Comprehensive Clinical Nephrology: Expert Consult - Online and Print, Fourth Edition

Cover......Page 1
Front Matter......Page 2
ISBN    9780323058766......Page 4
Copyright......Page 5
Dedication......Page 6
Contributors......Page 8
Preface......Page 18
Microvasculature......Page 21
Renal Glomerulus (Renal Corpuscle)......Page 22
Glomerular Basement Membrane......Page 23
Visceral Epithelium (Podocytes)......Page 25
Parietal Epithelium......Page 26
Proximal Tubule......Page 27
Collecting Duct System......Page 28
Collecting Ducts......Page 29
Renal Interstitium......Page 30
References......Page 31
Glomerular Filtration Rate......Page 33
Measurement of Renal Plasma Flow......Page 34
Passive Transport......Page 35
Active Transport......Page 36
Glomerulotubular Balance......Page 37
Countercurrent System......Page 40
Renal Medullary Hypoxia......Page 42
Renal Interstitial Hydrostatic Pressure and Nitric Oxide......Page 43
Eicosanoids......Page 44
References......Page 45
Plasma Clearance......Page 49
Creatinine Metabolism and Excretion......Page 50
Cockcroft-Gault Formula......Page 52
Modification of Diet in Renal Disease Study Equation......Page 53
Cystatin C Metabolism and Excretion......Page 54
Acute Kidney Injury......Page 55
References......Page 56
Odor......Page 57
Hemoglobin......Page 58
The 24-Hour Protein Excretion......Page 59
Methods......Page 60
Lipids......Page 61
Casts......Page 62
Uric Acid Crystals and Amorphous Uric Acids......Page 65
Crystals Due to Drugs......Page 67
Clinical Significance of Crystals......Page 68
Organisms......Page 69
Nephrotic Sediment......Page 70
Nonspecific Urinary Abnormalities......Page 71
Automated Analysis of the Urine Sediment......Page 72
References......Page 73
Complex Cysts......Page 74
Renal Artery Duplex Scanning......Page 75
Plain Radiography and Intravenous Urography......Page 78
Intravenous Contrast Urography......Page 79
Ileal Conduits......Page 80
Tissue Density......Page 81
Contrast-Enhanced and Noncontrast Computed Tomography......Page 82
Limitations of Computed Tomography......Page 83
Magnetic Resonance Urography......Page 84
Magnetic Resonance Angiography......Page 85
Incidental Findings on CT or MRI......Page 86
Nuclear Medicine......Page 87
Renogram......Page 88
Molecular Imaging......Page 89
Contrast-Induced Nephropathy......Page 90
References......Page 91
Systemic Disease Associated with Renal Dysfunction......Page 93
The Role of Repeated Renal Biopsy......Page 94
Prebiopsy Evaluation......Page 95
Native Renal Biopsy......Page 96
Postbiopsy Monitoring......Page 98
Hemorrhage......Page 99
References......Page 100
The Afferent (Sensor) Limb......Page 103
Renin-Angiotensin-Aldosterone System......Page 104
Renal Losses......Page 105
Clinical Manifestations......Page 106
Therapy for Extracellular Volume Contraction......Page 107
Primary Renal Sodium Retention......Page 108
Sodium and Water Retention in Cardiac Failure......Page 109
Sodium and Water Retention in Nephrotic Syndrome......Page 110
Clinical Manifestations......Page 112
Diuretic Tolerance and Resistance......Page 113
Loop Diuretics......Page 114
References......Page 116
Thirst and Water Balance......Page 118
Quantitation of Renal Water Excretion......Page 119
Serum Sodium Concentration, Osmolality, and Tonicity......Page 120
Etiology and Classification of Hyponatremia......Page 121
Salt-Losing Nephropathy......Page 122
Hepatic Failure......Page 123
Syndrome of Inappropriate ADH Secretion......Page 124
Clinical Manifestations of Hyponatremia......Page 126
Chronic “Asymptomatic” Hyponatremia......Page 127
Maneuvers That Increase Solute Excretion......Page 128
Hypernatremic Disorders......Page 129
Euvolemia: Hypernatremia Associated with Normal Body Sodium......Page 130
causes......Page 131
electrolyte disorders......Page 132
Gestational Diabetes Insipidus......Page 133
Treatment of Hypernatremia......Page 134
References......Page 135
Potassium Distribution......Page 136
Renal Potassium Handling with Normal Renal Function......Page 137
Hormonal......Page 139
Other......Page 140
Treatment......Page 141
Excess Intake......Page 143
Specific Medicines......Page 144
Treatment......Page 145
Potassium Removal......Page 146
References......Page 147
Intestinal, Skeletal, and Renal Handling of Calcium......Page 148
Malignant Neoplasias......Page 152
Clinical Manifestations......Page 153
Hypocalcemia......Page 154
Treatment......Page 155
Distribution of Phosphate in the Organism......Page 156
Intestinal, Renal, and Skeletal Handling of Phosphate......Page 157
Chronic Kidney Disease......Page 158
Treatment......Page 159
Autosomal Recessive Hypophosphatemic Rickets......Page 160
Drug-Induced Hypophosphatemia......Page 161
Intestinal and Renal Handling of Magnesium......Page 162
Hypomagnesemia and Magnesium Deficiency......Page 164
References......Page 165
Respiratory System in Regulation of pH......Page 167
Thick Ascending Limb of the Loop of Henle......Page 168
Distal Nephron......Page 169
