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دانلود کتاب Comprehensive Clinical Nephrology
دانلود کتاب نفرولوژی بالینی جامع
مشخصات کتاب
Comprehensive Clinical Nephrology
دسته بندی: پزشکی ویرایش: 6 نویسندگان: John Feehally سری: ISBN (شابک) : 032347909X ناشر: Elsevier سال نشر: 2019 تعداد صفحات: 1570 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 53 مگابایت
قیمت کتاب (تومان) : 28,000
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توضیحاتی در مورد کتاب نفرولوژی بالینی جامع
نوشته و ویرایش شده توسط رهبران جهان در نفرولوژی، جامع نفرولوژی بالینی، ویرایش ششم، توسط Drs. جان فیهالی، یورگن فلوگ، ریچارد جی. جانسون و مارچلو تونلی، اطلاعات فعلی را در مورد روش‌ها و شرایط بالینی و همچنین حقایق علمی و پاتوفیزیولوژی که برای عمل نفرولوژی اساسی هستند، ارائه می‌دهند. ایده‌آل برای متخصصان نفرولوژیست، همکار، دستیار و متخصص داخلی است، مایعات و الکترولیت‌ها، فشار خون بالا، دیابت، دیالیز و پیوند و موارد دیگر را به طور کامل پوشش می‌دهد - همه در یک حجم مناسب. الگوریتم‌های محبوب و با کد رنگی دسترسی آسان به محتوای کلیدی را فراهم می‌کنند: جعبه‌های زرد برای اطلاعات عمومی، جعبه‌های سبز برای مداخله درمانی و جعبه‌های آبی برای بررسی‌های لازم. مقدار "درست" علوم پایه و راهنمایی های بالینی عملی به شما کمک می کند تا تصمیمات کارآمد و آگاهانه بگیرید. بیش از 1500 تصویر تمام رنگی موضوعات کلیدی و پاتوژنز جزئیات را برای طیف کاملی از شرایط کلیوی و مدیریت بالینی برجسته می کند. جعبه های مرجع سریع جدید با پیوندهایی به دستورالعمل های بالینی در تمام فصل های مربوطه. فصل های جدید در مورد مسائل رایج در مورد تجویز در بیماری های کلیوی، نفرولوژی تسکین دهنده، نفروپاتی های بومی، پاتوفیزیولوژی بیماری مزمن کلیه، و نتایج دیالیز. Expert ConsultT نسخه کتاب الکترونیکی همراه با خرید. این تجربه پیشرفته کتاب الکترونیکی به شما امکان می‌دهد تمام متن، شکل‌ها و مراجع کتاب را در دستگاه‌های مختلف جستجو کنید.
توضیحاتی درمورد کتاب به خارجی
Written and edited by world leaders in nephrology, Comprehensive Clinical Nephrology, 6th Edition, by Drs. John Feehally, Jurgen Floege, Richard J. Johnson, and Marcello Tonelli, provides current information on clinical procedures and conditions as well as the scientific facts and pathophysiology that are foundational to nephrology practice. Ideal for practicing nephrologists, fellows, residents, and internists, it thoroughly covers fluids and electrolytes, hypertension, diabetes, dialysis, and transplantation, and more - all in a single convenient volume. Popular, color-coded algorithms provide easy access to key content: yellow boxes for general information, green boxes for therapeutic intervention, and blue boxes for necessary investigations. A "just right" amount of basic science and practical clinical guidance helps you make efficient and informed decisions. More than 1,500 full-color illustrations highlight key topics and detail pathogenesis for a full range of kidney conditions and clinical management. New quick-reference boxes with links to clinical guidelines in all relevant chapters. New chapters on common issues regarding prescribing in kidney disease, palliative nephrology, endemic nephropathies, pathophysiology of chronic kidney disease, and outcomes of dialysis. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
فهرست مطالب
Front Cover Inside Front Cover Comprehensive Clinical Nephrology Copyright Page Table Of Contents Preface List of Contributors Dedication I Essential Renal Anatomy and Physiology 1 Renal Anatomy Structure of the Kidney Nephrons Collecting Ducts Microvasculature Fig. 1.1 Coronal section through a unipapillary kidney. Glomerulus (Renal Corpuscle) Glomerular Basement Membrane Mesangium Mesangial cells. Mesangial matrix. Endothelium Visceral Epithelium (Podocytes) Function and Maintenance of the Filtration Barrier Filtration pressure and expansion. Filtrate flow and shear stress. Barrier function. Pathology. Parietal Epithelium Renal Tubule Proximal Tubule Intermediate Tubule Distal Straight Tubule (Thick Ascending Limb of the Loop of Henle) Distal Convoluted Tubule Collecting Duct System Collecting Ducts Juxtaglomerular Apparatus Renal Interstitium References Self-assessment Questions 2 Renal Physiology Glomerular Structure and Ultrastructure Glomerular Filtration Rate Measurement of Renal Plasma Flow Autoregulation of Renal Blood Flow and Glomerular Filtration Rate Tubular Transport Passive Transport Active Transport Transport in Specific Nephron Segments Proximal Tubule Loop of Henle Distal Nephron Glomerulotubular Balance Countercurrent System Role of Urea Vasa Recta Renal Medullary Hypoxia Vasopressin (Antidiuretic Hormone) and Water Reabsorption Integrated Control of Renal Function Renal Interstitial Hydrostatic Pressure and Nitric Oxide Renal Sympathetic Nerves Renin-Angiotensin-Aldosterone System Eicosanoids Atrial Natriuretic Peptide Endothelins Purines Exosomes, Other Extracellular Vesicles and Luminal Factors References Self-assessment Questions II Investigation of Renal Disease 3 Assessment of Glomerular Filtration Rate Glomerular Filtration Rate Measurement and Estimation of the Glomerular Filtration Rate Clearance Measurements Concept of Clearance Urinary Clearance Plasma Clearance Estimation of the Glomerular Filtration Rate Filtration Markers Exogenous Filtration Markers Endogenous Filtration Markers Creatinine Metabolism and Excretion Creatinine Assay Estimated Glomerular Filtration Rate From Serum Creatinine Equation Currently Recommended for Use Equations Previously Recommended for Use Other Equations That Could Be Considered for Use in Selected Populations Cystatin C Metabolism and Excretion Cystatin C Assay Estimated Glomerular Filtration Rate From Serum Cystatin C Urea and Other Metabolites Other Low-Molecular-Weight Serum Proteins Clinical Application of Estimated Glomerular Filtration Rate Chronic Kidney Disease Acute Kidney Disease Living Kidney Donor Candidates Drug Dosing References Self-Assessment Questions 4 Urinalysis Definition The Urine Sample Physical Characteristics Color Turbidity Odor Relative Density Chemical Characteristics pH Hemoglobin Glucose Protein Albumin Reagent Strip 24-Hour Protein Excretion Protein-to-Creatinine Ratio and Albumin-to-Creatinine Ratio on Random Urine Sample Specific Proteins Albuminuria. Tubular proteins. Bence Jones proteinuria. Leukocyte Esterase Nitrites Ketones Urine Microscopy Methods Cells Erythrocytes Leukocytes Renal Tubular Epithelial Cells Transitional Epithelial Cells Squamous Epithelial Cells Lipids Casts Crystals Common Crystals Uric acid crystals and amorphous urates. Calcium oxalate crystals. Calcium phosphate crystals (brushite) and amorphous phosphates. Triple phosphate (struvite) crystals. Pathologic Crystals Cholesterol crystals. Cystine crystals. 2,8-dihydroxyadenine(2,8-DHA) crystals. Crystals Caused by Drugs Other Crystals Clinical Significance of Crystals Organisms Contaminants Interpretation of Urine Sediment Findings Nephrotic Syndrome Nephritic Syndrome Acute Kidney Injury Urinary Tract Infection BK Virus Infection Urologic Diseases Nonspecific Urinary Abnormalities Automated Analysis of Urine Sediment References Self-Assessment Questions 5 Imaging Ultrasound Kidney Size Renal Echo Pattern Renal Cysts Simple Cysts Complex Cysts Bladder Renal Vasculature Renal Artery Duplex Scanning Contrast-Enhanced and Three-Dimensional Ultrasound Plain Radiography and Intravenous Urography Renal Calcification Intravenous Contrast Urography Kidneys Pelvicalyceal System Ureters Bladder Retrograde Pyelography Antegrade Pyelography Imaging Ileal Conduits Cystography Computed Tomography Tissue Density Contrast-Enhanced and Noncontrast Computed Tomography Computed Tomographic Angiography Dual-Energy Computed Tomography Limitations of Computed Tomography Magnetic Resonance Imaging Contrast-Enhanced Magnetic Resonance Imaging Magnetic Resonance Urography Magnetic Resonance Angiography Disadvantages of Magnetic Resonance Imaging Incidental Findings Measurement of Glomerular Filtration Rate Angiography Renal Venography Nuclear Scintigraphy Glomerular Filtration Agents Tubular Secretion Agents Tubular Retention Agents Renogram Cortical Imaging Vesicoureteral Reflux Renal Transplant Positron Emission Tomography Molecular Imaging Radiologic Contrast Agents X-ray Contrast Agents Contrast-Induced Nephropathy Magnetic Resonance Contrast Agents References Self-Assessment Questions 6 Renal Biopsy Indications for Renal Biopsy Nephrotic Syndrome Acute Kidney Injury Systemic Disease Associated With Renal Dysfunction Renal Transplant Dysfunction Non-Nephrotic Proteinuria Isolated Microhematuria Unexplained Chronic Kidney Disease Familial Renal Disease Role of Repeat Renal Biopsy Value of Renal Biopsy Biopsy Adequacy Is Renal Biopsy a Necessary Investigation? Prebiopsy Evaluation Contraindications to Renal Biopsy Renal Biopsy Technique Percutaneous Renal Biopsy Native Renal Biopsy Renal Transplant Biopsy Postbiopsy Monitoring Alternatives to the Percutaneous Approach Transvenous (Transjugular or Transfemoral) Renal Biopsy Open Renal Biopsy Laparoscopic Renal Biopsy Complications of Renal Biopsy Pain Hemorrhage Arteriovenous Fistula Other Complications Death References Self-assessment Questions III Fluid and Electrolyte Disorders 7 Disorders of Extracellular Volume Extracellular Fluid Compartment Regulation of Extracellular Fluid Homeostasis Afferent (Sensor) Limb Glomerulotubular Balance Pressure Natriuresis Efferent (Effector) Limb Renin-Angiotensin-Aldosterone System Sympathetic Nervous System Natriuretic Peptides Prostaglandins Arginine Vasopressin Other Hormones Terms Useful for Disorders of Extracellular Fluid Volume Extracellular Fluid Volume Contraction Extrarenal Causes Gastrointestinal Losses Dermal Losses Third-Space Sequestration Hemorrhage Renal Losses Diuretic Use Genetic and Acquired Tubular Disorders Hormonal and Metabolic Disturbances Renal Water Loss Clinical Manifestations of Extracellular Fluid Volume Contraction Laboratory Tests Therapy of Extracellular Fluid Volume Contraction Extracellular Fluid Volume Expansion Pathogenesis Capillary Hemodynamic Disturbances Renal Sodium Retention Primary renal sodium retention. Secondary renal sodium retention. Sodium and Water Retention in Heart Failure Sodium and Water Retention in Cirrhosis Sodium and Water Retention in Nephrotic Syndrome Drug-Induced Edema Idiopathic Edema Sodium and Water Retention in Pregnancy Clinical Manifestations of Extracellular Fluid Volume Expansion Diagnostic and Therapeutic Approach to Extracellular Volume Expansion Diuretics Principles of Action Classes of Diuretics Loop diuretics. Distal convoluted tubule diuretics. Collecting duct diuretics. Proximal tubule diuretics. Osmotic diuretics. Adverse Effects Approach to Diuretic Treatment of Extracellular Fluid Volume Expansion Diuretic Resistance References Self-Assessment Questions 8 Disorders of Water Metabolism Physiology of Water Balance Vasopressin Osmotic Stimuli for Vasopressin Release Nonosmotic Stimuli for Vasopressin Release Mechanism of Vasopressin Action Thirst and Water Balance Quantitation of Renal Water Excretion Serum Sodium Concentration, Osmolality, and Tonicity Estimation of Total Body Water Hyponatremic Disorders Etiology and Classification of Hyponatremia Hypovolemia: Hyponatremia Associated With Decreased Total Body Sodium Gastrointestinal and third-space sequestered losses. Diuretics. Salt-losing nephropathy. Mineralocorticoid deficiency. Osmotic diuresis. Cerebral salt wasting. Hypervolemia: Hyponatremia Associated With Increased Total Body Sodium Congestive heart failure. Hepatic failure. Nephrotic syndrome. Advanced chronic kidney disease. Euvolemia: Hyponatremia Associated With Normal Total Body Sodium Glucocorticoid deficiency. Hypothyroidism. Psychosis. Postoperative hyponatremia. Exercise-induced hyponatremia. Drugs causing hyponatremia. Syndrome of inappropriate antidiuretic hormone secretion. Clinical Manifestations of Hyponatremia Cerebral Edema Osmotic Demyelination Treatment of Hyponatremia Acute Symptomatic Hyponatremia Chronic Symptomatic Hyponatremia Chronic “Asymptomatic” Hyponatremia Fluid restriction. Increase solute excretion. Pharmacologic inhibition of vasopressin. Hypovolemic Hyponatremia Hypervolemic Hyponatremia Congestive heart failure. Cirrhosis. Hypernatremic Disorders Etiology and Classification of Hypernatremia Hypovolemia: Hypernatremia Associated With Low Total Body Sodium Hypervolemia: Hypernatremia Associated With Increased Total Body Sodium Euvolemia: Hypernatremia Associated With Normal Body Sodium Diabetes Insipidus Central diabetes insipidus Clinical features. Causes. Differential diagnosis. Treatment. Congenital nephrogenic diabetes insipidus. Acquired nephrogenic diabetes insipidus. Chronic kidney disease. Electrolyte disorders. Pharmacologic agents. Sickle cell anemia. Dietary abnormalities. Gestational diabetes insipidus. Clinical Manifestations of Hypernatremia Treatment of Hypernatremia References Self-assessment Questions 9 Disorders of Potassium Metabolism Normal Physiology of Potassium Metabolism Potassium Intake Potassium Distribution Renal Potassium Handling With Normal Renal Function Renal Potassium Handling in Chronic Kidney Disease Hypokalemia Epidemiology Clinical Manifestations Cardiovascular Hormonal Muscular Renal Etiology Pseudohypokalemia Redistribution Nonrenal Potassium Loss Renal Potassium Loss Drugs. Endogenous hormones. Genetic causes. Magnesium depletion. Primary renal defect. Bicarbonaturia. Diagnostic Evaluation Treatment Hyperkalemia Epidemiology Clinical Manifestations Etiology Pseudohyperkalemia Redistribution Excess Intake Impaired Renal Potassium Excretion Determining the Role of Excessive Potassium Intake in Chronic Hyperkalemia Treatment Acute Therapy Blocking cardiac effects. Cellular potassium uptake. Potassium removal. Chronic Treatment References Self-Assessment Questions 10 Disorders of Calcium, Phosphate, and Magnesium Metabolism Calcium Homeostasis and Disorders of Calcium Metabolism Distribution of Calcium in the Organism Intestinal, Skeletal, and Renal Handling of Calcium Hypercalcemia Causes of Hypercalcemia Malignant Neoplasias Primary Hyperparathyroidism Jansen Disease Familial Hypocalciuric Hypercalcemia Other Endocrine Causes Other Causes Clinical Manifestations Diagnosis Treatment Hypocalcemia Hypocalcemia Associated With Hyperphosphatemia Hypocalcemia Associated With Hypophosphatemia Clinical Manifestations Laboratory and Radiographic Signs Treatment Phosphate Homeostasis Distribution of Phosphate in the Organism Hyperphosphatemia Causes of Hyperphosphatemia Acute Kidney Injury Chronic Kidney Disease Lytic States Treatment-Induced Hyperphosphatemia Hypoparathyroidism Chronic Hypocalcemia Acromegaly Familial Tumoral Calcinosis Respiratory Alkalosis With Prolonged Hyperventilation Clinical