephropathy. However, there are many controversial strategies for the treatment of patients with IgA nephropathy throughout the world, as there are several limitations for treatment in each country. This volume provides nephrologists everywhere with an overview and comparison of both global and regional findings in basic and clinical fields in IgA nephropathy. It covers genetic variation, aberrant IgA1 production, and classification etiology, guidelines, and treatment goals, with all chapters written by top international researchers.
This book is designed to assist physicians in choosing among diagnostic procedures and therapeutic options when caring for patients with hypertension and markers of organ damage. The comprehensive description of practical clinical cases sets this book apart from other publications and will help the reader to transfer general guideline recommendations to the clinical setting. With this purpose, the cases have been selected to reflect situations frequently encountered during clinical routine, rather than hypertensive crises or emergencies or the rare presentations that tend to be addressed in case reports in scientific journals. The scenarios considered include treated hypertension with uncontrolled blood pressure levels in patients with left ventricular hypertrophy, diastolic dysfunction, carotid atherosclerosis, microalbuminuria and renal impairment, proteinuria and renal disease, and abnormal pulse pressure. By representing clinical practice in a "real world" setting, these paradigmatic cases will enable the practitioner to select the diagnostic tools and form of treatment best suited to the individual patient and the particular cardiovascular risk profile, thereby optimizing outcomes.
This book gives a complete description of online hemodiafiltration, in five sections. It is unique in the systematic and complete way in which hemodiafiltration is described. Each chapter is completed by a point-to-point summary of essential information, in a separate text box. Part of the book is dedicated to the theoretical background of convective clearance. In this part, safety issues and quality control is reviewed (especially on the quality of water for dialysis and substitution fluid), as well as equipment (both dialyzers and machines) with which this treatment can be performed. As recently the results of several randomized controlled trials were available, the effect of hemodiafiltration on hard clinical end points (mortality and morbidity) is discussed in detail. This has not been done before, as the most recent book/journal on hemodiafiltration was published in 2011, before the results of the 3 randomized controlled trials were published. Furthermore, the methodological quality of the trials is discussed by an expert, in order to help the readers in their judgment of the trials Part of the book concentrates on the effect of the treatment on several biomarkers and uremic toxins. Several clinically relevant issues is discussed separately, such as the prescription of anticoagulation during the treatment, drug prescription and clearance for patients treated with hemodiafiltration, and hemodynamic stability. Finally, a practical guide on how to perform the treatment is provided. In this unique section, seemingly simple but important details of hemodiafiltration-treatment is discussed, such as the importance of needle size for blood flow rates, the difference between filtration fraction and substitution ratio, the different targets that can be set and how to reach them. As most literature is mainly focused on theoretical issues, this unique feature really will help the field to perform hemodiafiltration, and answer practical questions.
Approximately 14 million people in the UK live with some form of bladder complaint. This equates to over one in five people, so even if you don't personally experience the embarrassing and intrusive symptoms of bladder dysfunction, it is likely that you know someone who does. Bladder dysfunction does not discriminate as these problems affect all ages and genders. Despite the fact that these health issues are very common, it can be difficult to discuss them with family, friends and even a doctor. Many people suffer needlessly in silence even though there is now a wide range of investigations and treatments that can lead to effective and long-lasting symptom relief. This book guides you through the different conditions associated with bladder dysfunction, how you can help yourself, what to expect if you need to undergo investigations and the numerous evidence-based treatments that are available - both mainstream and complementary - so that you will no longer need to feel reluctant to broach the subject with your GP - meaning you can find your way back to good health.