Ammonia Metabolism......Page 170
Mineralocorticoids, Distal Sodium Delivery, and Extracellular Fluid Volume......Page 171
References......Page 172
Non–Anion Gap (Normal Anion Gap) Metabolic Acidosis......Page 173
Proximal Renal Tubular Acidosis (Type 2)......Page 174
Hypokalemic Distal Renal Tubular Acidosis (Type 1)......Page 176
Hyperkalemic Distal Renal Tubular Acidosis (Type 4)......Page 177
Renal Tubular Acidosis in Chronic Kidney Disease......Page 178
Lactic Acidosis......Page 179
D-Lactic Acidosis......Page 180
Ethylene Glycol and Methanol Intoxications......Page 181
Alkali Treatment of Metabolic Acidosis......Page 182
References......Page 183
Chloride Depletion......Page 185
Exogenous Alkali......Page 186
Secondary Response to an Increase in Serum [HCO3−]......Page 187
Impairment of Cl−-Linked Na+ Transport......Page 188
Apparent Mineralocorticoid Excess Syndromes......Page 189
Diagnosis......Page 190
Chloride Depletion Alkalosis......Page 191
References......Page 192
Secondary Physiologic Response......Page 194
Treatment......Page 195
Etiology and Pathogenesis......Page 198
Clinical Manifestations......Page 199
Treatment......Page 200
Metabolic Acidosis and Respiratory Acidosis......Page 201
Mixed Metabolic Acidosis......Page 202
Triple Disorders......Page 203
Diagnosis......Page 204
Treatment......Page 205
References......Page 207
Laboratory Studies......Page 211
Asymptomatic Microscopic Hematuria......Page 213
Asymptomatic Non-nephrotic Proteinuria......Page 214
Macroscopic Hematuria......Page 215
Edema......Page 216
Hyperlipidemia and Lipiduria......Page 218
Chronic Kidney Disease......Page 219
Rapidly Progressive Glomerulonephritis......Page 220
Progressive Chronic Kidney Disease......Page 221
Treatment of Hyperlipidemia......Page 222
Correction of Hypoproteinemia......Page 223
References......Page 224
Immunofluorescence and Immunoperoxidase Microscopy......Page 226
Proteinuria......Page 227
Antibody and Antigen......Page 228
Complement......Page 230
Mechanisms of Immune Glomerular Injury......Page 231
Inflammation......Page 232
Minimal Change Disease......Page 233
Poststreptococcal Glomerulonephritis......Page 234
References......Page 235
Etiology and Pathogenesis......Page 236
Clinical Manifestations......Page 237
IgM Nephropathy......Page 238
Natural History......Page 239
Treatment of Relapses......Page 240
Frequently Relapsing and Corticosteroid-Dependent Nephrotic Syndrome......Page 242
Minimal Change Disease with Non-nephrotic Proteinuria......Page 243
References......Page 244
Minimal Change Disease Versus Focal Segmental Glomerulosclerosis......Page 246
Drug-Induced Focal Segmental Glomerulosclerosis......Page 247
Clinical Manifestations......Page 248
Classic Focal Segmental Glomerulosclerosis (Focal Segmental Glomerulosclerosis Not Otherwise Specified)......Page 249
Collapsing Variant of Focal Segmental Glomerulosclerosis......Page 250
Other Variants of Focal Segmental Glomerulosclerosis......Page 252
Natural History and Prognosis......Page 253
Use of Corticosteroids......Page 254
Other Immunosuppressive Agents......Page 255
Transplantation......Page 256
References......Page 257
Corticosteroid-Resistant Nephrotic Syndrome......Page 259
Isolated Diffuse Mesangial Sclerosis......Page 260
Autosomal Dominant Familial Focal Segmental Glomerulosclerosis......Page 261
Denys-Drash and Frasier Syndromes......Page 262
Glomerulopathy Associated with Abnormalities in Lipid Metabolism......Page 263
Genetic Testing......Page 264
References......Page 265
Mechanisms of Immune Deposit Formation......Page 266
Mechanism of Glomerular Injury......Page 267
Clinical Manifestations......Page 268
Immunohistology......Page 269
Electron Microscopy......Page 270
Diagnosis and Differential Diagnosis......Page 271
Predictors of Poor Outcome......Page 272
Immunosuppressive Therapy......Page 273
Calcineurin Inhibitors......Page 274
References......Page 275
Etiology and Pathogenesis......Page 278
Adult Population......Page 281
Laboratory Findings......Page 282
Pathology......Page 283
Diagnosis and Differential Diagnosis......Page 284
Idiopathic Membranoproliferative Glomerulonephritis in Adults......Page 285
Other Types of Membranoproliferative Glomerulonephritis......Page 286
References......Page 287
IgA Immune System......Page 288
Glomerular Injury After IgA Deposition......Page 289
Epidemiology......Page 290
Clinical Associations with IgA Nephropathy......Page 291
Clinical Manifestations of Henoch-Schönlein Purpura......Page 292
Electron Microscopy......Page 293
Natural History of IgA Nephropathy......Page 294
Reduction of IgA Production......Page 295
Corticosteroids......Page 296
Treatment of Henoch-Schönlein Nephritis......Page 297
References......Page 298
Mechanisms of Renal Injury......Page 300
Lung Hemorrhage......Page 301
Glomerulonephritis......Page 302
Immunohistology......Page 303
Antineutrophil Cytoplasmic Antibody and Systemic Small-Vessel Vasculitis......Page 304
Immunosuppressive Regimens......Page 305