Manifestations Treatment Hypophosphatemia Causes of Hypophosphatemia Inherited Forms of Hypophosphatemia Autosomal dominant hypophosphatemic rickets. X-linked hypophosphatemic rickets. Autosomal recessive hypophosphatemic rickets. Fanconi syndrome and proximal renal tubular acidosis. Vitamin D–dependent rickets. Distal renal tubular acidosis (type 1). Acquired Forms of Hypophosphatemia Alcoholism. Hyperparathyroidism. Post-transplant hypophosphatemia. Acute respiratory alkalosis. Diabetic ketoacidosis. Total parenteral nutrition. Oncogenic hypophosphatemic osteomalacia. Drug-induced hypophosphatemia. Clinical Manifestations Treatment Magnesium Homeostasis and Disorders of Magnesium Metabolism Distribution of Magnesium in the Organism Intestinal and Renal Handling of Magnesium Hypermagnesemia Clinical Manifestations Treatment Hypomagnesemia and Magnesium Deficiency Clinical Manifestations Treatment References Self-Assessment Questions 11 Normal Acid-Base Balance Definition Net Acid Production Buffer Systems in Regulation of pH Respiratory System in Regulation of pH Renal Regulation of pH Renal Transport Mechanisms of Hydrogen and Bicarbonate Ions Glomerulus Proximal Tubule Thick Ascending Limb of the Loop of Henle Distal Nephron Net Acid Excretion Ammonia Metabolism Regulation of Renal Acidification Blood pH Mineralocorticoids, Distal Sodium Delivery, and Extracellular Fluid Volume Plasma Volume Potassium References Self-Assessment Questions 12 Metabolic Acidosis Definition Non–Anion Gap (Normal Anion Gap) Metabolic Acidosis Metabolic Acidosis of Renal Origin Proximal Renal Tubular Acidosis (Type 2) Hypokalemic Distal Renal Tubular Acidosis (Type 1) Hyperkalemic Distal Renal Tubular Acidosis (Type 4) Renal Tubular Acidosis in Chronic Kidney Disease Metabolic Acidosis of Extrarenal Origin Diarrhea Ileal Conduits Anion Gap Metabolic Acidosis Lactic Acidosis Diabetic Ketoacidosis d-Lactic Acidosis Starvation Ketosis Alcoholic Ketoacidosis Ethylene Glycol and Methanol Intoxications Salicylate Pyroglutamic Acidosis Alkali Treatment of Metabolic Acidosis References Self-Assessment Questions 13 Metabolic Alkalosis Definition Bicarbonate Transport Along the Nephron Factors Affecting Bicarbonate Reabsorption and Secretion Angiotensin II Aldosterone Pendrin Hypokalemia Pathophysiology of Metabolic Alkalosis Secondary Stimulation of Collecting Duct Ion Transport Chloride Depletion Potassium Depletion Primary Stimulation of Collecting Duct Ion Transport Exogenous Alkali Secondary Response to the Alkalemia Induced by HCO3− Retention Etiology Secondary Stimulation of Collecting Duct Ion Transport Vomiting or Nasogastric Drainage Diuretic Administration Genetic Impairment of Cl−-Linked Na+ Transport Recovery From Chronic Hypercapnia Congenital Chloridorrhea Other Causes of Excessive Chloride Losses Severe K+ Deficiency Primary Stimulation of Collecting Duct Ion Transport Mineralocorticoid Excess Apparent Mineralocorticoid Excess Syndromes Alkali Administration Other Causes Clinical Manifestations Diagnosis Treatment Chloride Depletion Metabolic Alkalosis Mineralocorticoid and Apparent Mineralocorticoid-Induced Metabolic Alkalosis Alkali Ingestion Special Problems in Management References Self-assessment Questions 14 Respiratory Acidosis, Respiratory Alkalosis, and Mixed Disorders Respiratory Acidosis (Primary Hypercapnia) Definition Etiology and Pathogenesis Secondary Physiologic Response Clinical Manifestations Neurologic Cardiovascular Renal Diagnosis Treatment Respiratory Alkalosis (Primary Hypocapnia) Definition Etiology and Pathogenesis Secondary Physiologic Response Clinical Manifestations Diagnosis Treatment Mixed Acid-Base Disturbances Definition Etiology and Pathogenesis Metabolic Acidosis and Respiratory Acidosis Metabolic Alkalosis and Respiratory Alkalosis Metabolic Alkalosis and Respiratory Acidosis Metabolic Acidosis and Respiratory Alkalosis Metabolic Acidosis and Metabolic Alkalosis Mixed Metabolic Acidosis Mixed Metabolic Alkalosis Triple Disorders Clinical Manifestations Diagnosis Treatment References Self-assessments Questions IV Glomerular Disease 15 Introduction to Glomerular Disease Definition Clinical Evaluation of Glomerular Disease History Physical Examination Laboratory Studies Imaging Renal Biopsy Asymptomatic Urine Abnormalities Asymptomatic Microhematuria Pathogenesis Evaluation Asymptomatic Non-Nephrotic Proteinuria Overflow Proteinuria Tubular Proteinuria Glomerular Proteinuria Functional proteinuria. Orthostatic proteinuria. Fixed non-nephrotic proteinuria. Asymptomatic Proteinuria With Hematuria Macrohematuria Nephrotic Syndrome Definition Etiology Hypoalbuminemia Edema Metabolic Consequences of Nephrotic Syndrome Negative Nitrogen Balance Hypercoagulability Hyperlipidemia and Lipiduria Other Metabolic Effects of Nephrotic Syndrome Infection Acute and Chronic Changes in Renal Function Acute Kidney Injury Chronic Kidney Disease Nephritic Syndrome Etiology Rapidly Progressive Glomerulonephritis Etiology Progressive Chronic Kidney Disease Treatment of Glomerular Disease General Principles Hypertension Treatment of Proteinuria Treatment of Hyperlipidemia Avoidance of Nephrotoxic Substances Special Therapeutic Issues in Patients With Nephrotic Syndrome Treatment of Nephrotic Edema Correction of Hypoproteinemia Treatment of Hypercoagulability Management of Infection Disease-Specific Therapies References Self-assessment Questions 16 Introduction to Glomerular Disease Histologic Classification Histopathology Light Microscopy Immunofluorescence and Immunoperoxidase Microscopy Electron Microscopy General Mechanisms of Glomerular Injury Proteinuria Antibody and Antigen Complement Mechanisms of Immune Glomerular Injury Inflammation Proliferation, Apoptosis, and Fibrosis Pathogenesis of Specific Glomerular Syndromes Minimal Change Disease Focal Segmental Glomerulosclerosis Membranous Nephropathy Membranoproliferative Glomerulonephritis Dense Deposit Disease and C3 Glomerulonephritis Mesangial Proliferative Glomerulonephritis Poststreptococcal Glomerulonephritis Goodpasture Disease Antineutrophil Cytoplasmic Antibody–Associated Vasculitis References Self-Assessment Questions 17 Minimal Change Disease Epidemiology Etiology Pathogenesis Circulating Factor(s) Cytokines Hemopexin Microbial Products Mechanism(s) of Proteinuria Loss of Anionic Charges in the Glomerular Filtration Barrier as a Cause of Minimal Change Disease Podocyte Dysfunction as a Cause of Minimal Change Disease CD80. Angptl-4. Pathology Clinical Manifestations Laboratory Findings Other Presentations (Complications) Diagnosis and Differential Diagnosis Natural History Treatment General Considerations Treatment of Children Initial Treatment Treatment of Relapses Treatment of Adults Initial Treatment Frequently Relapsing and Corticosteroid-Dependent Minimal Change Disease Minimal Change Disease With Non-Nephrotic Proteinuria Treatment of Secondary Minimal Change Disease References Self-assessment Questions 18 Primary and Secondary (Non-Genetic) Causes of Focal and Segmental Glomerulosclerosis Etiology and Pathogenesis Minimal Change Disease Versus Focal Segmental Glomerulosclerosis Genetic Variants of Focal Segmental Glomerulosclerosis Viral Induction of Focal Segmental Glomerulosclerosis Drug-Induced Focal Segmental Glomerulosclerosis Structural Maladaptation Leading to Focal Segmental Glomerulosclerosis Pathogenesis of Progressive Renal Failure in Focal Segmental Glomerulosclerosis Epidemiology Clinical Manifestations Diagnosis and Differential Diagnosis Pathology Classic Focal Segmental Glomerulosclerosis (FSGS Not Otherwise Specified) Perihilar Variant of Focal Segmental Glomerulosclerosis Cellular Variant of Focal Segmental Glomerulosclerosis Collapsing Variant of Focal Segmental Glomerulosclerosis Tip Variant of Focal Segmental Glomerulosclerosis Other Variants of Focal Segmental Glomerulosclerosis Distinguishing Pathologic Features of Secondary Focal Segmental Glomerulosclerosis Natural History and Prognosis Treatment Corticosteroids Other Immunosuppressive Agents and Corticosteroid Resistant Patients Other Forms of Therapeutic Interventions Transplantation References Self-assessment Questions 19 Inherited Causes of Nephrotic Syndrome Clinical Features of Nephrotic Syndrome Monogenic Causes of Nephrotic Syndrome Elucidate Its Pathogenesis Genotype Phenotype Correlations Recessive Versus Dominant Steroid-Resistant Nephrotic Syndrome Gene-Specific Phenotypes Allele-Specific Phenotypes Syndromic Proteinuric Renal Disease Galloway-Mowat Syndrome Denys-Drash and Frasier Syndromes Nail-Patella Syndrome Pierson Syndrome Genetic Testing by Whole Exome Sequencing Specific Therapies for Hereditary Nephrotic Syndrome Future Directions References Self-assessment Questions 20 Membranous Nephropathy Definition Etiology and Pathogenesis Experimental Membranous Nephropathy Human Membranous Nephropathy Epidemiology and Genetics Clinical and Serologic Manifestations Pathology Light Microscopy Immunohistology Electron Microscopy Diagnosis and Differential Diagnosis Clinical Course, Outcomes, and Complications Predictors of Poor Outcome Relapse After Complete Remission or Partial Remission Treatment Nonimmunosuppressive Therapy Immunosuppressive Therapy Corticosteroids Cytotoxic Agents Combined With Corticosteroids Calcineurin Inhibitors Mycophenolate Mofetil Rituximab Eculizumab Adrenocorticotropic Hormone Treatment Summary References 21 Membranoproliferative Glomerulonephritis and Cryoglobulinemic Glomerulonephritis Membranoproliferative Glomerulonephritis Definition Epidemiology Former Classification Newer Classification Based on Etiology and Pathogenesis Clinical Presentation and Pathology Infection-Associated MPGN Autoimmune-Associated MPGN Monoclonal Immunoglobulin–Associated MPGN MPGN With Masked Immune Deposits Complement-Mediated MPGN MPGN Without Immunoglobulins or Complement Uncommon Causes of MPGN Cryofibrinogen-related membranoproliferative glomerulonephritis. C4 glomerulopathy. Collagen type III glomerulopathy. Evaluation Infections Autoimmune Diseases Monoclonal Gammopathy Treatment Transplantation Cryoglobulinemic Glomerulonephritis Definition Clinical Presentation Evaluation Treatment References Self-assessment Questions 22 Glomerulonephritis Associated With Complement Disorders C3 Glomerulopathy Etiology and Pathogenesis Epidemiology Clinical Manifestations Dense Deposit Disease C3 Glomerulonephritis Laboratory Findings Pathology Differential Diagnosis Treatment References 23 Immunoglobulin A Nephropathy and IgA Vasculitis (Henoch-Schönlein Purpura) IgA Nephropathy Definition Etiology and Pathogenesis IgA Immune System IgA Glycosylation Role of Infection Glomerular Injury After IgA Deposition Animal Models of IgA Nephropathy Genetic Basis of IgA Nephropathy Other Modulators of the Course of IgA Nephropathy Epidemiology Clinical Manifestations IgA Nephropathy Macroscopic Hematuria Asymptomatic Hematuria and Proteinuria Proteinuria and Nephrotic Syndrome Acute Kidney Injury Chronic Kidney Disease Clinical Associations With IgA Nephropathy Pathology Immune Deposits Light Microscopy Electron Microscopy Differential Diagnosis Hematuria Nephrotic Syndrome Chronic Kidney Disease: Hypertension, Proteinuria, Renal Impairment Acute Kidney Injury Natural History IgA Nephropathy Transplantation Recurrent IgA Nephropathy Treatment Slowly Progressive IgA Nephropathy (“Intermediate Prognosis”) Antihypertensives and proteinuria-lowering drugs. Fish oil. Immunosuppressive or Antiinflammatory Regimens Corticosteroids. Cyclophosphamide and azathioprine. Other immunosuppressive approaches. Dipyridamole and warfarin. Rapidly Progressive IgA Nephropathy (“Poor Prognosis”) Other Therapeutic Approaches to Progressive IgA Nephropathy Reduction of IgA production. Prevention and removal of IgA deposits. Transplant recurrence. IgA Vasculitis Definition Epidemiology Pathogenesis Genetics Clinical Manifestations Pathology Differential Diagnosis Natural History Transplantation Treatment Rapidly Progressive Chronic Kidney Disease Caused by Crescentic Nephritis Active IgA Vasculitis Without Renal Failure Slowly Progressive Chronic Kidney Disease Transplant Recurrence References Self-assessment Questions 24 Anti–Glomerular Basement Membrane Disease and Goodpasture Disease Etiology and Pathogenesis Autoimmunity to a Component of Glomerular Basement Membrane Predisposing Factors Precipitating Factors Mechanisms of Renal Injury Lung Hemorrhage Epidemiology Clinical Manifestations Lung Hemorrhage Glomerulonephritis Pathology Immunohistology Pathology in Other Tissues Differential Diagnosis Detection of Anti–Glomerular Basement Membrane Antibodies Patients With Anti-GBM Antibodies and Other Diseases Antineutrophil Cytoplasmic Antibody and Systemic Small-Vessel Vasculitis Membranous Nephropathy Alemtuzumab Treatment Pulmonary-Renal Syndromes Natural History Treatment Immunosuppressive Regimens Plasma Exchange and Immunosuppression Supportive Treatment Monitoring Effect of Treatment on Disease Activity Duration of Treatment and Relapses Electing Not to Treat Treatment of Double-Positive Patients Transplantation Alport Syndrome Post-Transplant Anti–Glomerular Basement Membrane Disease References Self-assessment Questions 25 Renal and Systemic Vasculitis Definition Small-Vessel Vasculitis Medium-Vessel Vasculitis Large-Vessel Vasculitis Small-Vessel Pauci-Immune Vasculitis Pathogenesis Epidemiology Clinical Manifestations Antineutrophil Cytoplasmic Autoantibody Pathology Differential Diagnosis Natural History Treatment Induction Therapy Maintenance Therapy Relapse Therapy Transplantation Polyarteritis Nodosa Pathogenesis Epidemiology Clinical Manifestations Pathology Differential Diagnosis Natural History Treatment Kawasaki Disease Definition Pathogenesis Epidemiology Clinical Manifestations Pathology Differential Diagnosis Natural History Treatment Takayasu Arteritis and Giant Cell Arteritis Pathogenesis Epidemiology Clinical Manifestations Pathology Differential Diagnosis Treatment References Self-Assessment Questions 26 Lupus Nephritis Definition Epidemiology Etiology and Pathogenesis Genetics and Environment Autoimmunity in Systemic Lupus Erythematosus Pathogenesis of Lupus Nephritis Clinical Manifestations Extrarenal Manifestations Diagnosis and Differential Diagnosis Immunologic Tests in Lupus Renal Biopsy in Systemic Lupus Erythematosus Pathology Tubulointerstitial and Vascular Disease Transformation of Histologic Appearance and “Silent” Lupus Nephritis Clinical, Laboratory, and Histopathologic Correlations and Outcomes Long-Term Prognosis and Kidney Histology Treatment Proliferative Lupus Nephritis: Induction Corticosteroids Immunosuppressive Agents Other