This book provides the latest recommendations for ultrasound examination of the entire urogenital system, particularly in the male. The coverage encompasses the role of ultrasound in imaging of disorders of the kidneys, urinary tract, prostate, seminal vesicles, bladder, testes, and penis, including male infertility disorders. In addition, detailed consideration is given to intraoperative and interventional ultrasound and recently developed ultrasound techniques. Each chapter defines the purpose of and indications for ultrasound, identifies its benefits and limitations, specifies the technological standards for devices, outlines performance of the investigation, establishes the expected accuracy for differential diagnosis, and indicates the reporting method. Most of the recommendations are based on review of the literature, on previous recommendations, and on the opinions of the experts of the Imaging Working Group of the Italian Society of Urology (SIU) and the Italian Society of Ultrasound in Urology, Andrology, and Nephrology (SIEUN). The book will be of value for all physicians involved in the first-line evaluation of diseases of the renal/urinary system and male genital disorders.
In some countries such as the United States, kidney disease kills more people than cancers of the prostate or breast. In the United States for example there are over 15 million individuals with kidney disease. Translated to a worldwide basis, kidney disease of various aetiologies represent a significant burden on healthcare systems, affecting mortality, morbidity and also the family unit. It is therefore imperative that appropriate use is made of conventional, new and emerging biomarker platforms to aid diagnosis, treatment and an understanding of outcome measures. Biomarkers in Kidney Disease embraces a holistic approach by combining information on different conditions that affect the kidney and the use of biomarkers. Biomarkers are described in terms of conventional, new and emerging analytes, techniques, platforms and applications. It covers the latest knowledge and trends. New platforms are described which combine advances in biomedical sciences, physics, computing and chemistry.
This book provides a case based approach to the problems faced within pediatric urology and an evidence based approach to their solutions. Chapters on urodynamics, external genitalia, the upper urinary tract, the lower urinary tract, and office pediatric urology are included. Practical Pediatric Urology aims to utilise real life scenarios to improve data analysis, diagnosis, and treatment decisions within clinical settings. Key learning objectives are included to enable medical professionals to assimilate, synthesise, and formulate a management plan for pediatric urological conditions encountered in clinical practice in a safe and evidence based approach. This book is relevant to pediatricians, pediatric surgeons, pediatric urologists and adult urologists who undertake some pediatric urology practice.
In modern medicine, the aging population is prone to many simultaneous cardiovascular (CV) risk factors which often produce co-incident pathology. Nowhere is this more obvious than in the interaction between Chronic Kidney Disease (CKD), Diabetes and diverse CV diseases (CVD). This is a complex and challenging area, as the presence of CKD/diabetes promotes CVD while also complicating its treatment. The emergence of CKD as a public health priority is one of the most challenging problems of modern medicine. It is now solidly established that renal dysfunction portends a high risk for cardiovascular disease. Cardiovascular diseases remains the main cause of death in western societies and the amplification of the death risk conveyed by coexisting CKD, even though still poorly understood, appears considerable. The bidirectional link that associates renal and cardiovascular diseases, the high risk of the death signalled by their coexistence and the considerable epidemiological burden imposed by this link is at the basis of the emergence of a new discipline aiming at making the borders between nephrology and cardiovascular medicine even more permeable than before. The term Cardio-Renal Syndrome was coined around 5 years ago to try to formalize this link, and act as a stimulus to interaction between clinical teams, researchers and others to achieve better management and outcomes for all. This book takes clinical presentations and clinical problems as its base, and then discuss the evidence for best management of common clinical problems as well as the reasons for the complex interplay between the cardiac and renal systems. Moreover, it addresses the issue of organizing healthcare to maximize the opportunities for prevention and best healthcare economic returns, building on cutting edge initiatives at the Karolinska, Stockholm. The book will be of immediate value and interest to all cardiologists and renal physicians.
This book presents a comprehensive and instructive management plan for physicians who care for CKD patients. Basic aspects of CKD, clinical assessment, evaluation and management of risk factors, cardiovascular disease in the context of CKD, assessment and management of CKD complications, special circumstances in CKD patients, and the path to renal replacement therapy are all thoroughly covered. Diagnostic and therapeutic approaches are presented according to the latest staging system for CKD, with patient care being discussed separately for each disease stage. The proposed management plan is both "best available evidence based" and "practice based." The book also recognizes the needs of busy clinicians by including helpful boxes summarizing the evidence on diagnostic and therapeutic issues and practice pearls based on guidelines. The authors are recognized experts from across the world, ensuring global coverage of the problem, and most have participated in writing guidelines on CKD.