Plasma Exchange and Immunosuppression......Page 306
Duration of Treatment and Relapses......Page 307
References......Page 308
Pathogenesis......Page 310
Clinical Manifestations......Page 312
Antineutrophil Cytoplasmic Autoantibodies......Page 314
Pathology......Page 316
Differential Diagnosis......Page 317
Treatment......Page 318
Relapse Therapy......Page 319
Pathology......Page 320
Treatment......Page 321
Pathology......Page 322
Pathology......Page 323
References......Page 324
Autoimmunity in Systemic Lupus Erythematosus......Page 326
Extrarenal Manifestations......Page 327
Pathology......Page 328
Tubulointerstitial and Vascular Disease......Page 329
Other Histologic Prognostic Factors......Page 332
Corticosteroids......Page 333
Other Immunosuppressive Strategies......Page 334
The Treatment of Proliferative Lupus Nephritis: Maintenance Therapy......Page 335
Membranous Lupus Nephropathy......Page 336
Antiphospholipid Antibodies and Atherosclerotic and Other Complications......Page 337
References......Page 338
Pathology......Page 340
Clinical Manifestations......Page 342
Natural History and Treatment......Page 344
Natural History and Treatment......Page 345
Pathogenesis......Page 346
Hematologic Findings......Page 347
Electron Microscopy......Page 348
Definition......Page 349
Immunotactoid Glomerulopathy......Page 350
References......Page 351
Mesangial Proliferative Glomerulonephritis without IgA Deposits......Page 353
Treatment of Mesangial Proliferative Glomerulonephritis......Page 354
Polymyositis and Dermatomyositis......Page 355
Scleroderma (Systemic Sclerosis)......Page 356
Glomerulonephritis Associated with Malignant Disease......Page 357
Lipoprotein Glomerulopathy......Page 358
Nephropathic Cystinosis......Page 359
References......Page 360
Pathology......Page 362
Shiga Toxin–Associated Hemolytic-Uremic Syndrome......Page 364
Thrombotic Thrombocytopenic Purpura Associated with Genetic or Immune-Mediated ADAMTS13 Abnormalities......Page 367
Factor H......Page 368
Screening and Diagnosis of Atypical Hemolytic-Uremic Syndrome......Page 369
Mitomycin and Anticancer Drugs......Page 370
Recurrent Post-Transplantation Hemolytic-Uremic Syndrome......Page 371
References......Page 372
Hemodynamic Changes......Page 377
Renal Hypertrophy......Page 378
Tubulointerstitial Fibrosis and Tubular Atrophy......Page 379
Role of Glucose Control......Page 380
Advanced Glycation End Products Pathway......Page 381
Uric Acid and Fructose......Page 382
Epidemiology......Page 383
Obesity, The Metabolic Syndrome, and Renal Disease......Page 384
Hypertension and Diabetic Nephropathy......Page 385
Survival in Patients with Diabetic Nephropathy......Page 386
Renal Pathology......Page 387
Measurement of Albuminuria or Proteinuria......Page 390
Differential Diagnoses......Page 391
Points to Consider in Dealing with a Diabetic Patient with Impaired Renal Function......Page 392
References......Page 393
Glycemic Control......Page 395
Renin-Angiotensin-Aldosterone System Blockade......Page 396
Renin-Angiotensin-Aldosterone System Blockade in Diabetic Nephropathy......Page 397
Combination Therapy of RAS Antagonists in Diabetic Nephropathy......Page 398
Glycemic Control......Page 399
References......Page 400
Metabolic Control......Page 403
Diet and Malnutrition......Page 406
Prevention and Treatment of Cardiac Disease......Page 407
Renal Replacement Therapy......Page 408
References......Page 409
Normal Blood Pressure Control......Page 413
Blood Pressure in Relation to Morbidity and Mortality......Page 416
Operational Definitions......Page 417
White Coat Hypertension......Page 419
Hypertension in Pregnancy......Page 421
Proper Measurement of Blood Pressure......Page 422
Wake-Sleep Cycle and Office Versus Home Blood Pressure......Page 423
Ambulatory Blood Pressure......Page 424
Evaluation for Primary Versus Secondary Hypertension......Page 426
References......Page 428
Genetic (Polygene) Hypothesis......Page 429
What Pathogenic Mechanisms Are Driving the Current Epidemic of Hypertension?......Page 431
Epidemiology......Page 432
Clinical Manifestations......Page 433
Natural History......Page 434
Kidney Disease......Page 435
Effect of Antihypertensive Therapy on the Natural History of Hypertensive Cardiovascular Disease and Kidney Disease Progression......Page 436
References......Page 437
Physical Activity......Page 439
Salt Intake......Page 440
Potassium Intake......Page 442
Dietary Fats and Sugars......Page 443
Caffeine......Page 444
Adopting Lifestyle Modifications......Page 445
References......Page 446
What are the Blood Pressure Treatment Goals?......Page 448
Key Principles from Clinical Trials......Page 449
Selection of Drug Therapy......Page 450
Thiazide-Type Diuretics......Page 451
Potassium-Retaining Diuretics (e.g., Spironolactone, Amiloride, Eplerenone)......Page 452
β-Adrenoceptor Blocking Drugs (β-Blockers)......Page 454
Angiotensin-Converting Enzyme Inhibitors......Page 455
Direct Vasodilators......Page 456