Immunosuppressive Strategies Biologic Agents Resistant Proliferative Lupus Nephritis Renal Response to Initial Therapy Proliferative Lupus Nephritis: Maintenance Therapy Membranous Lupus Nephropathy Long-Term Monitoring of Lupus Nephritis Patients Antiphospholipid Antibody Syndrome, Atherosclerosis, and Pregnancy in Lupus Nephritis End-Stage Renal Disease and Renal Transplantation References Self-assessment Questions 27 Renal Amyloidosis and Glomerular Diseases With Monoclonal Immunoglobulin Deposition Renal Amyloidosis General Characteristics of Amyloidosis Definition Amyloid Precursor–Based Classification Other Components of All Amyloid Fibrils General Mechanisms of Fibrillogenesis Pathology Immunoglobulin-Associated Amyloidosis (AL Amyloidosis) Pathogenesis Epidemiology Clinical Manifestations Diagnosis Treatment and Outcome Dialysis and Transplantation Inflammatory (Secondary) Amyloidosis (AA Amyloidosis) Epidemiology Clinical Manifestations Diagnosis Natural History and Treatment Familial Mediterranean Fever and Other Hereditary Recurrent Fever Syndromes Monoclonal Immunoglobulin Deposition Disease History and Definition Epidemiology Pathogenesis Clinical Manifestations Renal Manifestations Extrarenal Manifestations Pathology Light Microscopy Immunohistology Electron Microscopy Diagnosis Treatment and Outcome Renal Diseases Associated With Monoclonal Immunoglobulin Deposition Disease Nonamyloid Fibrillary and Immunotactoid Glomerulopathies Epidemiology Clinical Manifestations Pathology Immunotactoid Glomerulopathy Fibrillary Glomerulopathy Diagnosis Outcome and Treatment Glomerular Lesions Associated With Waldenström Macroglobulinemia and Other Monoclonal Immunoglobulin M-Secreting B Cell Lymphoproliferative Disorders Other Types of Glomerulonephritis References Self-assessment Questions 28 Rare Glomerular Disorders Mesangial Proliferative Glomerulonephritis Without IgA Deposits Immunoglobulin M Nephropathy C1q Nephropathy Mesangial Proliferative Glomerulonephritis Associated With Minimal Change Disease Glomerulonephritis With Rheumatic Disease Rheumatoid Arthritis Mixed Connective Tissue Disease Polymyositis and Dermatomyositis Acute Rheumatic Fever Ankylosing Spondylitis and Reiter Syndrome (Seronegative Spondyloarthropathies) Scleroderma (Systemic Sclerosis) Relapsing Polychondritis Antiphospholipid Antibody Syndrome Other Uncommon Glomerular Disorders Lipoprotein Glomerulopathy Lecithin–Cholesterol Acyltransferase Deficiency Collagen III Glomerulopathy Fibronectin Glomerulopathy Nephropathic Cystinosis Miscellaneous Storage Diseases Rarely Associated With Glomerular Lesions Idiopathic (Nondiabetic) Nodular Glomerulosclerosis Macrophage Activation Syndrome DRESS Syndrome Kimura Disease References Self-assessment Questions 29 Thrombotic Microangiopathies, Including Hemolytic Uremic Syndrome Definitions Laboratory Signs Pathology Mechanisms, Clinical Features, and Management of Specific Forms of Thrombotic Microangiopathy Shiga Toxin–Producing Escherichia coli–Associated Hemolytic Uremic Syndrome Mechanisms Diagnosis Clinical Course Therapy Hemolytic Uremia Syndrome Associated With Streptococcus pneumoniae Mechanisms Clinical Course and Therapy Atypical Hemolytic Uremic Syndrome Mechanisms Complement factor H. Membrane cofactor protein. Complement factor I. Complement factor B and C3. Thrombomodulin. Determinants of disease penetrance. Diacylglycerol kinase ε. Diagnosis of Atypical Hemolytic Uremia Syndrome and Testing for Genetic Mutations Clinical Course Therapy Fresh frozen plasma. Kidney transplantation Complement inhibitors. Liver-kidney transplant. Thrombotic Microangiopathy Associated With Cobalamin C Deficiency Thrombotic Thrombocytopenic Purpura Mechanisms TTP associated with Anti-ADAMTS13 antibodies. TTP associated with genetic deficiency of ADAMTS13. Clinical Course Therapy Other Forms of Thrombotic Microangiopathies Associated With Systemic Diseases or Drugs Antiphospholipid Syndrome, Scleroderma, and Hypertensive Emergencies Human Immunodeficiency Virus Malignancy Thrombotic Microangiopathy After Bone Marrow Transplantation Drugs References Self-Assessment Questions V Diabetic Kidney Disease 30 Pathogenesis, Clinical Manifestations, and Natural History of Diabetic Kidney Disease Definitions Pathogenesis of Diabetic Kidney Disease Genetic and Environmental Factors Hemodynamic Changes Renal Hypertrophy and Mesangial Matrix Expansion Inflammation and Diabetic Kidney Disease Mechanisms Underlying Proteinuria Tubular Changes Hyperglycemia and Diabetic Kidney Disease Role of Glucose Control Protein kinase C pathway. Advanced glycation end products pathway. Polyol pathway. Hexosamine pathway. Adenosine monophosphate kinase. Kallikrein-kinin pathway. Activation of innate immunity. Renin-Angiotensin-Aldosterone System and Diabetic Kidney Disease Uric Acid and Fructose Epidemiology Clinical Manifestations and Natural History Obesity, Metabolic Syndrome, and Renal Disease Evolution of Diabetic Kidney Disease Hypertension and Diabetic Kidney Disease Associated Extrarenal Microvascular and Macrovascular Complications Survival in Patients With Diabetic Kidney Disease Renal Pathology Diagnosis and Differential Diagnosis Measurement of Albuminuria or Proteinuria Measurement of Blood Pressure Measurement of Serum Creatinine and Estimation of Glomerular Filtration Rate Differential Diagnosis Indications for Renal Biopsy Approach to the Diabetic Patient With Impaired Renal Function References Self-Assessment Questions 31 Prevention and Treatment of Diabetic Kidney Disease Glycemic Control Glycemic Targets Antihyperglycemic Therapeutic Options in Type 2 Diabetic Kidney Disease SGLT2 Inhibitors Analogues of Human Glucagon-Like Peptide-1 Dipeptidyl Peptidase-4 Inhibitors Blood Pressure Control Renin-Angiotensin System Blockade in the Prevention of Diabetic Kidney Disease Renin-Angiotensin System Blockade in the Treatment of Diabetic Kidney Disease Type 1 Diabetic Patients Type 2 Diabetic Patients Aldosterone Blockade in Diabetic Kidney Disease Combination Therapy With Renin-Angiotensin System Antagonists Dosing and Adverse Effects Associated With Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Other Antihypertensive and Antiproteinuric Agents Diuretics and Low Sodium Intake Calcium Channel Blockers β-Blockers Treatment of Dyslipidemia Nonpharmacologic Interventions Emerging Treatments for Diabetic Kidney Disease Mineralocorticoid Receptor Antagonists Endothelin Receptor Antagonists Vitamin D Receptor Activators Xanthine Oxidase Inhibitors Phosphodiesterase Inhibitors Novel Therapeutic Approaches References 32 Management of the Diabetic Patient With Chronic Kidney Disease Diagnostic Considerations General Management Considerations Monitoring Diabetic Renal Disease (Stage CKD3b-5) Hemoglobin A1c Albuminuria Management of Diabetes in Subjects With Stage 3B-5 CKD Hypoglycemia and Hyperglycemia Oral Hypoglycemic Agents Biguanides Sulfonylureas Thiazolidinediones Meglinitides Incretin Mimetics: Glucagon-Like Peptide-1 Analogues Gliptins: Dipeptidyl Peptidase-4 Inhibitors α-Glucosidase Inhibitors Amylin Analogues SGLT-2 Inhibitors Insulin Types of insulin. Future Therapeutics Management of Hypertension in the Diabetic Subject With Chronic Kidney Disease Blood Pressure Goals What Agents Should Be Used? Renin-Angiotensin-Aldosterone System Blockade Cardiovascular Complications Coronary Heart Disease Peripheral Vascular Disease Erectile Dysfunction Antiplatelet Agents Dyslipidemia Microvascular Complications of Diabetes Retinopathy Neuropathy Autonomic Neuropathy Diabetic Foot Disease Complications From Chronic Kidney Disease Anemia Mineral Bone Disease Diet and Malnutrition Electrolytes and Fluid Retention End-Stage Renal Disease Dialysis Hemodialysis Vascular Access Peritoneal Dialysis Transplantation References Self-assessment Questions VI Hypertension 33 Normal Blood Pressure Control and the Evaluation of Hypertension Normal Blood Pressure Control Definition and Classification of Hypertension Blood Pressure in Relation to Morbidity and Mortality Elevation of Blood Pressure by Arbitrary Cut-Off Points Threshold of Therapeutic Benefit Operational Definitions Special Definitions Prehypertension. White coat hypertension. Masked hypertension. Sustained hypertension. Pseudohypertension. Isolated systolic hypertension. Resistant hypertension. Hypertensive emergencies and urgencies. Hypertension in children and adolescents. Hypertension in pregnancy. Classification by Cause of Hypertension Evaluation of Hypertension Blood Pressure Measurement Variability of Blood Pressure Office Versus Home Blood Pressure and Circadian Variation Home and Ambulatory Blood Pressure Monitoring Risk Assessment in Hypertension Consideration of Primary Versus Secondary Hypertension References Self-Assessment Questions 34 Primary Hypertension Definition Etiology and Pathogenesis Genetic (Polygene) Hypothesis Congenital (Low Nephron Number) Hypothesis The Role of the Immune System and Acquired Renal Injury What Initiates the Renal Inflammatory Response? How Does Sodium Retention Lead to Hypertension? Pathogenic Mechanisms Driving the Current Epidemic of Hypertension Epidemiology Clinical Manifestations Pathology Diagnosis Natural History Kidney Disease Effect of Antihypertensive Therapy on Natural History of Hypertensive Cardiovascular Disease and Kidney Disease Progression Can Primary Hypertension Spontaneously Remit? References Self-Assessment Questions 35 Nonpharmacologic Prevention and Treatment of Hypertension Prevention Weight Loss Physical Activity Exercise Training Dose Response Mechanisms Antihypertensive Medication and Guidelines for Exercise Diet Salt Intake Potassium Intake Calcium, Vitamin D, and Dairy Food Intake Magnesium Intake, Other Micronutrients, and Bioactive Food Components Dietary Sugars and Fats Dietary Approaches to Lower Blood Pressure Smoking Alcohol Caffeine Psychological Stress Adopting Lifestyle Modifications References Self-assessment Questions 36 Pharmacologic Treatment of Hypertension Defining Who Should Receive Pharmacologic Treatment Blood Pressure Thresholds for Intervention (Office Blood Pressure) Clinical Dilemma of End-Organ Damage and “Normal” Blood Pressure Blood Pressure Thresholds for Intervention (Ambulatory and Home Blood Pressure Monitoring) Blood Pressure Treatment Goals Guide to Selection of Antihypertensive Agents Key Principles From Clinical Trials Selection of Drug Therapy Thiazide and Thiazide-Like Diuretics Potassium-Retaining Diuretics β-Adrenoceptor Blockers Calcium Channel Blockers Blockade of Renin-Angiotensin System Angiotensin-converting enzyme inhibitors. Angiotensin receptor blockers. Direct renin inhibitor. α-Adrenergic Blockers Combined α-Adrenergic and β-Adrenergic Blocker Centrally Acting Sympatholytic Drugs Direct Vasodilators Treatment Strategies Initial Drug Therapy Choice of initial therapy. Combination Therapy Initial therapy with a two-drug combination. Combining Renin-Angiotensin System Blockade Resistant Hypertension Medication to Reduce Cardiovascular Risk Follow-Up Withdrawal of Therapy Indications for Specialist Referral Hypertension in People of Black African Origin Hypertension in Older People References Self-assessment Questions 37 Evaluation and Treatment of Hypertensive Emergencies and Urgencies Etiology and Pathogenesis Epidemiology Diagnostic Evaluation Treatment General Principles for Managing Hypertensive Emergencies Specific Aspects of Antihypertensive Drug Use for Hypertensive Emergencies Treatment of Hypertensive Urgencies References Self-assessment Questions 38 Endocrine Causes of Hypertension Etiology and Pathogenesis Pathogenesis of Aldosterone-Dependent Hypertension Other Hormones That Can Cause Hypertension Through Mineralocorticoid Receptor Activation Types of Primary Aldosteronism Familial Forms of Primary Aldosteronism Familial Hypertension Type I Familial Hyperaldosteronism Type II Familial Hyperaldosteronism Type III Familial Hyperaldosteronism Type IV Sporadic Forms Epidemiology Clinical Manifestations Diagnosis and Differential Diagnosis Who to Screen for Primary Aldosteronism Evaluation of Suspected Primary Aldosteronism Use of the Aldosterone-Renin Ratio (ARR) Effect of Drugs on Screening for Primary Aldosteronism When to Withold Drugs That Affect the Renin-Angiotensin-Aldosterone System Before Screening Confirmatory Testing Differentiation of Etiology Selection of Patients for Further Testing Imaging Approaches Adrenal Vein Sampling Other Testing Options Natural History Treatment Adrenalectomy Mineralocorticoid Receptor Antagonists Non–Mineralocorticoid Receptor Blocker Therapy References Self-Assessment Questions 39 Other Endocrine Causes of Hypertension Cushing Syndrome Definition Etiology, Pathogenesis, and Epidemiology Clinical Manifestations Differential Diagnosis Diagnosis Treatment and Prognosis Pheochromocytoma Definition Etiology, Pathogenesis, and Epidemiology Clinical Manifestations Diagnosis Treatment Adrenal Incidentaloma Definition and Epidemiology Management Renin-Secreting Tumor Definition Etiology and Pathogenesis Clinical Manifestations Pathology Diagnosis and Differential Diagnosis Treatment Acromegaly Definition and Epidemiology Clinical Manifestations Diagnosis Treatment Management of Hypertension in Acromegaly Hypothyroidism Definition and Epidemiology Clinical Features Diagnosis Hyperthyroidism Definition and Epidemiology Clinical Features Diagnosis and Treatment Primary Hyperparathyroidism References Self-assessment Questions 40 Neurogenic Hypertension, Including Hypertension Associated With Stroke or Spinal Cord Injury Physiology and Pathophysiology Neural Control of Blood Pressure Cerebrovascular Autoregulation Specific Syndromes Hypertension After Stroke Epidemiology Pathophysiology Diagnosis and Treatment Acute ischemic stroke. Intracerebral hemorrhage. Subarachnoid hemorrhage. Hypertension After Carotid Endarterectomy and Endovascular Procedures Definition, Incidence, and Clinical Features Pathophysiology Diagnosis and Treatment Hypertension After Spinal Cord Injury Definition and Epidemiology Pathophysiology and Diagnosis Treatment Cerebrovascular Effects of Antihypertensive Agents References Self-Assessment Questions VII Renovascular Disease 41 Renovascular Hypertension and Ischemic Nephropathy Normal Renovascular Anatomy Clinical Syndromes Associated With Renal Vascular Disease Renovascular Hypertension Renal Artery Stenosis Fibromuscular Dysplasia Atherosclerotic Renal Artery Stenosis Takayasu Arteritis Coarctation and Middle Aortic Syndrome Renal Artery Aneurysms Ischemic Renal Disease Heart Failure and Unstable Cardiac Conditions Imaging Renovascular Hypertension and Renal Artery Stenosis Treatment of