This thoughtful new book presents strategies for helping end-stage renal disease patients and their families deal with the psychosocial aspects of the chronic long-term illness. Technological advances in the treatment of this disease have offered much hope for improved quality in living which has led caregivers to have a greater concern for preserving the quality of life of their patients. In Psychosocial Aspects of End-Stage Renal Disease leaders in the field of many disciplines share knowledge and reveal problems that are still evident to them in the confrontation with this potentially fatal illness.Five comprehensive sections devote special attention to the different areas of concern for the psychosocial well-being of end-stage renal disease patients. The impact of renal disease on family relationships is covered by examining issues of family responses and coping measures such as marital and family reactions to home and hospital dialysis treatment. Ethical issues in treatment are explored, including the ethics of treatment refusal and a Jewish perspective on kidney transplants. Relations between staff and patients and a timely section on renal disease and special populations, particularly the elderly and AIDS patients, make up the final two sections of this informative volume. Professionals in all allied health disciplines will benefit from this important volume as it demonstrates a model approach, if not the definitive one, for the treatment of the psychosocial aspects of end-stage renal disease as well as other chronic illnesses.
The Oxford Handbook of Epidemiology for Clinicians provides all the information required by students and junior doctors who need to understand and translate key epidemiological concepts into medical practice. Unlike standard textbooks in this area, the focus throughout is on clinical applications of epidemiological knowledge. Divided into four sections, the handbook begins with the basics of epidemiology in the clinic, moving on to the theories behind evidence-based practice, discussions of optimum methods and studies, and then ends by looking at the epidemiology of common diseases. The material is presented in a logical manner, from problems to the most appropriate solutions or tools to be applied. Interesting topics such as controversies in prevention intervention encourage discussion and thought, and the authors pose sensible and important questions throughout. This handbook is a must for all junior doctors, medical students, and clinicians who need to apply epidemiological concepts to day-to-day practice or who want a practical step-by-step guide to undertaking research, conducting reviews of evidence, or writing up publications.
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.
In these pages, you will find updated information on the clinical evaluation of kidney function, fluids and electrolytes, acid-base disorders, hypertension, chronic tubulointerstitial nephritis, glomerular diseases, kidney manifestations of deposition disease, genetic disorders and kidney disease, acute kidney injury, kidney stones, the kidney in pregnancy, and chronic kidney disease, including 108 all-new peer-reviewed, psychometrically validated, multiple-choice questions (MCQs) for self-assessment and study. MKSAP (R) 18 is specifically intended for physicians who provide personal, non-surgical care to adults, including general internists and primary care physicians, subspecialists who need to remain up-to-date in internal medicine, residents preparing for the Certification Exam in internal medicine, physicians preparing for the Maintenance of the Certification Exam in internal medicine, and medical educators. The learning objectives of MKSAP (R) 18 are: - Close gaps between actual care in your practice and preferred standards of care, based on best evidence. - Diagnose disease states that are less common and sometimes overlooked or confusing. - Improve management of comorbid conditions that can complicate patient care. - Determine when to refer patients for surgery or care by subspecialists. - Pass the ABIM Certification Examination and the ABIM Maintenance of Certification Examination.
Urolithiasis is one of the oldest documented medical ailments with archeological evidence showing that humans have suffered from kidney and bladder stones for centuries. Urolithiasis is a common multifactorial problem with multi-effect on the patients' quality of life and an economic burden on the individual and the health system of the country. Various intrinsic and extrinsic factors are associated with the risk for stone formation. Among intrinsic factors are race, sex, and genetics. Finding the cause of urolithiasis or establishing it early in life will reduce the consequence and complications of kidney stone disease and hence reduction of the cost in the treatment by establishing preventative measures in addition to patient education. Genetic factors play an important role in the etiology of urolithiasis as a polygenic (common) or monogenic (rare) forms, however its knowledge and early diagnosis is important for achieving the goals of reducing patient suffering as well as economic burdens that inevitably follow a diagnosis. This book discusses the symptoms, management and prevention strategies of urolithiasis.