Choice of Initial Therapy......Page 457
Resistant Hypertension......Page 458
Medication to Reduce Cardiovascular Risk......Page 459
Hypertension in Older People......Page 460
References......Page 461
Epidemiology......Page 463
Diagnosis......Page 464
Specific Aspects of Antihypertensive Drug Use for Hypertensive Emergencies (see Fig. 36.5)......Page 465
References......Page 468
Fibromuscular Dysplasia......Page 469
Atherosclerotic Renovascular Disease......Page 471
Pathophysiology......Page 472
Relationship to Ischemic Renal Disease......Page 474
Renovascular Hypertension......Page 475
Flash Pulmonary Edema......Page 476
Mortality......Page 477
Diagnosis......Page 478
Adverse Consequences of Medical Therapy......Page 480
Fibromuscular Dysplasia......Page 481
Surgical Revascularization......Page 482
An Integrated Approach to Treatment of Renovascular Disease......Page 483
References......Page 485
Epidemiology......Page 487
Clinical Manifestations......Page 489
Diagnosis and Differential Diagnosis......Page 490
Treatment......Page 492
References......Page 493
Etiology, Pathogenesis, and Epidemiology......Page 495
Differential Diagnosis......Page 496
Clinical Manifestations......Page 497
Diagnosis......Page 498
Definition......Page 499
Treatment......Page 500
Diagnosis......Page 501
Definition and Epidemiology......Page 502
References......Page 503
Epidemiology......Page 504
Pathophysiology......Page 505
Diagnosis and Treatment......Page 506
Intracerebral Hemorrhage......Page 507
Definition and Epidemiology......Page 508
Cerebrovascular Effects of Antihypertensive Agents......Page 509
References......Page 510
Renal Hemodynamics......Page 515
Abnormal Renal Hemodynamics......Page 517
Protein......Page 518
Volume Regulation......Page 519
Impact of Maternal Hemodynamic Changes on Fetal Programming......Page 520
References......Page 521
Kidney Size and Hydronephrosis......Page 522
Asymptomatic Bacteriuria......Page 523
Hypertensive Disorders of Pregnancy......Page 524
Definition......Page 525
The Preeclampsia Factors......Page 526
Circulating Antiangiogenic Factors......Page 527
Pathology......Page 528
Uric Acid......Page 529
Treatment......Page 530
Hemolytic-Uremic Syndrome and Thrombotic Thrombocytopenic Purpura......Page 531
References......Page 532
Excretory Renal Function......Page 534
Serum Electrolytes, Albumin, and Volume Homeostasis......Page 535
Hypertension......Page 536
Renal Biopsy in Pregnancy......Page 537
Diabetic Nephropathy......Page 538
Recurrent Urinary Tract Infection......Page 539
Initiating Dialysis for Progressive Chronic Kidney Disease......Page 540
Renal Transplantation and Pregnancy......Page 541
Course of Chronic Kidney Disease after Pregnancy......Page 542
References......Page 543
Mechanisms of Cyst Formation......Page 547
Hypertension......Page 548
Renal Ultrasound......Page 550
Pain......Page 551
End-Stage Renal Disease......Page 552
Intracranial Aneurysms......Page 553
Other Associated Conditions......Page 554
Pathology......Page 555
Urinary Tract and Cyst Infection......Page 556
Polycystic Liver Disease......Page 557
mTOR Inhibitors......Page 558
References......Page 559
Clinical Manifestations......Page 561
Liver......Page 562
Treatment......Page 563
Renal Disease......Page 565
Autosomal Dominant Medullary Cystic Kidney Disease......Page 566
Diagnosis......Page 567
Genetic Basis of Tuberous Sclerosis Complex......Page 568
Renal Cystic Disease......Page 569
Renal Angiomyolipomas......Page 570
Clinical Manifestations......Page 571
Treatment......Page 572
Solitary Multilocular Cysts......Page 574
Acquired Cystic Disease in Renal Failure......Page 575
References......Page 576
Autosomal Recessive Alport’s Syndrome......Page 578
Renal Defects......Page 579
Leiomyomatosis......Page 580
Diagnosis and Differential Diagnosis......Page 581
Transplantation......Page 584
Diagnosis and Differential Diagnosis......Page 585
Heart Defects......Page 586
Diagnosis......Page 587
Nails......Page 588
References......Page 589
Bartter Syndrome......Page 591
Clinical Manifestations......Page 592
Diagnosis......Page 593
Differential Diagnosis......Page 594
Clinical Manifestations and Diagnosis......Page 595
Pathogenesis......Page 596
Pathogenesis......Page 597
Deficiency of 21-Hydroxylase......Page 598
Pathogenesis......Page 599
Differential Diagnosis......Page 600
References......Page 601
Hypophosphatemia......Page 602
Hyperchloremic Metabolic Acidosis......Page 603
Etiology and Pathogenesis......Page 604
Treatment......Page 605
Treatment......Page 606
Etiology and Pathogenesis......Page 607
Clinical Manifestations......Page 608
Cancer Chemotherapy Agents......Page 609
Etiology and Pathogenesis......Page 610
Treatment......Page 611
Familial Juvenile Hyperuricemic Nephropathy and Medullary Cystic Kidney Disease Type 2......Page 612
References......Page 613
Polymerization of Hemoglobin S......Page 614
Natural History......Page 615
Concentrating Capacity......Page 616
Diluting Capacity......Page 617