Atherosclerotic Renal Artery Stenosis and Fibromuscular Dysplasia Indications to Consider Renal Revascularization in Atherosclerotic Renal Artery Stenosis Surgical Renal Revascularization Transplant Renal Artery Stenosis Renal Infarction Treatment of Acute Renal Infarction Atheroembolic Renal Disease Clinical Presentation Diagnosis Differential Diagnosis Pathology and Pathophysiology Natural History Treatment Renal Vein Thrombosis Acute Versus Chronic Renal Vein Thrombosis Clinical Presentation Etiology Diagnosis Treatment References Self-assessment Questions VIII Pregnancy and Renal Disease 42 Renal Physiology and Complications in Normal Pregnancy Renal Physiology in Normal Pregnancy Anatomy Hemodynamic Changes Systemic Renal Mechanisms of Increased Glomerular Filtration Rate Measuring Glomerular Filtration Rate Renin-Angiotensin-Aldosterone System Renal Tubular Changes Sodium Handling and Osmoregulation Potassium Calcium Uric Acid Acid-Base Urine Protein Glucose Renal Complications in Normal Pregnancy Urinalysis and Microscopy Hematuria Definition and Epidemiology Etiology and Outcome Differential Diagnosis Treatment Proteinuria Definition Differential Diagnosis Natural History Treatment Pyuria Urinary Tract Infection Definitions Epidemiology Pathogenesis Clinical Manifestations Asymptomatic Bacteriuria Pyelonephritis Treatment Asymptomatic Bacteriuria Cystitis Pyelonephritis Renal Calculi Epidemiology Pathogenesis Clinical Manifestations Treatment Hypertension in Pregnancy Definitions Epidemiology Preeclampsia Epidemiology Pathogenesis Renal Abnormalities in Preeclampsia Proteinuria Decreased Glomerular Filtration Rate Acute Tubular Necrosis Sodium Retention Renin-Angiotensin-Aldosterone System Increased Uric Acid Reabsorption Clinical Manifestations Eclampsia HELLP Syndrome Natural History Prediction and Prevention Treatment General Management Blood Pressure Management Postpartum Management Acute Fatty Liver of Pregnancy Pathogenesis and Pathology Clinical Manifestations Differential Diagnosis Treatment and Outcome Thrombotic Microangiopathy Clinical Manifestations and Differential Diagnosis Natural History Treatment Acute Kidney Injury Definition Epidemiology Etiology and Pathogenesis Antepartum Hemorrhage, Prolonged Intrauterine Fetal Death, or Amniotic Fluid Embolism Sepsis Preeclampsia, Acute Fatty Liver of Pregnancy, and Thrombotic Microangiography Clinical Manifestations and Differential Diagnosis Preeclampsia Obstructive Uropathy Natural History Treatment Dialysis Ovarian Hyperstimulation Syndrome Definition and Epidemiology Pathogenesis Clinical Manifestations and Investigations Management References Self-assessment Questions 43 Pregnancy With Preexisting Kidney Disease The Adverse Effects of Chronic Kidney Disease on Pregnancy Severity of Hypertension Proteinuria Management Common to All Pregnancy With Preexisting Kidney Disease Prepregnancy Counseling Fertility Assessment Volume Homeostasis Urinalysis: Proteinuria Hypertension Renal Biopsy in Pregnancy Superimposed Preeclampsia Assessment of Fetal Well-Being Timing of Delivery Course of Chronic Kidney Disease During and After Pregnancy Management of Specific Renal Disorders During Pregnancy IgA Nephropathy Diabetic Nephropathy Lupus Nephritis Reflux Nephropathy Inherited Renal Disorders Dialysis in Pregnancy Initiating Dialysis for Progressive Chronic Kidney Disease Dialysis Regimens in Pregnancy Peritoneal Dialysis and Pregnancy Renal Transplantation and Pregnancy Timing of Pregnancy Immunosuppression in Pregnancy Pregnancy Outcomes Infection in Pregnant Transplant Recipients Male Transplant Recipients Pregnancy in the Kidney Donor Summary References Self-Assessment Questions IX Hereditary and Congenital Diseases of the Kidney 44 Autosomal Dominant Polycystic Kidney Disease Definition Etiology and Pathogenesis Genetic Mechanisms Polycystic Kidney Disease Proteins Mechanisms of Cyst Formation Liver Cyst Development Hypertension Epidemiology Phenotypic Variability Diagnosis Renal Ultrasound Genetic Testing Differential Diagnosis Clinical Manifestations Renal Manifestations Renal Size Pain Hematuria and Cyst Hemorrhage Urinary Tract Infection and Cyst Infection Nephrolithiasis Hypertension End-Stage Renal Disease Extrarenal Manifestations Polycystic Liver Disease Intracranial Aneurysms Other Vascular Abnormalities Valvular Heart Disease and Other Cardiac Manifestations Other Associated Conditions Pathology Treatment Flank Pain Cyst Hemorrhage Urinary Tract and Cyst Infection Nephrolithiasis Hypertension Progressive Renal Failure Polycystic Liver Disease Intracranial Aneurysm Novel Therapies Vasopressin Antagonists Somatostatin Analogues Mammalian Target of Rapamycin (mTOR) Inhibitors Other Investigational Therapies Transplantation References Self-assessment Questions 45 Other Cystic Kidney Diseases Autosomal Recessive Polycystic Kidney Disease Definition Etiology and Pathogenesis Genetic Basis Pathogenesis Epidemiology Clinical Manifestations Pathology Kidney Liver Diagnosis Imaging Genetic Testing Treatment Transplantation Nephronophthisis: Autosomal Dominant Tubulointerstitial Kidney Disease Definitions Nephronophthisis Genetic Basis Clinical Manifestations Renal Disease. Associated Extrarenal Abnormalities. Pathology Diagnosis Treatment Autosomal Dominant Tubulointerstitial Kidney Disease Medullary Sponge Kidney Definition Etiology and Pathogenesis Epidemiology Clinical Manifestations Pathology Diagnosis Treatment Tuberous Sclerosis Complex Definition Etiology and Pathogenesis Epidemiology Clinicopathologic Manifestations Renal Angiomyolipomas Renal Cystic Disease Renal Neoplasms Diagnosis Treatment Renal Angiomyolipomas Renal Cystic Disease Renal Carcinoma Renal Replacement Therapy Von Hippel–Lindau Disease Definition Etiology and Pathogenesis Clinical Manifestations Pathology Diagnosis Differential Diagnosis Treatment Simple Cysts Introduction and Definition Etiology and Pathogenesis Clinical Manifestations Pathology Diagnosis Treatment Solitary Multilocular Cysts Renal Lymphangiomatosis Glomerulocystic Kidney Disease Acquired Cystic Disease Hypokalemic Cystic Disease Hilar Cysts Perinephric Pseudocysts Acquired Cystic Disease in Renal Failure References Self-assessment Questions 46 Alport Syndrome and Other Familial Glomerular Syndromes Alport Syndrome Definition Etiology and Pathogenesis Type IV Collagen Genetics X-Linked Alport syndrome. Autosomal recessive Alport syndrome. Autosomal dominant Alport syndrome. Type IV Collagen in Alport Basement Membranes Clinical Manifestations Renal Defects Cochlear Defects Ocular Defects Leiomyomatosis Hematologic Defects Arterial Abnormalities Renal Pathology Diagnosis and Differential Diagnosis Natural History Treatment Transplantation Hereditary Angiopathy with Nephropathy, Aneurysms, and Cramps (HANAC Syndrome) Thin Basement Membrane Nephropathy Definition Etiology and Pathogenesis Clinical Manifestations Pathology Diagnosis and Differential Diagnosis Treatment Fabry Disease (Anderson-Fabry Disease) Definition Etiology and Pathogenesis Clinical Manifestations and Pathology Renal Defects Heart Defects Nervous System Skin Eyes Lungs Diagnosis Treatment Fabry Disease in Childhood Nail-Patella Syndrome Definition Etiology and Pathogenesis Clinical Manifestations Renal Defects Skeletal Defects Nails Renal Pathology Treatment References Self-assessment Questions 47 Inherited Disorders of Sodium and Water Handling Physiology of Sodium and Water Reabsorption Sodium Transporters and the Corresponding Inherited Disorders Water Reabsorption Disorders of Sodium Handling Conditions With Hypokalemia, Metabolic Alkalosis, and Low-Normal Blood Pressure Bartter Syndrome Pathogenesis Clinical Manifestations Diagnosis and Differential Diagnosis Treatment Outcome Gitelman Syndrome Pathogenesis Clinical Manifestations and Diagnosis Treatment EAST Syndrome Conditions With Hypokalemia, Metabolic Alkalosis, and Hypertension Liddle Syndrome Pathogenesis Clinical Manifestations and Diagnosis Treatment Apparent Mineralocorticoid Excess Pathogenesis Clinical Manifestations and Diagnosis Treatment Glucocorticoid-Remediable Aldosteronism Pathogenesis Diagnosis Treatment Adrenal Enzymatic Disorders Conditions With Hyponatremia, Hyperkalemia, Metabolic Acidosis, and Normal/Low Blood Pressure Pseudohypoaldosteronism Diagnosis Clinical Features Treatment Aldosterone Biosynthetic Defects A Condition With Hyperkalemia, Metabolic Acidosis, and Hypertension Pseudohypoaldosteronism Type 2 (Gordon Syndrome) Pathogenesis Clinical Manifestations and Diagnosis Treatment Inherited Disorders of Water Handling Congenital Nephrogenic Diabetes Insipidus Pathogenesis Clinical Features Diagnosis Differential Diagnosis Treatment Nephrogenic Syndrome of Inappropriate Antidiuresis Pathogenesis Clinical Features, Diagnosis, and Treatment References Self-Assessment Questions 48 Fanconi Syndrome and Other Proximal Tubule Disorders Fanconi Syndrome Definition Etiology and Pathogenesis Clinical Manifestations Aminoaciduria Glycosuria Hypophosphatemia Natriuresis and Kaliuresis Hyperchloremic Metabolic Acidosis Polyuria and Polydipsia Growth Retardation Hypouricemia Proteinuria Treatment of Fanconi Syndrome Inherited Causes of Fanconi Syndrome Cystinosis Definition Etiology and Pathogenesis Clinical Manifestations Renal Pathology Treatment Galactosemia Etiology and Pathogenesis Clinical Manifestations Treatment Hereditary Fructose Intolerance Etiology and Pathogenesis Clinical Manifestations Diagnosis Treatment Glycogenosis Tyrosinemia Definition Etiology and Pathogenesis Clinical Manifestations Diagnosis Treatment Wilson Disease Definition Etiology and Pathogenesis Clinical Manifestations Renal Pathology Diagnosis Treatment Lowe Syndrome Dent Disease Definition Etiology and Pathogenesis Mitochondrial Cytopathies Definition Clinical Manifestations Diagnosis Treatment Idiopathic Fanconi Syndrome Acquired Causes of Fanconi Syndrome Heavy Metal Intoxication Tetracycline Cancer Chemotherapy Agents Other Drugs and Toxins Dysproteinemias Glomerular Disease After Acute Kidney Injury After Renal Transplantation Familial Glucose-Galactose Malabsorption and Hereditary Renal Glycosuria Definition Etiology and Pathogenesis Natural History Aminoacidurias Cystinuria Definition Etiology and Pathogenesis Clinical Manifestations Diagnosis Treatment Hereditary Defects in Uric Acid Handling Hereditary Renal Hypouricemia Familial Juvenile Hyperuricemic Nephropathy, Medullary Cystic Kidney Disease Type 2, and Uromodulin Mutations References Self-Assessment Questions 49 Sickle Cell Diseases and the Kidney Sickle Cell Disease Epidemiology Genetics Pathophysiology Natural History and Clinical Manifestations Sickle Cell Nephropathy Genetic Modifiers of Risk for Developing Sickle Cell Nephropathy Pathophysiology of Sickle Cell Nephropathy Clinical Manifestations of Sickle Cell Nephropathy Glomerular Abnormalities Hyperfiltration Microalbuminuria and Proteinuria Tubular Abnormalities Hyposthenuria Increased Proximal Tubular Function Acidification Defect Hematuria, Papillary Necrosis, and Renal Medullary Carcinoma Urinary Tract Infections Clinical Syndromes of Renal Impairment Acute Kidney Injury Progressive Chronic Kidney Disease Investigation and Management of Sickle Cell Nephropathy Inhibition of the Renin-Angiotensin System Hydroxycarbamide and Blood Transfusion Erythropoiesis-Stimulating Agents Hemopoietic Stem Cell Transplantation Renal Replacement Therapy Dialysis Transplantation Sickle Cell Trait and Chronic Kidney Disease References Self-Assessment Questions 50 Congenital Anomalies of the Kidney and Urinary Tract Clinical Principles Development of the Kidney and Urinary Tract Pathogenesis Epidemiology Renal Malformations Large Kidneys Irregular Kidneys Renal Dysplasia Renal Hypoplasia (Oligomeganephronia) Differential Diagnosis of Scarred Kidneys Renal hypodysplasia versus reflux. Renal scarring in adults. Absent Kidneys Unilateral Renal Agenesis Bilateral Renal Agenesis Misplaced Kidneys Renal Ectopia, Malrotation, and Crossed Fused Kidneys Horseshoe Kidney Calyceal Abnormalities Hydrocalyx and Hydrocalycosis Megacalycosis Calyceal Diverticulum (Calyceal Cyst) Bardet-Biedl Syndrome Pelviureteral Junction Obstruction Gonadal Dysgenesis Ureteral Abnormalities Duplex Ureters Pathogenesis Clinical Manifestations Ectopic Ureters Ureterocele Megaureter Pathogenesis Clinical Manifestations Treatment Bladder and Outflow Disorders Prune-Belly Syndrome Pathogenesis Clinical Manifestations Differential Diagnosis Natural History Treatment Bladder Exstrophy (Ectopia Vesicae) Pathogenesis Clinical Manifestations Natural History Treatment Neuropathic Bladder Contractile Behavior Intermediate Behavior Acontractile Behavior Myelodysplasia Pathogenesis Clinical Manifestations Bladder dysfunction. Bowel dysfunction. Cognitive impairment. Natural History Treatment Bladder Neck Obstruction Posterior Urethral Valves Pathogenesis Clinical Manifestations Natural History Treatment Urethral Diverticulum Other Congenital Causes of Bladder Outflow Obstruction Urofacial Syndrome General Management of Congenital Renal Tract Abnormalities Clinical Evaluation Exclude Obstruction Urodynamics Surgical Correction of the Urinary Tract Complications Urinary Tract Infections Glomerular Hyperfiltration Proteinuria and Progressive Renal Failure Hypertension Stones Tubular Dysfunction Polyuria Salt Depletion Acidosis Bone Disease Urinary Diversions Ureterosigmoidostomy Ileal Conduits Enterocystoplasty and Intestinal Urinary Reservoirs End-Stage Renal Disease and Transplantation Pretransplantation Assessment Transplant Outcome Management Complications References Self-assessment Questions X Infectious Diseases and the Kidney 51 Urinary Tract Infections in Adults Definition Epidemiology Pathogenesis Uncomplicated Infection Complicated Infection Etiologic Agents Clinical Syndromes Acute Uncomplicated Cystitis in Young Women Recurrent Acute Uncomplicated Cystitis in Women Acute Uncomplicated Pyelonephritis in Women Complicated Infections Chronic Kidney Disease. Catheter-Associated Infections. Spinal Cord Injury. Prostatitis. Renal Abscess. Papillary Necrosis. Emphysematous Pyelonephritis. Renal Malacoplakia. Xanthogranulomatous Pyelonephritis. Asymptomatic Bacteriuria Imaging of the Urinary Tract References Self-assessment Questions 52 Tuberculosis of the Urinary Tract Definition Etiology Pathogenesis Clinical Manifestations Asymptomatic Presentations Lower Urinary Tract Symptoms Proteinuria and Nephrotic Syndrome Low Glomerular Filtration Rate Pain Stone Formation Genital Involvement Other Manifestations Pathology Diagnosis and Differential Diagnosis Differential Diagnosis Natural History Treatment Surgical