Glomerulonephritis is a term referring to direct injury of the glomeruli with resulting disturbances of normal glomerular function, progressively leading to renal failure. Glomerular diseases are classified as primary, where glomerular damage is the prime disturbance, with extrarenal manifestations as a result of renal impairment, and secondary, following systemic disorders, infections or exposure to certain drugs. Although noteworthy progress has been made in the past years in the symptomatic and specific treatment, therapy of both primary and secondary glomerulonephritis can be challenging. Management of these patients requires early diagnosis, expert knowledge of the immunosuppressive agents and other drugs currently available for the treatment of each glomerulonephritis, consideration of possible adverse reactions to these drugs, alternative therapeutic strategies in cases of hyporesponsiveness or non-responsiveness of the patient to the treatment, and possible relapses of the disease. This book reviews knowledge of the main primary and secondary glomerulonephritis, with emphasis on current therapeutic strategies and practical recommendations. Glomerulonephritis are grouped according the presence or absence of proliferative histological alternations into primary and secondary proliferative and non-proliferative types. Each chapter deals with etiopathogenesis, epidemiology, pathology, clinical manifestations, natural history and therapeutic options of the commonest primary and secondary glomerular diseases, with exception the last chapter that covers inherited diseases with renal involvement. An atlas of the pathology of the glomerular diseases discussed completes this work.
This book describes the latest research on the gut-kidney axis of ureic solutes; the toxico-pathological mechanisms of uremic toxin-induced organ failure, including kidney and cardiovascular tissue; and the preventive therapeutic strategies for uremia and related organ failure associated with kidney injuries and diseases. Retained uremic toxins cause a variety of symptoms, such as hypertension, fatigue, renal anemia, osteoporosis and neurologic impairment, which are apparent in chronic kidney disease (CKD) patients. The human gastrointestinal tract contains trillions of microorganisms, referred to as gut microbiota, which support the host metabolism by producing nutrients, such as vitamins and short-chain fatty acids. However, they also produce various harmful uremic toxins that show renal and cardiovascular toxicity, and correlate with an increased mortality in CKD patients. The composition and balance of gut microbiota are associated with the accumulation of uremic toxins and the pathophysiology of CKD, and as such are being considered for a novel therapeutic strategy.
This manual will meet the everyday needs of the wide range of medical professionals who play a role in the treatment of children referred to hospital because of renal disease. It is an easy-to-use, portable guide that will assist pediatricians, residents, and trainees in making prompt first-level management decisions. It will also prove invaluable for the adult nephrologists who care for children in many developing countries, and will serve as a teaching guide for experts when training non-subspecialists. Individual sections are devoted to the evaluation of renal disease; fluid, electrolyte, and acid-base disorders; glomerular diseases; tubular disorders; congenital, inherited, and urological disorders; consequences of renal disease; and miscellaneous topics. The text is in a bulleted format with tables and algorithms wherever possible, making it straightforward and easy to read. An appendix includes further important information such as normal values, drug dosages, and drug nephrotoxicity.
Misconceptions have stalked Andy Cole like a hatchet-man defender determined to cut him down to size. Now, in his candid and inspirational autobiography, Cole finally tells his side of the story.
In the world of modern-day football, Andy Cole's reserved demeanour, combined with belief in his own ability, was often interpreted as an attitude problem that overshadowed his natural aptitude for goalscoring. Throughout his glittering career, he scored 187 Premier League goals, won 5 Premier League titles and 1 Champions League trophy. Now, two decades on from United's historic Treble, he not only gives the inside track on Eric Cantona, Roy Keane, Dwight Yorke and other members of that illustrious side, but also opens up about his fractious relationship with Teddy Sheringham and reveals the prejudices and preconceptions he had to contend with in his twenty years in the game.
Compelling in its honesty and frankness, Fast Forward is the thought-provoking story of one man's determination to succeed and survive against all the odds.
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