Renal Hemodynamics......Page 618
Glomerular Injury......Page 619
Papillary Necrosis......Page 620
Urinary Tract Infection......Page 621
Distal Tubular Function......Page 622
Natural History......Page 623
Treatment......Page 624
References......Page 625
Pathogenesis of Maldevelopment......Page 627
Large Kidneys......Page 628
Renal Scarring in Adults......Page 629
Renal Ectopia, Malrotation, and Crossed Fused Kidneys......Page 630
Bardet-Biedl Syndrome......Page 631
Pathogenesis......Page 632
Pathogenesis......Page 633
Treatment......Page 634
Clinical Manifestations......Page 635
Contractile Behavior......Page 636
Treatment......Page 637
Treatment......Page 638
Exclude Obstruction......Page 639
Urinary Tract Infections (To Treat or Not To Treat)......Page 640
Proteinuria and Progressive Renal Failure......Page 641
Enterocystoplasty and Intestinal Urinary Reservoirs......Page 642
Complications......Page 643
References......Page 644
Uncomplicated Infection......Page 647
Etiologic Agents......Page 648
Recurrent Acute Uncomplicated Cystitis in Women......Page 649
Acute Uncomplicated Pyelonephritis in Women......Page 650
Acute Cystitis in Healthy Adults with Possible Occult Renal or Prostatic Involvement......Page 651
Complicated Infections......Page 653
Spinal Cord Injury......Page 654
Papillary Necrosis......Page 655
Xanthogranulomatous Pyelonephritis......Page 656
References......Page 657
Pathogenesis......Page 659
Clinical Manifestations......Page 660
Diagnosis and Differential Diagnosis......Page 662
Treatment......Page 664
Treatment of Patients with Liver Disease......Page 665
References......Page 666
Microbiology......Page 667
Diagnosis......Page 668
Treatment with Systemic Antifungal Agents......Page 669
Local Antifungal Administration......Page 670
References......Page 671
Pathogenesis......Page 672
Bladder Cancer......Page 673
Interstitial Nephritis......Page 674
Glomerulonephritis......Page 675
Schistosoma haematobium Urinary Tract Disease......Page 677
Schistosoma mansoni Glomerulonephritis......Page 678
References......Page 679
Epidemiology......Page 680
Pathogenesis......Page 681
Pathology......Page 682
Endocarditis-Associated Glomerulonephritis......Page 683
Pathogenesis......Page 684
Glomerulonephritis Associated with Other Bacterial Infections......Page 685
Hepatitis B Virus–Associated Renal Disease......Page 686
Polyarteritis Nodosa......Page 687
Malaria......Page 688
Onchocercosis......Page 690
References......Page 691
Etiology and Pathogenesis......Page 693
Diagnosis and Differential Diagnosis......Page 694
HIV-Associated Immune Complex Glomerulonephritis......Page 695
Tubular Disorders......Page 696
Dosing of Antiretroviral Therapy in Chronic Kidney Disease......Page 697
Screening for Chronic Kidney Disease......Page 699
References......Page 700
Pathogenesis......Page 705
Loin Pain–Hematuria Syndrome......Page 706
History......Page 707
Physical Examination......Page 708
Imaging......Page 709
Dietary Protein......Page 711
Treatment......Page 712
Treatment of Primary Hyperoxaluria......Page 713
Etiology and Pathogenesis......Page 714
Treatment......Page 715
Medullary Nephrocalcinosis......Page 716
Clinical Manifestations......Page 717
References......Page 718
Intraluminal Obstruction......Page 720
Extrinsic Obstruction......Page 721
Changes in Glomerular Function......Page 722
Histopathologic Changes......Page 723
Clinical Manifestations......Page 724
Urinary Tract Infections......Page 725
Imaging......Page 726
Ultrasound......Page 727
Retrograde Pyelography......Page 728
Pressure-Flow Studies......Page 729
General Considerations......Page 730
Specific Therapies......Page 731
References......Page 732
Extracorporeal Shock Wave Lithotripsy......Page 734
Percutaneous Nephrolithotomy......Page 735
Stones in Transplanted Kidneys......Page 736
Pelviureteral Junction Obstruction......Page 737
Investigation of Hematuria......Page 738
Evaluation of Asymptomatic Microscopic Hematuria......Page 739
Investigation and Management of a Renal Mass......Page 741
References......Page 742
Clinical Manifestations......Page 747
Other Specific Drug Associations......Page 748
Diagnosis......Page 751
Treatment......Page 752
Sarcoidosis......Page 753
Acute Interstitial Nephritis in Renal Transplants......Page 754
References......Page 755
Etiology and Pathogenesis......Page 756
Presentation with Vesicoureteral Reflux......Page 758
Reflux Identified Secondary to Antenatal Hydronephrosis......Page 759
Renal Ultrasound......Page 760
Magnetic Resonance Imaging......Page 761
Medical Management......Page 762
Hypertension and Proteinuria......Page 763
References......Page 764
Clinical Manifestations......Page 766
Drug-Induced Chronic Interstitial Nephritis......Page 767
Chronic Lithium Nephropathy......Page 768
Diagnosis......Page 769
Treatment......Page 770
Clinical Manifestations......Page 771
Chronic Interstitial Nephritis Due to Hereditary Diseases of the Kidney......Page 772
Other Heavy Metal–Induced Nephropathies......Page 773