Treatment Treatment Regimens in Special Situations Women During Pregnancy and Lactation Patients With Liver Disease Patients With Chronic Kidney Disease Renal Allograft Recipients Acquired Immunodeficiency Syndrome Patients Who Fail Treatment Patient Monitoring References Self-Assessment Questions 53 Fungal Infections of the Urinary Tract Candida Epidemiology Pathogenesis Microbiology Clinical Manifestations Diagnosis Treatment With Systemic Antifungal Agents Local Antifungal Administration Localized Candida Infections Other Yeasts Aspergillus and Other Molds Endemic Fungi References Self-assessment Questions 54 The Kidney in Schistosomiasis Pathogenesis Clinical Manifestations Lower Urinary Tract Schistosomiasis Bladder Cancer Upstream Consequences Interstitial Nephritis Glomerulonephritis Coinfection Human Immunodeficiency Virus Hepatitis B Virus Diagnosis Schistosoma haematobium Urinary Tract Disease Schistosoma mansoni Glomerulonephritis Treatment Schistosoma haematobium Urinary Tract Disease Schistosoma mansoni Glomerulonephritis References Self-Assessment Questions 55 Glomerular Diseases Associated With Infection Bacterial Infections Poststreptococcal Glomerulonephritis Etiology and Pathogenesis Epidemiology Clinical Manifestations Pathology Differential Diagnosis Natural History Treatment IgA–Dominant Infection-Related Glomerulonephritis Etiology and Pathogenesis Epidemiology Clinical Manifestations and Pathology Differential Diagnosis, Natural History, and Treatment Endocarditis-Associated Glomerulonephritis Etiology and Pathogenesis Epidemiology Clinical Manifestations Pathology Differential Diagnosis, Natural History, and Treatment Shunt Nephritis Etiology, Pathogenesis, and Epidemiology Clinical Manifestations and Pathology Natural History and Treatment Glomerulonephritis Associated With Other Bacterial Infections Viral Infections Hepatitis A–Associated Glomerulonephritis Hepatitis B–Associated Glomerular Lesions Etiology and Pathogenesis Epidemiology Clinical Manifestations and Pathology Hepatitis B Virus–Associated Membranous Nephropathy Hepatitis B Virus–Associated Membranoproliferative Glomerulonephritis Other Hepatitis B Virus–Associated Glomerular Lesions Polyarteritis Nodosa Treatment Hepatitis C–Associated Glomerular Lesions Etiology, Pathogenesis, and Epidemiology Clinical Manifestations and Pathology Hepatitis C Virus–Associated Membranoproliferative Glomerulonephritis Hepatitis C Virus–Associated Membranous Nephropathy Polyarteritis Nodosa Other Hepatitis C Virus–Associated Glomerular Lesions Natural History and Treatment Human Immunodeficiency Virus–Associated Renal Disease Other Virus-Associated Renal Disease Parasitic Infections Malaria Etiology and Pathogenesis Epidemiology, Clinical Manifestations, and Pathology Filariasis Leishmaniasis Schistosomiasis References Self-assessment Questions 56 Human Immunodeficiency Virus Infection and the Kidney Epidemiology of Human Immunodeficiency Virus Chronic Kidney Disease Developed World The Developing World Glomerular Disorders Human Immunodeficiency Virus–Associated Nephropathy Etiology and Pathogenesis Clinical Manifestations Pathology Diagnosis and Differential Diagnosis Treatment Natural History Human Immunodeficiency Virus Immune Complex Kidney Disease Other Glomerular Disorders Systemic Inflammation and Arterionephrosclerosis Tubular Disorders Current Antiretroviral Drug Regimens and Renal Toxicity Tenofovir Disoproxil Fumarate and Tenofovir Alafenamide Antiretroviral Therapy Dosing in Chronic Kidney Disease End-Stage Renal Disease Hemodialysis Peritoneal Dialysis Kidney Transplantation Evaluation for Kidney Disease Acknowledgment References Self-assessment Questions XI Urologic Disorders 57 Nephrolithiasis and Nephrocalcinosis Nephrolithiasis Epidemiology Pathogenesis Clinical Manifestations Pain Hematuria Loin Pain–Hematuria Syndrome Asymptomatic Stone Disease Clinical Evaluation of Stone Formers Basic Evaluation History. Physical examination. Laboratory findings. Stone analysis. Imaging. Complete Evaluation General Treatment Medical Management Fluid intake. Salt intake. Dietary protein. Dietary calcium. Vitamin D. Specific Types of Stones Calcium Stones Hypercalciuria Etiology. Treatment. Dietary recommendations. Hyperoxaluria Etiology. Treatment of dietary and enteric hyperoxaluria. Treatment of primary hyperoxaluria. Hypocitraturia Distal Renal Tubular Acidosis Hyperuricosuria Uric Acid Stones Epidemiology Etiology and Pathogenesis Treatment Struvite Stones Etiology and Pathogenesis Treatment Cystine Stones Stones Associated With Melamine Exposure Nephrocalcinosis Etiology and Pathogenesis Medullary Nephrocalcinosis Cortical Nephrocalcinosis Clinical Manifestations Treatment References Self-assessment Questions 58 Urinary Tract Obstruction Definitions Etiology and Pathogenesis Congenital Urinary Tract Obstruction Acquired Urinary Tract Obstruction Intrinsic Obstruction Intraluminal obstruction. Intramural obstruction. Extrinsic Obstruction Pathophysiology Changes in Glomerular Function Changes in Tubular Function Histopathologic Changes Epidemiology Clinical Manifestations Pain Lower Urinary Tract Symptoms Urinary Tract Infections Hematuria Changes in Urine Output Abnormal Physical Findings Abnormal Laboratory Findings Obstruction in Neonates or Infants Diagnosis Imaging Ultrasound Plain Abdominal Radiography Intravenous Urography Computed Tomography Magnetic Resonance Urography Retrograde Pyelography Diuresis Renography Pressure Flow Studies Other Evaluations Differential Diagnosis Natural History Treatment General Considerations Specific Therapies Management of Postobstructive Diuresis Future Prospects References Self-assessment Questions 59 Urologic Issues for the Nephrologist Advances in Management of Kidney Stones Improvements in Imaging Conservative (Nonsurgical) Management Acute Surgical Intervention Elective Surgical Intervention Extracorporeal Shock Wave Lithotripsy Percutaneous Nephrolithotomy Open Stone Surgery Ureteroscopy Management of Staghorn Calculus Stones in Transplanted Kidneys Urinary Tract Obstruction General Aspect Acute Management Specific Types of Obstruction Pelviureteral Junction Obstruction Retroperitoneal Fibrosis Malignant Obstruction Benign Ureteral Strictures Bladder Outflow Obstruction Neurologic Diseases of the Lower Urinary Tract Investigation of Hematuria Evaluation of Visible Hematuria Evaluation of Microhematuria Cyclophosphamide Investigation and Management of a Renal Mass Adjunctive Therapy for Renal Cancer Natural History of Renal Impairment After Surgical Treatment of Renal Cancer Renal Cell Carcinoma in von Hippel–Lindau Disease References Self-Assessment Questions XII Tubulointerstitial and Vascular Diseases 60 Acute Interstitial Nephritis Definition Pathogenesis Epidemiology Drug-Induced Acute Interstitial Nephritis Clinical Manifestations Renal Manifestations Extrarenal Manifestations Specific Drug Associations Pathology Diagnosis Identification of the Causative Drug Natural History Treatment Acute Interstitial Nephritis Secondary to Infectious Diseases Acute Interstitial Nephritis Associated With Systemic Diseases Sarcoidosis Sjögren Syndrome Systemic Lupus Erythematosus Immunoglobulin G4–Related Disease Other Systemic Diseases Acute Interstitial Nephritis Associated With Malignant Neoplasms Idiopathic Acute Interstitial Nephritis Acute Interstitial Nephritis in Renal Transplants Self-assessment Questions References 61 Primary Vesicoureteral Reflux and Reflux Nephropathy Definition Classification Epidemiology Etiology and Pathogenesis Reflux Nephropathy Pathology Clinical Manifestations Presentation of Vesicoureteral Reflux Reflux Identified Secondary to Antenatal Hydronephrosis Reflux Identified After a Urinary Tract Infection Vesicoureteral Reflux in a Sibling Presentation of Vesicoureteral Reflux in Women During Pregnancy Other Presentations Reflux Nephropathy Hypertension Proteinuria End-Stage Renal Disease Diagnosis of Vesicoureteral Reflux and Reflux Nephropathy Renal Ultrasound Voiding Cystourethrography DMSA Renal Scintigraphy Magnetic Resonance Imaging Proteinuria as a Marker for Reflux Nephropathy Natural History of Vesicoureteral Reflux and Reflux Nephropathy Treatment Medical Management Antibiotic Prophylaxis Versus Surveillance Only Hypertension and Proteinuria Surgical Management References Self-assessment Questions 62 Chronic Interstitial Nephritis Definition Pathogenesis Epidemiology Pathology Clinical Manifestations Treatment Drug-Induced Chronic Interstitial Nephritis Lithium Nephropathy Definition and Epidemiology Pathogenesis Pathology Clinical Manifestations Lithium-associated diabetes insipidus. Chronic lithium nephropathy. Treatment Analgesic Nephropathy Definition and Epidemiology Pathogenesis and Pathology Clinical Manifestations Diagnosis Treatment Chronic Interstitial Nephritis Caused by Metabolic Disorders Chronic Uric Acid Nephropathy Definition and Epidemiology Pathogenesis Pathology Clinical Manifestations Diagnosis Treatment Hypokalemic Nephropathy Definition and Epidemiology Pathology Clinical Manifestations Diagnosis Treatment Hypercalcemic Nephropathy Definition and Epidemiology Pathology Clinical Manifestations Chronic Interstitial Nephritis Caused by Hereditary Diseases of the Kidney Chronic Interstitial Nephritis Associated With Heavy Metal Exposure Lead Nephropathy Definition and Epidemiology Pathology Clinical Manifestations Diagnosis Treatment Other Heavy Metal–induced Nephropathies Radiation Nephritis Definition and Epidemiology Pathology Clinical Manifestations Treatment Interstitial Nephritis Mediated by Immunologic Mechanisms Sjögren Syndrome Definition and Epidemiology Pathology Clinical Manifestations Treatment Sarcoidosis Definition and Epidemiology Pathogenesis and Pathology Clinical Manifestations Treatment Systemic Lupus Erythematosus Definition and Epidemiology Clinical Manifestations Treatment Inflammatory Bowel Disease IgG4-Related Kidney Disease Definition and Epidemiology Pathogenesis Pathology Clinical Manifestations Treatment Other Forms of Immune-Mediated Interstitial Nephritis Obstructive Uropathy Vascular Diseases Infection-Associated Chronic Interstitial Nephritis References Self-assessment Questions 63 Endemic Nephropathies Mesoamerican Nephropathy Definition and Epidemiology Pathogenesis Pathology Clinical Manifestations Diagnosis, Treatment, and Prognosis Sri Lankan Nephropathy Other Endemic Nephropathies Potential Role of Climate Change and Global Warming References Self-assessment Questions 64 Myeloma and the Kidney Etiology and Pathogenesis of Myeloma Etiology and Pathogenesis of Renal Disease in Myeloma Epidemiology Clinical Presentation Pathology Diagnosis and Differential Diagnosis Natural History Treatment Chemotherapy Adjunctive Therapies Dialysis and Transplantation References Self-assessment Questions XIII Renal Disease and Cancer 65 Onconephrology Cancer and Kidney Disease Acute Kidney Injury Prerenal Acute Kidney Injury Intrarenal Acute Kidney Injury Postrenal Acute Kidney Injury Chronic Kidney Disease Mortality in Cancer Patients With Kidney Disease Important Malignancies Associated With Kidney Disease Multiple Myeloma and Amyloidosis Leukemia and Lymphoma Anticancer Drugs and Kidney Disease Chemotherapeutic Agents Immunotherapies Immune Checkpoint Inhibitors Interferon Therapy Targeted Therapies Antiangiogenesis Therapy B-RAF Inhibitors Anaplastic Lymphoma Kinase Inhibitors Metabolic Complications Tumor Lysis Syndrome Common Electrolyte Disorders Cancer-Related Glomerulonephritis Hematopoietic Stem Cell Transplantation Cancer Therapy in Chronic Kidney Disease and End-Stage Renal Disease References Self-assessment Questions XIV Acute Kidney Injury 66 Pathophysiology and Etiology of Acute Kidney Injury Definition Etiology Overview Pathophysiology and Etiology of Prerenal Acute Kidney Injury Pathophysiology and Etiology of Postrenal Acute Kidney Injury Pathophysiology of Acute Tubular Necrosis Histology Site of Tubular Injury in Acute Tubular Necrosis Hemodynamic Factors in the Development of Acute Tubular Necrosis Impaired Renal Autoregulation Intrarenal Vasoconstriction Tubuloglomerular Feedback Endothelial Cell Injury and the Development of Acute Tubular Necrosis Tubular Epithelial Cell Injury and the Development of Acute Tubular Necrosis Inflammatory Factors in the Development of Acute Tubular Necrosis Recovery Phase Nephrotoxic Agents and Mechanisms of Toxicity Nonsteroidal Antiinflammatory Drugs Acetaminophen (Paracetamol) Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Aminoglycosides Vancomycin Amphotericin B Antiviral Therapy Acyclovir Tenofovir Atazanivir Other Antiviral Agents Hypoglycemic Therapy: SGLT2 Inhibitors Immunosuppressive Agents Calcineurin Inhibitors Other Immunosuppressive Agents Ethylene Glycol Anticoagulation-Related Nephropathy Acute Phosphate Nephropathy Drugs of Abuse Occupational Toxins Heavy Metals Organic Solvents Herbal Remedies Radiocontrast-Induced Nephropathy Other Specific Etiologies of Acute Kidney Injury Heme Pigment Nephropathy Causes of Rhabdomyolysis Causes of Hemoglobinuria Pathogenesis of Heme Pigment Nephropathy Atheroembolic Renal Disease Renal Artery or Vein Occlusion Acute Interstitial Nephritis Thrombotic Microangiopathy Glomerular Disease Specific Clinical Situations Acute Kidney Injury in the Patient With Sepsis Acute Kidney Injury in the Trauma Patient Acute Kidney Injury in the Postoperative Patient After Cardiac Surgery After Vascular Surgery Abdominal Compartment Syndrome Pulmonary-Renal Syndrome Acute Kidney Injury and Liver Disease Acute Kidney Injury in Heart Failure (Cardiorenal Syndrome) Acute Kidney Injury in the Cancer Patient Tumor Lysis Syndrome Hypercalcemia Chemotherapeutic Agents References Self-Assessment Questions 67 Acute Kidney Injury in the Tropics Snakebite Clinical and Laboratory Features Pathology Pathogenesis Management Arthropods Bees Caterpillars Loxosceles Scorpions Natural Medicine Malaria Pathophysiology Clinical Manifestations Leptospirosis Hemorrhagic Fevers Dengue Fever Yellow Fever Ebola Virus Disease References 68 Diagnosis and Clinical Evaluation of Acute Kidney Injury Early Detection of Acute Kidney Injury Diagnostic Approach to Acute Kidney Injury Acute Kidney Injury Versus Chronic Kidney Disease Clinical Assessment Electronic Health Record to Predict Acute Kidney Injury Diagnostic Evaluation Ratio of Blood Urea Nitrogen to Creatinine Urine Volume Urinalysis and Urine Microscopy Fractional Excretion of Sodium and Urea Laboratory Evaluation of Acute Kidney Injury in Systemic Illnesses Imaging Studies Kidney Biopsy Acute Kidney Injury in Specific Settings Acute Tubular Necrosis Acute Interstitial Nephritis Acute Kidney Injury from Intratubular Obstruction Rhabdomyolysis Acute Kidney Injury in Myeloma Contrast-Induced Nephropathy References Self-Assessment Questions 69 Epidemiology and Prognostic Impact of Acute Kidney Injury Incidence of Acute Kidney Injury Risk Factors for Acute Kidney Injury Age Reduced Estimated Glomerular Filtration Rate Proteinuria Hyperuricemia Association Between Acute Kidney Injury and Adverse Outcomes Mortality Chronic Kidney Disease Cardiovascular Risk Health Care Costs Acute Kidney Injury as a Public Health Issue References Self-assessment Questions 70 Prevention and Nondialytic Management of Acute Kidney Injury Risk Assessment Primary Preventive Measures Optimizing Volume and Hemodynamic Status Prevention of Contrast-Induced Acute Kidney Injury Prevention of Drug-Induced and Nephrotoxin-Induced Acute Kidney Injury Amphotericin Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers Nonsteroidal Antiinflammatory Drugs Aminoglycosides Tumor Lysis Syndrome Traumatic and Nontraumatic Rhabdomyolysis Hyperglycemia Remote Ischemic Preconditioning Pharmacologic Approaches N-Acetylcysteine Loop Diuretics and Natriuretics Vasoactive Agents Statins Calcium Channel Blockers Adenosine Antagonists Emerging Agents Summary Treatment of Acute Kidney Injury General Management Fluid and Electrolyte Management Drugs to Promote Recovery From Acute Kidney Injury Loop Diuretics Natriuretics Vasoactive Agents Other Agents Summary Treatment of Acute Kidney Injury Complications Fluid Overload Potassium Disorders Sodium Disorders Calcium, Phosphorus, and Magnesium Disorders Acid-Base Disorders Nutrition References Self-Assessment Questions 71 Dialytic Management of Acute Kidney Injury and Intensive Care Unit Nephrology Organizational Aspects of Acute Renal Replacement Therapy Programs Overview of Acute Renal Replacement Therapies Intermittent Acute Renal Replacement Therapy Techniques for Acute Intermittent Hemodialysis Strategies to Reduce Intradialytic Hemodynamic Instability During Intermittent Hemodialysis Prolonged Intermittent Renal Replacement Therapy Dosage of Intermittent Acute Renal Replacement Therapy Continuous Renal Replacement Therapy Techniques for Continuous Renal Replacement Therapy Mechanisms of Solute Removal Hemodialysis Hemofiltration Hemodiafiltration Specific Techniques Dosage of Continuous Renal Replacement Therapy Technical Aspects of Continuous Renal Replacement Therapy Equipment Hemofilters Replacement Fluids and Dialysate Vascular Access Anticoagulation in Acute Renal Replacement Therapy Modality Choice and Outcomes in Acute Renal Replacement Therapy Acute Renal Replacement Therapy During Mechanical Circulatory Support Technical Aspects of Acute Renal Replacement Therapy During Mechanical Circulatory Support Access Options and Techniques Monitoring and Management of Key Acute Renal Replacement Therapy–Related Issues Drug Dosage in Acute Renal Replacement Therapy References Self-assessment Questions 72 Dialytic Management of Refractory Heart Failure Definition and Scope of the Problem Pathogenesis Venous Congestion Adenosine Anemia Diuretic Resistance and Adverse Effects Treatment General Approach and Limitations Pharmacologic Therapeutic Strategies Diuretics Renin-Angiotensin-Aldosterone System Antagonists Neprilysin Inhibitors Miscellaneous Therapies Medications Under Development Nonrenal Salt and Water Removal Paracentesis Peritoneal Dialysis Conventional Hemodialysis or Hemofiltration Setting the Rate of Fluid Removal Effect of Extracorporeal Ultrafiltration on the Pathophysiology of Heart Failure Effect of Extracorporeal Ultrafiltration on Renal Function Recent Advances in Extracorporeal Techniques Safety and Risks of Extracorporeal Therapies Summary References Self-Assessment Questions 73 Hepatorenal Syndrome Definition Pseudohepatorenal Syndrome Pathophysiology and Pathogenesis Circulatory Dysfunction: Renal and Systemic Hemodynamic Changes Neurohumoral Abnormalities Systemic Inflammation Summary of Pathogenetic Events Epidemiology Clinical Manifestations Pathology Diagnosis and Differential Diagnosis Natural History Prevention and Treatment General Principles in the Prevention of AKI Preventive Measures General Approach to Treatment Pharmacotherapy Transjugular Intrahepatic Portosystemic Shunt Extracorporeal Liver Support Therapy Renal Replacement Therapy Liver Transplantation Therapeutic Algorithm References Self-assessment Questions XV Drug Therapy in Kidney Disease 74 Principles of Drug Therapy, Dosing, and Prescribing in Chronic Kidney Disease and Renal Replacement Therapy Pharmacokinetic Principles Absorption: Bioavailability Distribution Volume of Distribution Plasma Protein Binding Metabolism Elimination Prescribing Principles for Chronic Kidney Disease and Renal Replacement Therapy Initial Assessment and Laboratory Data Estimating Renal Function for Drug Dosage Activity and Toxicity of Metabolites Fraction of Active Drug (and Active or Toxic Metabolite) Excreted Unchanged in Urine Therapeutic Index of the Drug or Metabolites Avoiding Nephrotoxic Drugs Drugs That Aggravate the Metabolic Effects of Renal Impairment Effect of Renal Impairment on Pharmacodynamic or Physiologic Mechanisms Effect of Renal Impairment on the Concentration of Drug at the Site of Action Location of Drug Action Method of Administration Drug Interactions Clinical Condition of the Patient Methods of Dose Reduction Loading Doses Maintenance Doses Interval Method Dose Method Combination Method Ongoing Assessment Therapeutic Drug Monitoring Clinical Response Extracorporeal Drug Losses Hemodialysis Peritoneal Dialysis Continuous Renal Replacement Therapy References Self-Assessment Questions 75 Common Issues in Prescribing in Kidney Disease and Renal Replacement Therapy Analgesics Acetaminophen (Paracetamol) Opioid Analgesics Nonsteroidal Antiinflammatory Drugs Drugs for Neuropathic Pain Antimicrobial Agents Antibacterials Aminoglycosides Aminoglycoside dosage schedules. Aminoglycoside concentration monitoring. Carbapenems. Cephalosporins. Fluoroquinolones. Glycopeptides. Lincosamides. Macrolides. Penicillins. Rifamycins. Tetracyclines. Sulfonamides and trimethoprim. Other antibiotics. Antimycobacterials Antifungals Amphotericin. Azole antifungals. Other antifungals. Antivirals Guanine Analogues Hepatitis B and C Neuraminidase Inhibitors Other Antivirals Immunosuppressants Calcineurin Inhibitors Corticosteroids Antiproliferative and Cytotoxic Agents mTOR Inhibitors Immunosuppressant Antibodies Anticoagulants, Antiplatelet Agents, Thrombolytics, and Hemostatics Unfractionated Heparin Low Molecular Weight Heparins Other Parenteral Anticoagulants Oral Anticoagulants Antiplatelet Drugs Thrombolytics Hemostatics Diuretics Thiazide Diuretics Loop Diuretics Potassium-Sparing Diuretics Antihypertensives Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers β-Blockers Calcium Channel Blockers Other Antihypertensives Antianginal Agents Antiarrhythmics Lipid-Lowering Agents Bile Acid–Binding Resins Statins Fibrates Diabetes Diabetes Management in Peritoneal Dialysis Biguanides Insulins Meglitinides Sulfonylureas SGLT2 Inhibitors DPP-4 Inhibitors Thiazolidinediones Drugs for Thyroid Disorders Mineral and Bone Disorders Phosphate Binders Vitamin D Calcimimetics Dyspepsia, Gastroesophageal Reflux Disease, and Peptic Ulcers Antacids Histamine-2 Antagonists Proton Pump Inhibitors Antiemetics Dopamine Antagonists 5-HT3 Antagonists Aperients and Laxatives Antidiarrheals Drugs for Erectile Dysfunction Phosphodiesterase-5 Inhibitors Intracavernosal Therapy Musculoskeletal Drugs Nonsteroidal Antiinflammatory Drugs Miscellaneous Arthritis Drugs Gout and Hyperuricemia Bisphosphonates Antiepileptics Benzodiazepines Carbamazepine Phenytoin Other Antiepileptics Antiparkinsonian Drugs Antimigraine Drugs Psychotropic Drugs Selective Serotonin Reuptake Inhibitors Tricyclic Antidepressants Monoamine Oxidase Inhibitors Other Antidepressants Antipsychotics Benzodiazepines Anemia Drugs Erythropoiesis-Stimulating Proteins Iron Therapy Antihistamines Vaccines Vitamin Supplementation References Self-assessment Questions 76 Herbal and Over-the-Counter Medicines and the Kidney Herbal Medications and the Kidney Aristolochic Acid Nephropathy Aristolochic Acids Aristolochic Acid Nephropathy Definition Epidemiology Clinical Manifestations Pathology Pathogenesis Diagnosis Treatment Kidney Injury Caused by Other Medicinals Acute Kidney Injury Mushrooms Diagnosis of Acute Kidney Injury Induced by Folk Remedies Treatment Other Renal Complications of Herbal Remedies Hypertension Crystalluria and Nephrocalcinosis Hyperkalemia Urinary Obstruction Renal Toxicity From Contaminants Within Herbal Medicines Herb-Drug Interactions Resulting in Adverse Renal Effects Over-the-Counter Medicines and the Kidney Analgesics Analgesic Nephropathy Proton Pump Inhibitors References Self-assessment Questions XVI Chronic Kidney Disease and the Uremic Syndrome 77 Epidemiology of Chronic Kidney Disease and Dialysis Defining Chronic Kidney Disease Chronic Kidney Disease Staging Classification Based on Estimated Glomerular Filtration Rate Classification Based on Albuminuria Classification Based on Chronic Kidney Disease Cause Rationale for the Chronic Kidney Disease Definition Associations With Adverse Outcomes Persistent Relationships Within Subgroups Global Burden of Chronic Kidney Disease Risk Factors for Chronic Kidney Disease Age Sex and Race Social Determinants Comorbid Conditions Issues With Identifying Chronic Kidney Disease Lack of Awareness Imperfect Biomarkers Errors in Urine Albumin Assessment Outcomes of Chronic Kidney Disease Associations With Adverse Outcomes Variation in Absolute Risk for Adverse Outcomes Dialysis Epidemiology Incidence and Prevalence of Chronic Dialysis Dialysis Practice Patterns Outcomes Epidemiologic Concepts Evidence Quality References Self-assessment Questions 78 Pathophysiology of Disease Progression in Proteinuric and Nonproteinuric Kidney Disease From Glomerular Hypertension to Loss of Size-Selective Properties Podocyte Response to Protein Trafficking Crosstalk of Podocytes With Mesangial and Endothelial Cells Activation of Parietal Epithelial Cells Proximal Tubular Cell Injury Tubular Cell Apoptosis Tubular Cell Phenotypic Changes Interstitial Inflammation and Fibrosis Resident Monocyte and Lymphocyte Activation Fibroblast Activation and Extracellular Matrix Deposition Chronic Hypoxia Primary Chronic Tubulointerstitial Injury Analgesics and Nonsteroidal Antiinflammatory Drugs Aristolochic Acid Autosomal Dominant Polycystic Kidney Disease Conclusions References Self-assessment Questions 79 Retarding Progression of Kidney Disease Level of Glomerular Filtration Rate and the Risk for Natural Progression Proteinuria Magnitude and the Risk for Natural Progression Diagnosis of Natural Progression Monitoring Kidney Disease Progression Monitoring Proteinuria Trends Monitoring Glomerular Filtration Rate Trends Role of Cystatin C in Estimating Glomerular Filtration Rate for Clinical Management Glomerular Filtration Rate Trajectories in Chronic Kidney Disease Therapy for Natural Progression Level 1 Recommendations to Slow Natural Progression Control Blood Pressure Renin-Angiotensin System Blockade Combination Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Therapy Renin Inhibitor Therapy Avoid Dihydropyridine Calcium Channel Blockers Control Protein Intake Level 2 Recommendations to Slow Natural Progression Restrict Salt Intake and Avoid Diuretic Therapy Nondihydropyridine Calcium Channel Blocker Therapy Control Each Component of the Metabolic Syndrome Aldosterone Antagonist Therapy β-Blocker Therapy Control Serum Phosphorous Smoking Cessation Control Hyperuricemia Avoid Anticoagulant-Related Nephropathy Alkali Therapy Monitor Serum Creatinine in Patients Receiving a Proton Pump Inhibitor Correct Vitamin D Deficiency Avoid or Minimize Nonsteroidal Antiinflammatory Drug Use References Self-Assessment Questions 80 Clinical Evaluation and Management of Chronic Kidney Disease Definitions Clinical Presentation Evaluation of Chronic Kidney Disease Establishing Chronicity Assessment of Glomerular Filtration Rate Assessment of Proteinuria Kidney Imaging Further Investigations Predicting Prognosis Monitoring and Defining Progression When to Refer to the Nephrologist Prevention of Chronic Kidney Disease Progression Hypertension Dietary Advice Management of Complications of Chronic Kidney Disease Anemia Bone and Mineral Metabolism Metabolic Acidosis Cardiovascular Risk Risk for Infections Care of the Patient With Progressive Chronic Kidney Disease Chronic Kidney Disease and Risk of Acute Kidney Injury Timing the Initiation of Renal Replacement Therapy Conservative Management References Self-Assessment Questions 81 Cardiovascular Disease in Chronic Kidney Disease Epidemiology Prevalence of Cardiovascular Complications in Chronic Kidney Disease Cardiovascular Disease Is Present Before the Start of Renal Replacement Therapy Racial and International Differences in Cardiovascular Disease Prevalence Reverse Epidemiology Etiology and Risk Factors Traditional Risk Factors Age, Gender, and Smoking Diabetes Mellitus Hypertension Dyslipidemia Insulin Resistance and Atherosclerosis Nontraditional and Uremia-Specific Risk Factors Oxidative Stress Inflammation Gut Dysbiosis Endothelial Dysfunction Anemia Secondary Hyperparathyroidism and Mineral Metabolism Cardiovascular Calcification Advanced Glycation End-Products Dialysis Modality Clinical Manifestations and Natural History Chest Pain, Coronary Heart Disease, and Acute Myocardial Infarction Peripheral Arterial Disease Cerebrovascular Disease and Atrial Fibrillation Left Ventricular Remodeling and Hypertrophy Extracellular Volume Overload Pericarditis Autonomic Dysfunction Valvular Disease Infective Endocarditis Sudden Cardiac Arrest Diagnosis and Differential Diagnosis Blood Pressure Measurements Electrocardiography and Echocardiography Stress Tests and Screening Renal Transplant Candidates Coronary Angiography Imaging of Vascular Calcification Biomarkers Treatment and Prevention of Cardiovascular Disease Risk Factor Reduction Lifestyle Factors and Smoking Weight and Diet Hypertension and Coronary Heart Disease Diabetes Mellitus Dyslipidemia Volume Anemia Inflammation Oxidative Stress Chronic Kidney Disease–Mineral Bone Disorder Revascularization References Self-Assessment Questions 82 Anemia in Chronic Kidney Disease Pathogenesis Epidemiology and Natural History Diagnosis and Differential Diagnosis Clinical Manifestations Treatment Erythropoiesis-Stimulating Agents Epoetin Therapy Darbepoetin Alfa Methoxy Polyethylene Glycol–Epoetin Beta (C.E.R.A.) Adverse Effects of the Erythropoiesis-Stimulating