Clinical Manifestations......Page 774
Pathology......Page 775
Definition and Epidemiology......Page 776
References......Page 777
Etiology and Pathogenesis of Renal Disease......Page 779
Pathology......Page 780
Diagnosis and Differential Diagnosis......Page 781
Treatment......Page 782
Chemotherapy......Page 783
Adjunctive Therapies......Page 784
Dialysis and Transplantation......Page 785
References......Page 786
Thromboembolic Ischemic Renal Disease......Page 788
Renal Infarction......Page 789
Thrombosis due to Trauma......Page 790
Renal Artery Embolism......Page 791
Thromboembolic Complication of Endovascular Interventions......Page 792
Treatment of Acute Renal Vascular Catastrophe......Page 793
Clinical Presentation......Page 794
Treatment......Page 795
Renal vein Thrombosis......Page 796
Neonatal Renal Vein Thrombosis......Page 797
Treatment......Page 798
References......Page 799
Assessment of Renal Function in the Elderly......Page 803
Prevalence of Chronic Kidney Disease in the Elderly......Page 804
Pathogenesis of Aging-Associated Chronic Kidney Disease......Page 805
Osmoregulation and Water Handling......Page 807
Glomerular Diseases......Page 808
Urinary Incontinence......Page 809
End-Stage Renal Disease and Renal Replacement Therapy......Page 810
References......Page 811
Pathophysiology and Etiology of Prerenal Azotemia......Page 815
Pathophysiology of Acute Tubular Necrosis......Page 816
Tubular Injury in Acute Tubular Necrosis......Page 817
Intrarenal Vasoconstriction......Page 818
Tubular Epithelial Cell Injury and the Development of Acute Tubular Necrosis......Page 819
Inflammatory Factors in the Development of Acute Tubular Necrosis......Page 820
Amphotericin......Page 821
Acyclovir......Page 822
Illicit Drug Use......Page 823
Pathogenesis of Heme Pigment Nephropathy......Page 824
Atheroembolic Renal Disease (Syndrome of Multiple Cholesterol Emboli)......Page 825
Acute Kidney Injury in the Patient with Multiorgan Failure......Page 826
Acute Kidney Injury and Liver Disease......Page 827
Tumor Lysis Syndrome......Page 828
References......Page 829
Management......Page 831
Arthropods......Page 832
Pathogenesis of Natural Medicine–Induced Acute Kidney Injury......Page 833
Clinical Manifestations......Page 835
Dengue Fever......Page 836
References......Page 837
Classification......Page 839
Early Detection of Acute Kidney Injury......Page 840
Clinical Assessment......Page 842
Serum Creatinine Concentration......Page 843
Fractional Excretion of Sodium......Page 844
Imaging Studies......Page 845
Renal Biopsy......Page 846
References......Page 847
Optimizing Volume Status and Hemodynamic Status......Page 848
Prevention of Contrast Medium Nephropathy......Page 851
Secondary Prevention......Page 852
Vasoactive Agents......Page 853
Calcium Channel Blockers......Page 854
Fluid and Electrolyte Management......Page 855
Natriuretics......Page 856
Potassium Disorders......Page 857
Nutritional Considerations......Page 858
References......Page 859
Overview of Acute Renal Replacement Therapies......Page 861
Strategies to Reduce Intradialytic Hemodynamic Instability......Page 862
Dosing of Acute Intermittent Hemodialysis......Page 863
Hemofiltration......Page 864
Specific Techniques......Page 865
Dosing of Continuous Renal Replacement Therapy......Page 866
Replacement Fluids and Dialysate......Page 867
Anticoagulation in Acute Renal Replacement Therapy......Page 868
Modality Choice and Outcomes in Acute Renal Replacement Therapy......Page 869
References......Page 870
Diuretic Tolerance and Adverse Effects......Page 871
General Approach and Limitations......Page 872
Ultrafiltration: Peritoneal Dialysis......Page 873
The Effect of Ultrafiltration on Renal Function......Page 874
References......Page 875
Summary of Pathogenetic Events......Page 876
Epidemiology......Page 877
Diagnosis and Differential Diagnosis......Page 878
Natural History......Page 879
Pharmacotherapy......Page 880
Transjugular Intrahepatic Portosystemic Stent-Shunt......Page 881
Renal Replacement Therapy......Page 882
Therapeutic Strategy and Choice of Treatment Modalities......Page 883
References......Page 884
Plasma Protein Binding......Page 889
Metabolism......Page 890
Initial Assessment and Laboratory Data......Page 891
Therapeutic Index of the Drug or Metabolites......Page 892
Clinical Condition of the Patient......Page 893
Dose Method......Page 895
Extracorporeal Drug Losses......Page 896
Hemodialysis......Page 897
Opioid Analgesics......Page 898
Aminoglycoside Concentration Monitoring......Page 899
Penicillins......Page 900
Guanine Analogues......Page 901
Diuretics......Page 902
Statins......Page 903
Phosphate Binders......Page 904
Phosphodiesterase-5 Inhibitors......Page 905
mTOR Inhibitors......Page 906
Phenytoin......Page 907
Antipsychotics......Page 908
References......Page 909
Tubulointerstitial Nephritis: Aristolochic Acid Nephropathy......Page 912
Hypertension......Page 916
Renal Toxicity from Contaminants in Herbal Medicines......Page 917