Agents Peginesatide Hypoxia-Inducible Transcription Factor Stabilizers Initiation of and Maintenance Therapy With Erythropoiesis-Stimulating Agents Hyporesponsiveness to Erythropoiesis-Stimulating Agents Iron Management References Self-assessment Questions 83 Other Blood and Immune Disorders in Chronic Kidney Disease Immune Dysfunction Bacterial Infections Viral Infections Vaccinations in Chronic Kidney Disease Inflammation Causes of Inflammation Consequences of Inflammation Immune Cell Abnormalities Monocytes T Lymphocytes B Lymphocytes Granulocytes Platelet Dysfunction and Platelet Inhibitors in Chronic Kidney Disease Hemorrhagic Diathesis and Uremic Platelet Dysfunction Treatment of Uremic Platelet Dysfunction Desmopressin Cryoprecipitate Tranexamic Acid Recombinant Activated Factor VII Estrogens Implications for Antiplatelet Agent Therapy Circulating Coagulation Factors Therapeutic Intervention References Self-Assessment Questions 84 Bone and Mineral Disorders in Chronic Kidney Disease Definition Epidemiology Pathogenesis Osteitis Fibrosa: Hyperparathyroidism—High-Turnover Renal Bone Disease Abnormalities of Calcium Metabolism Abnormalities of Phosphate Metabolism Abnormalities of Vitamin D Metabolism Abnormalities of Parathyroid Gland Function Abnormal Skeletal Response to Parathyroid Hormone Clinical Manifestations of High-Turnover Renal Osteodystrophy Diagnosis and Differential Diagnosis Serum Biochemistry Parathyroid Hormone Vitamin D Metabolites Markers of Bone Formation and Bone Resorption Radiology of the Skeleton Measurements of Bone Density Bone Biopsy Treatment of High-Turnover Bone Disease Prevention of Hypocalcemia Control of Phosphate Dietary Phosphate Restriction Phosphate Binders Use of Vitamin D Metabolites Role of Calcimimetics Role of Parathyroidectomy Synthesis of Therapeutic Strategies Low-Turnover Renal Bone Disease Pathogenesis of Adynamic Bone Disease Diagnosis and Differential Diagnosis Serum Biochemistry Bone Biopsy Radiology and Measurements of Bone Density Treatment of Adynamic Bone Disease Osteoporosis in Chronic Kidney Disease Pathogenesis of Osteoporosis in Chronic Kidney Disease Diagnosis and Differential Diagnosis Treatment of Osteoporosis in Chronic Kidney Disease β2-Microglobulin–Derived Amyloid Pathogenesis Epidemiology Clinical Manifestations and Diagnosis Diagnosis Treatment and Prevention References Self-assessment Questions 85 Neurologic Complications of Chronic Kidney Disease Uremic Encephalopathy Pathogenesis Clinical Manifestations Diagnosis and Differential Diagnosis Treatment Peripheral Neuropathy Autonomic Neuropathy Cranial Neuropathies Sleep Disorders Restless Legs Syndrome (Ekbom Syndrome) Neurologic Syndromes Associated With Renal Replacement Therapy References Self-assessment Questions 86 Gastroenterology and Nutrition in Chronic Kidney Disease Gastrointestinal Problems in Chronic Kidney Disease Gastrointestinal Disease in Chronic Kidney Disease Oral Disease in Chronic Kidney Disease Gastroesophageal Reflux Disease and Esophagitis Peptic Ulcer Disease, Gastritis, and Duodenitis Delayed Gastric Emptying and Gastroparesis Large Bowel Disorders Gastrointestinal Pseudoobstruction Vascular Disease of the Gastrointestinal Tract Gastrointestinal Hemorrhage Clostridium difficile Infection Acute Pancreatitis Acute Abdomen Combined Gastrointestinal and Renal Diseases Diabetes Systemic Vasculitis Systemic Amyloidosis Autosomal Dominant Polycystic Kidney Disease Inflammatory Bowel Disease Celiac Disease Drugs and Gastrointestinal Disease in Chronic Kidney Disease Specific Gastrointestinal Complications of Renal Replacement Therapy Idiopathic Dialysis-Related Ascites Peritoneal Dialysis–Related Gastrointestinal Conditions Dialysis-Related Amyloidosis Transplantation and Gastrointestinal Disturbance Nutrition in Chronic Kidney Disease Malnutrition: Protein-Energy Wasting Obesity Paradox in Chronic Kidney Disease Assessment of Nutritional Status Estimation of Intake Body Mass Index Body Composition Visceral Protein Tools to Diagnose Protein-Energy Wasting and Assess Nutritional Status Nutritional Guidelines Hyperlipidemia Hypertension Vitamins, Minerals, and Trace Elements Monitoring and Treatment Enteral Supplementation Supplementation of Dialysate Fluids Appetite Stimulants Gut-Targeted Therapeutics Metabolic Acidosis Exercise Potassium Binders References Self-Assessment Questions 87 Dermatologic Manifestations of Chronic Kidney Disease Uremic Pruritus Clinical Manifestations Pathogenesis Treatment Optimizing Dialysis and Mineral Metabolism Therapy Skin Emollients Antihistaminic Drugs Phototherapy 5-Hydroxytryptamine Antagonist Opioid Receptor Agonists Gabapentin Immunomodulators and Immunosuppressive Agents Long-Chain Essential Fatty Acids Capsaicin Oral Activated Charcoal Miscellaneous Bullous Dermatoses Calcific Uremic Arteriolopathy (Calciphylaxis) Definition Epidemiology, Pathogenesis, and Risk Factors Clinical Manifestations Pathology Diagnosis and Differential Diagnosis Natural History Prevention and Treatment Nephrogenic Systemic Fibrosis Definition Pathogenesis Epidemiology Clinical Manifestations and Natural History Pathology Diagnosis and Differential Diagnosis Treatment and Prevention References Self-Assessment Questions 88 Acquired Cystic Kidney Disease and Malignant Neoplasms Definition Pathogenesis Epidemiology Clinical Manifestations Acquired Cystic Kidney Disease–Associated Renal Cell Carcinoma Pathology Diagnosis and Differential Diagnosis Natural History Treatment Cancer in Dialysis Patients References Self-assessment Questions XVII Geriatric and Palliative Nephrology 89 Geriatric Nephrology Aging-Associated Structural Changes Anatomic Changes Glomerular Changes Tubular and Interstitial Changes Vascular Changes Aging-Associated Changes in Renal Function Glomerular Filtration Rate Renal Plasma Flow Assessment of Renal Function in the Elderly Albuminuria Hematuria Prevalence of Chronic Kidney Disease in the Elderly Risk Factors for Chronic Kidney Disease in the Elderly Pathogenesis of Age-Related Chronic Kidney Disease Fluid and Electrolytes in Aging Sodium Balance and Hypertension Osmoregulation and Water Handling Other Tubular Defects and Electrolyte Problems Endocrine Function and Renal Hormones Clinical Manifestations General Considerations Glomerular Diseases Renovascular and Atheroembolic Disease Diabetic Nephropathy Acute Kidney Injury Nephrotoxicity and Drug Dosage End-Stage Renal Disease and Renal Replacement Therapy Depression in Elderly Patients With Kidney Diseases References Self-assessment Questions XVIII Dialytic Therapies 90 Approach to Renal Replacement Therapy Prediction of End-Stage Renal Disease Multidisciplinary Care in Advanced Chronic Kidney Disease Predialysis Education Programs Education About Transplantation When Should Dialysis Be Started? Limitations of a Purely Clinical Approach to the Initiation of Dialysis Limitations of a Purely Laboratory Results–Based Approach to the Initiation of Dialysis The Choice Between Peritoneal Dialysis and Hemodialysis Contraindications to Peritoneal Dialysis Fresh Intraabdominal Foreign Body Body Size Limitations and Intolerance of Intraabdominal Fluid Volume Bowel Disease and Other Sources of Infection Severe Malnutrition or Morbid Obesity Contraindications to Hemodialysis Home Hemodialysis Hemodialysis or Hemodiafiltration Patient Choice of Hemodialysis or Peritoneal Dialysis Economic Factors Physician Preference The Importance of Dialysis Access The Decision Whether to Offer Renal Replacement Therapy The Availability of Dialysis Facilities Selection of Patients by Physicians and Nephrologists Rationing Versus Rational Dialysis Treatment Predictive Factors Advising Patients About Prognosis on Dialysis Conservative Kidney Care The Patient Who Does Not Want Dialysis Disagreement About a Decision to Dialyse Management of Disruptive Patients on Dialysis Resuscitation and Withdrawal of Dialysis Cardiopulmonary Resuscitation Withdrawal of Dialysis References Self-assessment Questions 91 Vascular Access for Dialytic Therapies Evaluation of the Patient for Vascular Access Primary Autogenous Vascular Access Radiocephalic Arteriovenous Fistula Nonmaturation of Radiocephalic Arteriovenous Fistula Secondary Autogenous Vascular Access Forearm Cephalic and Basilic Vein Transposition and Elevation Elbow and Upper Arm Cephalic Vein Arteriovenous Fistula Upper Arm Basilic Vein Arteriovenous Fistula Nonautogenous Prosthetic Vascular Access Measures to Improve Graft Patency Pharmacologic Approaches for Access Patency Lower Limb Vascular Access Vascular Access Complications Nonmaturation of Arteriovenous Fistulas Stenosis and Thrombosis Autogenous Fistula Stenosis or Thrombosis Arteriovenous Graft Stenosis or Thrombosis Central Venous Obstruction Endovascular Intervention Surgical Intervention Vascular Access–Induced Ischemia Diagnosis of Ischemia Endovascular and Surgical Management of Ischemia Central Venous Catheter Access Nontunneled Catheters Tunneled Catheters Catheter Infection Infections Involving Temporary Catheters Exit Site Versus Tunnel Tract Infections Catheter-Associated Bacteremia Catheter Removal Prevention of Infection Catheter Obstruction References Self-assessment Questions 92 Diagnostic and Interventional Nephrology Ultrasound Applications and Limitations of Ultrasound Chronic Kidney Disease Acute Kidney Injury Renal Transplantation Renal Biopsy Urinary Bladder Hemodialysis Access Renovascular Ultrasound Equipment Procedure Training and Certification Peritoneal Dialysis Catheters Catheter Insertion Burying (Embedding) the Peritoneal Dialysis Catheter Complications of Peritoneal Dialysis Catheter Insertion Catheter Repositioning Removal of Peritoneal Dialysis Catheters Training and Certification Tunneled Hemodialysis Catheters Tunneled Catheter Insertion Catheter Dysfunction Catheter Exchange and Fibrin Sheath Removal Training and Certification Procedures on Arteriovenous Fistulas and Grafts Percutaneous Balloon Angioplasty Percutaneous Thrombectomy Stents Training and Certification References Self-Assessment Questions 93 Hemodialysis Dialysis System Dialyzer Designs and Membranes Safety Monitors Anticoagulation Dialysate Fluid Water and Water Treatment Dialysate Solution Biocompatibility Hemofiltration and Hemodiafiltration Modes of Hemofiltration and Hemodiafiltration Postdilution Hemodiafiltration Predilution Hemodiafiltration Mixed Dilution Hemodiafiltration Middilution Hemodiafiltration Uremic Toxins and Their Removal by Hemodialysis Additional Devices and Technologies Relative Blood Volume Monitoring Ultrafiltration Profiling Sodium Profiling Online Clearance Monitoring Blood Temperature Monitoring and Dialysate Cooling Intradialytic Oxygen Measurement Bioimpedance Home Hemodialysis Dialysis Machine Choice and Other Equipment Water Preparation, Standards, and Plumbing Safety Wearable Artificial Kidney References Self-assessment Questions 94 Hemodialysis Assessment of Dialysis Dose Markers of Uremic Toxin Removal by Renal Replacement Therapy Urea Removal Intradialytic Urea Kinetics Urea Reduction Ratio Single-Pool Kt/V (spKt/V) and Equilibrated Double-Pool Kt/V (eKt/V) Weekly Dialysis Dose and Weekly Standard: Kt/V (stdKt/V) Middle Molecule Removal Phosphate Removal Prescription of Hemodialysis Hemodialysis Dose Hemodiafiltration Dose Treatment Time and Frequency Dialysate Composition Sodium Potassium Calcium Bicarbonate Magnesium Fluid Status and Ultrafiltration Rate Dialysis Adequacy Prevention of Intradialytic Hypotension Preservation of Residual Renal Function Maintenance or Improvement of Nutritional Status Dialysis Adequacy in the Elderly References Self-Assessment Questions 95 Acute Complications During Hemodialysis Cardiovascular Complications Intradialytic Hypotension Intradialytic Hypertension Cardiac Arrhythmias Sudden Death Pericarditis Dialysis-Associated Steal Syndrome Neuromuscular Complications Muscle Cramps Restless Legs Syndrome Dialysis Disequilibrium Syndrome Seizures Headache Hematologic Complications Complement Activation and Dialysis-Associated Neutropenia Intradialytic Hemolysis Hemorrhage Thrombocytopenia Pulmonary Complications Dialysis-Associated Hypoxemia Technical Malfunctions Air Embolism Incorrect Dialysate Composition Hypernatremia Hyponatremia Metabolic Acidosis Metabolic Alkalosis Temperature Monitor Malfunction Blood Loss Clotting of Dialysis Circuit Dialysis Reactions Anaphylactic and Anaphylactoid Reactions Clinical Presentation First-Use Reactions Reuse Reactions Bradykinin-Mediated Reactions Drug-Induced Reactions Treatment and Prevention Mild Reactions Fever and Pyrogenic Reactions Investigation of a Dialysis Pyrogenic Outbreak Miscellaneous Complications Postdialysis Fatigue Pruritus Genitourinary Problems Hearing and Visual Loss References Self-assessment Questions 96 Peritoneal Dialysis Advantages and Limitations of Peritoneal Dialysis Principles of Peritoneal Dialysis Three-Pore Model Fluid Kinetics Effective Peritoneal Surface Area Peritoneal Access Techniques of Peritoneal Dialysis Peritoneal Dialysis Fluids Electrolyte Concentration Osmotic Agents Assessments of Peritoneal Solute Transport and Ultrafiltration Small-Solute Removal Large-Solute Removal Ultrafiltration Peritoneal Membrane Function Peritoneal Equilibration Test Mini–Peritoneal Equilibration Test Double–Mini–Peritoneal Equilibration Test Residual Renal Function Adequacy Small-Solute Clearance Fluid Balance Management of Fluid Overload Nutrition Outcome of Peritoneal Dialysis References Self-assessment Questions 97 Complications of Peritoneal Dialysis Catheter Malfunction Optimal Timing and Placement of the Peritoneal Dialysis Catheter Catheter Function: Inflow Catheter Function: Outflow Fibrin in the Dialysate Fluid Leaks External Leaks Internal Leaks Hydrothorax Pain Related to Peritoneal Dialysis Inflow Pain Outflow Pain Blood-Stained Dialysate Infectious Complications Peritonitis Diagnosis of Peritonitis Treatment of Peritonitis Fungal Peritonitis Relapsing Peritonitis Culture-Negative Peritonitis Exit Site Infection Reduced Ultrafiltration and Ultrafiltration Failure Definition and Significance of Ultrafiltration Failure Establishing the Causes of Ultrafiltration Failure Fast Peritoneal Solute Transport Rate–Related Ultrafiltration Failure: Diagnosis and Management Low Osmotic Conductance–Related Ultrafiltration Failure: Diagnosis and Management Changes in Peritoneal Structure and Function Preventing Membrane Injury Encapsulating Peritoneal Sclerosis Nutritional and Metabolic Complications Undernutrition Acid-Base Status Lipids and Obesity References Self-assessment Questions 98 Extracorporeal Therapies for Drug Overdose and Poisoning When Should Extracorporeal Removal Be Considered? Molecular Weight Protein Binding Volume of Distribution Solute Compartmentalization Contribution of Extracorporeal Toxin Relative to Endogenous Clearance Treatment Modalities Intermittent Hemodialysis, Hemofiltration, and Hemodiafiltration Peritoneal Dialysis Continuous Renal Replacement Therapy Hemoperfusion Other Modalities Extracorporeal Therapy for Specific Drugs and Poisons Alcohols β-Blockers Lithium Metformin Salicylates Theophylline Valproate Tricyclic Antidepressant Drugs Thallium Barbiturates Acetaminophen Carbamazepine Phenytoin Digoxin References Self-Assessment Questions 99 Plasma Exchange Techniques Complications Mechanisms of Action Indications for Plasma Exchange Anti–Glomerular Basement Membrane Antibody Disease (Goodpasture Disease) Recommendation Small-Vessel Vasculitis Recommendation Other Crescentic Glomerulonephritis Recommendation Focal Segmental Glomerulosclerosis Thrombotic Microangiopathies Infection-Associated Hemolytic-Uremic Syndrome Thrombotic Thrombocytopenic Purpura Atypical Hemolytic Uremic Syndrome Recommendation Systemic Lupus Recommendation Cryoglobulinemia Myeloma Recommendation Transplantation Antibody-Mediated Rejection Anti–Human Leukocyte Antigen Antibodies ABO-Incompatible Renal Transplantation Recurrent Focal Segmental Glomerulosclerosis Recommendations References Self-assessment Questions XIX Transplantation 100 Immunologic Principles in Kidney Transplantation Ischemia/Reperfusion Injury Antigen Presentation Antigen-Presenting Cells T Cell Ontogeny and Major Histocompatibility Complex Specificity Pathways of Allorecognition Major Histocompatibility Complex Human Leukocyte Antigen Typing and Transplantation Human Leukocyte Antigen Inheritance Non–Major Histocompatibility Antigens T Cell Activation T Cell Receptor CD4 and CD8 Coreceptors T Cell Receptor Engagement of Antigen: Signal 1 T Cell Costimulation: Signal 2 T Cell Clonal Expansion and Differentiation Memory Cells Effector Functions Cytologic T Lymphocyte Differentiation and Function Macrophage Activation The Humoral Immune Response Natural Killer Lymphocytes Termination of the Immune Response Allograft Rejection Recruitment of Cells into the Interstitium of Kidney Allografts Acute T Cell–Mediated Rejection Acute Antibody-Mediated Rejection Chronic Rejection Transplantation Tolerance References Self-Assessment Questions 101 Immunosuppressive Medications in Kidney Transplantation Small-Molecule Drugs Corticosteroids Mechanism of Action Pharmacokinetics Side Effects Calcineurin Inhibitors Mechanism of Action Pharmacokinetics, Monitoring, and Drug Interactions Side Effects Mycophenolate Mechanism of Action Pharmacokinetics Side Effects Azathioprine Mammalian Target of Rapamycin Inhibitors Mechanism of Action Pharmacokinetics Side Effects Dihydroorotate Dehydrogenase Inhibitors Biologic Agents Polyclonal Antilymphocyte Sera Humanized Monoclonal Anti-CD52 Antibody Monoclonal Anti-CD25 Antibody B Cell–Depleting Monoclonal Anti-CD20 Antibody Intravenous Immunoglobulin Belatacept Other Agents Used in Transplantation Bortezomib Eculizumab References Self-assessment Questions 102 Evaluation and Preoperative Management of Kidney Transplant Recipient and Donor Recipient Evaluation Cardiovascular Disease Coronary Heart Disease and Left Ventricular Dysfunction Cerebrovascular Disease Peripheral Vascular Disease Cancer Infectious Complications Obesity Recurrent Disease Gastrointestinal Disease Genitourinary Disorders Pulmonary Disease Psychosocial Issues Presence of Multiple Comorbidities Reevaluation of Patients on the Waiting List Donor Evaluation Deceased Donors Classification of the Deceased Donor Evaluation of the Deceased Donor Deceased Donor Management Before Transplantation Living Donors Mortality and Morbidity Evaluation of the Living Donor Assessment of Renal Function Hypertension and Proteinuria in the Living Donor Obesity and Abnormal Glucose Tolerance in the Living Donor Renal Abnormalities in the Living Donor Malignancy Cardiovascular and Pulmonary Disease Compatibility and Immunologic Considerations Blood Group Compatibility Human Leukocyte Antigen Compatibility Assessing Human Leukocyte Antigen Sensitization References Self-Assessment Questions 103 Kidney Transplantation Surgery Sources of Kidneys for Transplantation Donation Before Cardiac Death Donors Donation After Cardiac Death Donors Donation After Cardiac Death Protocol Uncontrolled Donation After Cardiac Death Donors Controlled Donation After Cardiac Death Donors Living Kidney Donors Preoperative Imaging Minimal Access (Laparoscopic) Donor Nephrectomy Transperitoneal Laparoscopic Donor Nephrectomy Hand-Assisted Laparoscopic Donor Nephrectomy Retroperitoneoscopic Operative Technique Contraindications to Minimal Access Donor Nephrectomy Effect of Pneumoperitoneum Graft Function and Acute Rejection Technical Issues Postoperative Recovery Choice of Donor Operative Technique Renal Preservation Renal Transplantation Procedure Vascular Anastomosis Urinary Drainage Alternative Techniques of Urinary Reconstruction Drainage and Wound Closure Postoperative Course Surgical Complications of Renal Transplantation Wound Infection Wound Dehiscence Vascular Complications Bleeding From Vessels in the Renal Hilum Anastomotic Hemorrhage Renal Artery Thrombosis Renal Vein Thrombosis Transplant Renal Artery Stenosis Lymphocele Urologic Complications Urinary Leaks Ureteral Obstruction Complications in the Transplant Bed Transplant Nephrectomy References Self-assessment Questions 104 Prophylaxis and Treatment of Kidney Transplant Rejection Definition Antibody-Mediated Rejection T Cell–Mediated Rejection Borderline Rejection Clinical Manifestations Prophylaxis and Prevention Prophylaxis Prevention of Acute T Cell–Mediated Rejection: Induction Therapy Prevention of Acute Antibody-Mediated Rejection: Desensitization Maintenance Therapy for Prevention of Acute Rejection Calcineurin Inhibitors in the Prevention of Acute Rejection Antiproliferative Agents in the Prevention of Acute Rejection Acute Rejection Rates in Calcineurin-Sparing and Corticosteroid-Sparing Immunosuppression Regimens Treatment Acute T Cell–Mediated Rejection Acute Antibody-Mediated Rejection Chronic Rejection (T Cell–Mediated and/or Antibody-Mediated) Prognosis Summary and Recommendations References Self-assessment Questions 105 Medical Management of the Kidney Transplant Recipient Infectious Diseases Immunizations Before and After Transplantation Infectious Causes Risk Factors for Post-Transplant Infectious Complications Donor-Derived Infections Month 1 After Transplantation Months 1 to 6 After 6 Months Management and Prophylactic Therapy for Selected Infections Cytomegalovirus Infection Clinical Manifestations Immunomodulating Effects of Cytomegalovirus Infection Risk Factors for Cytomegalovirus Infection Prevention Treatment Candida Infections BK Virus Infection Other Infections Gastrointestinal Disease Drug-Related Gastrointestinal Complications Infections Cytomegalovirus Infection Herpes Simplex Virus Infection Fungal Infections Helicobacter Infection Diarrhea and Colon Disorders Transplant-Associated Malignancy Post-Transplant Lymphoproliferative Disorder Risk Factors Type of organ transplant. Age. Type of immunosuppression Calcineurin inhibitors. mTOR inhibitors. Antimetabolites. Induction agents. Belatacept. Viral infection Epstein-Barr virus. Hepatitis C virus. Miscellaneous. Clinical Manifestations Treatment Viral Load Monitoring and Preemptive Strategies Skin Cancer Management of Immunosuppressive Therapy in Post-Transplantation Malignancy References Self-Assessment Questions 106 Medical Management of the Kidney Transplant Recipient Cardiovascular Disease Conventional Cardiovascular Disease Risk Factors Post-Transplantation Hypertension Post-Transplantation Dyslipidemia Statin Therapy Nonstatin Drug Therapy Management of Hypertriglyceridemia Drug therapy for Hypertriglyceridemia Fibrates. Ezetimibe. Bile acid resins. Niacin. Summary Post-Transplantation Diabetes Mellitus (New-Onset Diabetes After Transplantation) Risk Factors Management of Post-Transplantation Diabetes Mellitus Therapeutic Interventions Nonpharmacologic Management Modification of Immunosuppression Pharmacologic Treatment Cigarette Smoking Obesity Unconventional Cardiovascular Disease Risk Factors Proteinuria Belatacept Use Common Laboratory Abnormalities Anemia Leukopenia and Thrombocytopenia Erythrocytosis Hyperkalemia Hypophosphatemia Hypercalcemia Hypomagnesemia Abnormal Liver Function Tests Bone and Mineral Metabolism After Kidney Transplantation Osteoporosis Avascular Necrosis Prevention and Management of Post-Transplantation Bone Diseases Gout Outpatient Care References Self-Assessment Questions 107 Chronic Allograft Injury Definitions and Epidemiology Pathogenesis: Nonimmunologic Factors Donor Age, Donor Gender, and Donor-Recipient Size Mismatching Ischemia/Reperfusion Injury and Delayed Graft Function BK Virus Nephropathy Calcineurin Inhibitor Toxicity Recurrent and De Novo Glomerular Diseases Cardiovascular Risk Factors Pathogenesis: Immunological Factors T Cell–Mediated Rejection Antibody-Mediated Rejection Insufficient Immunosuppression and Nonadherence to Medication Clinical Manifestations Pathology Diagnosis and Differential Diagnosis Prevention of Antibody-Mediated Allograft Injury Treatment of Chronic Allograft Injury References Self-Assessment Questions 108 Recurrent Disease in Kidney Transplantation Definitions Recurrent Glomerulonephritis Recurrence of Specific Glomerular Diseases Immunoglobulin A Nephropathy and IgA Vasculitis (Henoch-Schonlein Purpura) Membranous Nephropathy Focal Segmental Glomerulosclerosis Membranoproliferative Glomerulonephritis Membranoproliferative Glomerulonephritis Type I C3 Glomerulopathy Membranoproliferative Glomerulonephritis Type III Congenital Nephrotic Syndrome Antineutrophil Cytoplasmic Antibody–Associated Pauci-immune Vasculitis Anti–Glomerular Basement Membrane Disease Lupus Nephritis Thrombotic Microangiopathy and Hemolytic Uremic Syndrome Scleroderma Amyloid, Light-Chain Disease, and Fibrillary and Immunotactoid Glomerulopathies Amyloidosis Light-Chain Nephropathy Fibrillary and Immunotactoid Glomerulopathies Recurrence of Metabolic Diseases Affecting the Kidney Transplant Diabetes Mellitus Primary Hyperoxaluria Fabry Disease Recurrence of Virus-Associated Nephropathies and Tumors in the Transplanted Kidney References Self-Assessment Questions 109 Outcomes of Renal Transplantation Methods of Measurement and Analysis Types of Outcome Analyses Survival Analyses Half-Life Analysis Graft Survival Randomized Controlled Trials Cohort Studies Meta-Analyses Case Reports Expert Opinion Guidelines Qualitative Studies Economic Analysis Types of Data Collection Registries International Statistical Collections Randomized Controlled Trials: Data Collection Structured Reviews Variables Affecting the Outcomes of Transplantation Deceased Donor Variables Living Donor Variables Other Donor Variables Recipient Variables Effects of Immunosuppression on Transplant Outcome Transplant Center Variables Transplantation Matching Variables Outcomes Inform the Recipient Decision References Self-Assessment Questions 110 Pancreas and Islet Transplantation Patient Selection Criteria for Pancreas or Islet Transplantation Indications for Transplantation Medical Evaluation Pancreas Transplantation Patient and Graft Survival Surgical Procedure Immunosuppression Graft Monitoring Antimicrobial Prophylaxis Metabolic Monitoring Surgical Complications Nonsurgical Complications Urologic Complication Urinary Tract Infections Enteric Conversion Late Complications Impact of Pancreas Transplantation on Diabetic Complications Hypoglycemia Hyperglycemia Microvascular Complications Retinopathy Neuropathy Nephropathy Vascular Disease Quality of Life and Social Issues Pregnancy After Pancreas Transplantation Islet Transplantation Islet After Kidney Transplantation Technique of Islet Transplantation Medical Complications Glycemic Control and Insulin Independence Immunosuppressive Regimens References Self-assessment Questions 111 Kidney Disease in Liver, Cardiac, Lung, and Hematopoietic Stem Cell Transplantation Generic Issues of Kidney Disease in Nonrenal Solid Organ Transplantation Use of Serum Creatinine and Derived Equations to Estimate Glomerular Filtration Rate Nephrotoxicity of Calcineurin Inhibitors Acute Kidney Injury in the Immediate Pretransplant Period Acute Kidney Injury in the Early Post-Transplant Period Acute Kidney Injury in the Late Post-Transplantation Period Chronic Kidney Disease Management of Chronic Kidney Disease BK Virus Nephropathy Kidney Disease in Liver Transplantation Kidney Disease Before Cardiac Transplantation Kidney Disease in Lung Transplantation Kidney Disease in Hematopoietic Stem Cell Transplantation Acute Kidney Injury After Hematopoietic Stem Cell Transplantation Hepatic Sinusoidal Obstructive Syndrome Management of Acute Kidney Injury After Hematopoietic Stem Cell Transplantation Chronic Kidney Disease After Hematopoietic Stem Cell Transplantation Thrombotic Microangiopathy Calcineurin Inhibitor and Sirolimus Nephrotoxicity Glomerular Disease Management of Hematopoietic Stem Cell Transplantation–Related Chronic Kidney Disease References Self-assessment Questions XX Palliative Nephrology 112 Palliative Nephrology Prognosis Communication and Shared Decision Making Conservative Care Dialysis Withdrawal Symptom Control and Management of Last Days References Self-Assessment Questions Answers Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18 Chapter 19 Chapter 21 Chapter 23 Chapter 24 Chapter 25 Chapter 26 Chapter 27 Chapter 28 Chapter 29 Chapter 30 Chapter 32 Chapter 33 Chapter 34 Chapter 35 Chapter 36 Chapter 37 Chapter 38 Chapter 39 Chapter 40 Chapter 41 Chapter 42 Chapter 43 Chapter 44 Chapter 45 Chapter 46 Chapter 47 Chapter 48 Chapter 49 Chapter 50 Chapter 51 Chapter 52 Chapter 53 Chapter 54 Chapter 55 Chapter 56 Chapter 57 Chapter 58 Chapter 59 Chapter 60 Chapter 61 Chapter 62 Chapter 63 Chapter 64 Chapter 65 Chapter 66 Chapter 68 Chapter 69 Chapter 70 Chapter 71 Chapter 72 Chapter 73 Chapter 74 Chapter 75 Chapter 76 Chapter 77 Chapter 78 Chapter 79 Chapter 80 Chapter 81 Chapter 82 Chapter 83 Chapter 84 Chapter 85 Chapter 86 Chapter 87 Chapter 88 Chapter 89 Chapter 90 Chapter 91 Chapter 92 Chapter 93 Chapter 94 Chapter 95 Chapter 96 Chapter 97 Chapter 98 Chapter 99 Chapter 100 Chapter 101 Chapter 102 Chapter 103 Chapter 104 Chapter 105 Chapter 106 Chapter 107 Chapter 108 Chapter 109 Chapter 110 Chapter 111 Chapter 112 Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Inside Back Cover
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