Over-the-Counter Medicines and the Kidney: Analgesic Nephropathy......Page 918
References......Page 920
Epidemiology of End-Stage Renal Disease......Page 925
Natural History of Chronic Kidney Disease......Page 926
Factors Affecting Initiation and Progression of Chronic Kidney Disease......Page 927
Loss of Renal Mass......Page 928
Glycemia......Page 929
Renal Cell Loss, Activation, and Transformation......Page 930
Endothelial Cells......Page 931
Mesangial Cells......Page 932
Platelets......Page 933
References......Page 935
Monitoring Glomerular Filtration Rate Trends......Page 937
Control Blood Pressure......Page 939
Avoidance of Dihydropyridine CCBs......Page 940
Control Protein Intake......Page 941
β-Blocker Therapy......Page 943
References......Page 944
When to Refer to the Nephrologist......Page 945
Dyslipidemia......Page 946
Thyroid Hormones......Page 947
Acute Kidney Injury Versus Chronic Kidney Disease......Page 948
Minimizing Progression of Chronic Kidney Disease......Page 949
Conservative Management of Terminal Uremia......Page 950
References......Page 951
Racial and International Differences in Cardiovascular Disease Prevalence......Page 953
Hypertension......Page 954
Insulin Resistance and Atherosclerosis......Page 955
Inflammation......Page 957
Secondary Hyperparathyroidism and Mineral Metabolism......Page 958
Advanced Glycation End Products......Page 959
Left Ventricular Remodeling and Hypertrophy......Page 960
Valvular Disease......Page 961
Stress Tests and Screening Renal Transplant Candidates......Page 962
Coronary Angiography......Page 963
Hypertension and Coronary Artery Disease......Page 964
Revascularization......Page 965
References......Page 966
Pathogenesis......Page 969
Diagnosis and Differential Diagnosis......Page 970
Epoetin Therapy......Page 972
Initiation of and Maintenance Therapy with Erythropoiesis-Stimulating Agents......Page 973
Hyporesponsiveness to Erythropoiesis-Stimulating Agents......Page 974
Iron Management......Page 975
References......Page 976
Bleeding Diathesis in Uremia......Page 977
Correction of Anemia......Page 979
Desmopressin......Page 980
Argatroban......Page 981
Antiplatelet Agents in Patients with End-Stage Renal Disease......Page 982
Altered Function of Polymorphonuclear Leukocytes......Page 983
Hepatitis B Virus......Page 984
Influenza Virus......Page 985
References......Page 986
Abnormalities of Phosphate Metabolism......Page 987
Abnormalities of Vitamin D Metabolism......Page 988
Abnormalities of Parathyroid Gland Function......Page 989
Serum Biochemistry......Page 990
Bone Biopsy......Page 991
Prevention of Hypocalcemia......Page 992
Phosphate Binders......Page 993
Role of Parathyroidectomy......Page 994
Synthesis of Therapeutic Strategies......Page 996
Bone Biopsy......Page 997
Diagnosis and Differential Diagnosis......Page 998
Clinical Manifestations and Diagnosis......Page 999
Diagnosis......Page 1000
References......Page 1001
Clinical Manifestations......Page 1003
Peripheral Neuropathy......Page 1004
Restless Legs Syndrome (The Ekbom Syndrome)......Page 1006
References......Page 1007
Peptic Ulcer Disease, Gastritis, and Duodenitis......Page 1008
Gastrointestinal Pseudo-obstruction......Page 1009
Clostridium difficile Infection......Page 1010
Diabetes......Page 1011
Idiopathic Dialysis-Related Ascites......Page 1012
Estimation of Intake......Page 1013
Body Composition......Page 1014
Nutritional Guidelines......Page 1015
Vitamins, Minerals, and Trace Elements......Page 1016
References......Page 1017
Optimizing Dialysis Therapy......Page 1019
Antihistaminic Drugs......Page 1020
Immunomodulators and Immunosuppressive Agents......Page 1021
Definition......Page 1022
Prevention and Treatment......Page 1023
Epidemiology......Page 1024
Clinical Manifestations and Natural History......Page 1025
Treatment and Prevention......Page 1026
References......Page 1027
Clinical Manifestations......Page 1028
Pathology......Page 1029
Diagnosis and Differential Diagnosis......Page 1030
Treatment......Page 1031
Malignant Neoplasms in Dialysis Patients......Page 1032
References......Page 1033
Predialysis Education Programs......Page 1037
Education About Transplantation......Page 1038
Limitations of a Purely “Laboratory Result–Based” Approach to the Initiation of Dialysis......Page 1039
Bowel Disease and Other Sources of Infection......Page 1040
Home Hemodialysis......Page 1041
The Availability of Dialysis Facilities......Page 1042
Rationing of Dialysis Treatment......Page 1043
Predictive Factors......Page 1044
Management of Disruptive Patients on Dialysis......Page 1045
Withdrawal of Dialysis......Page 1046
References......Page 1047
Radiocephalic AV Fistula......Page 1049
Forearm Cephalic and Basilic Vein Transposition and Elevation......Page 1050
Upper Arm Basilic Vein AV Fistula......Page 1051
Nonautogenous Prosthetic Vascular Access......Page 1052
Lower Limb Vascular Access......Page 1053
AV Graft Stenosis or Thrombosis......Page 1054
Endovascular and Surgical Management of Ischemia......Page 1055
Tunneled Catheters......Page 1056
Catheter-Associated Bacteremia......Page 1057
Prevention of Infection......Page 1058
References......Page 1059
Hemodialysis Access......Page 1061
Peritoneal Dialysis Catheters......Page 1062
Catheter Insertion......Page 1063
Complications of Peritoneal Dialysis Catheter Insertion......Page 1065
Catheter Insertion......Page 1066
Catheter Exchange and Fibrin Sheath Removal......Page 1067
Percutaneous Balloon Angioplasty......Page 1068
Stents......Page 1069
References......Page 1070
Transport Properties......Page 1071
Anticoagulation......Page 1072
Dialysis Solution......Page 1073
Hemofiltration......Page 1074
Blood Volume Monitoring......Page 1075
References......Page 1077
Assessment of Dialysis Dose......Page 1078
Intradialytic Urea Kinetics......Page 1079
Equilibrated Kt/V (eKt/V)......Page 1080
Weekly Standard Kt/V (std-Kt/V)......Page 1081
Prescription of Dialysis Dose......Page 1082
Recommendations for Dialysis Dose Adequacy......Page 1083
Calcium......Page 1084
Quality of Life......Page 1085
References......Page 1086
Intradialytic Hypertension......Page 1087
Cardiac Arrhythmias......Page 1088
Muscle Cramps......Page 1089
Complement Activation and Dialysis-Associated Neutropenia......Page 1090
Intradialytic Hemolysis......Page 1091
Air Embolism......Page 1092
Metabolic Acidosis......Page 1093
Reuse Reactions......Page 1094
Drug-Induced Reactions......Page 1095
Investigation of a Dialysis Outbreak......Page 1096
References......Page 1097
The Three-Pore Model......Page 1099
Fluid Kinetics......Page 1100
Effective Peritoneal (Vascular) Surface Area......Page 1101
Peritoneal Access......Page 1102
Electrolyte Concentration......Page 1103
Osmotic Agents......Page 1104
Peritoneal Equilibration Test......Page 1105
Small Solute Clearance......Page 1106
Fluid Balance......Page 1107
References......Page 1108
Recognizing the Problem......Page 1110
Management of Slow Transport Ultrafiltration Failure (Dialysate to Plasma Creatinine Ratio <0.64)......Page 1111
Encapsulating Peritoneal Sclerosis......Page 1112
External Leaks......Page 1113
Outflow Pain......Page 1114
Acid-Base Status......Page 1115
Treatment of Peritonitis......Page 1116
Relapsing Peritonitis......Page 1117
References......Page 1118
Intermittent Hemodialysis and Hemofiltration......Page 1120
Continuous Renal Replacement Therapy......Page 1121
Hemoperfusion......Page 1122
β-Blockers......Page 1123
Valproate......Page 1124
References......Page 1125
Techniques......Page 1126
Anti–Glomerular Basement Membrane Antibody Disease (Goodpasture’s Disease)......Page 1129
Small-Vessel Vasculitis......Page 1130
Other Crescentic Glomerulonephritis......Page 1131
Recommendation......Page 1132
ABO-Incompatible Renal Transplantation......Page 1133
References......Page 1134
Antigen-Presenting Cells......Page 1137
Major Histocompatibility Complex......Page 1138
Non-MHC Antigens......Page 1140
T-Cell Receptor......Page 1141
T-Cell Costimulation: Signal 2......Page 1142
T-Cell Clonal Expansion and Differentiation......Page 1143
Memory Cells......Page 1144
Humoral Immune Response......Page 1145
Recruitment of Cells into the Interstitium of Kidney Allografts......Page 1146
Acute T Cell–Mediated Rejection......Page 1148
Chronic Rejection......Page 1149
References......Page 1150
Side Effects......Page 1152
Mechanism of Action......Page 1153
Pharmacokinetics, Monitoring, and Drug Interactions......Page 1154
Pharmacokinetics......Page 1155
Mechanism of Action......Page 1156
Polyclonal Antilymphocyte Sera......Page 1157
B Cell–Depleting Monoclonal Anti-CD20 Antibody......Page 1158
References......Page 1159
Cerebrovascular Disease......Page 1160
Cancer......Page 1161
Infectious Complications......Page 1162
Psychosocial Issues......Page 1163
Evaluation of the Deceased Donor......Page 1164
Deceased Donor Management Before Transplantation......Page 1165
Evaluation of the Live Donor......Page 1166
Obesity and Abnormal Glucose Tolerance in the Live Donor......Page 1167
Cardiovascular and Pulmonary Disease......Page 1168
Assessing HLA Sensitization......Page 1169
References......Page 1170
Uncontrolled DCD Donors......Page 1172
Hand-Assisted Laparoscopic Donor Nephrectomy......Page 1173
Effect of Pneumoperitoneum......Page 1174
Renal Preservation......Page 1175
Vascular Anastomosis......Page 1176
Surgical Complications of Renal Transplantation......Page 1177
Anastomotic Hemorrhage......Page 1178
Lymphocele......Page 1179
Urinary Leaks......Page 1180
Ureteral Obstruction......Page 1181
References......Page 1182
Antibody-Mediated Rejection......Page 1184
T Cell–Mediated Rejection......Page 1186
Clinical Manifestations......Page 1187
Prevention of Acute T Cell–Mediated Rejection: Induction Therapy......Page 1188
Prevention of Acute Antibody-Mediated Rejection: Desensitization......Page 1189
Antiproliferative Agents in the Prevention of Acute Rejection......Page 1190
Acute Antibody-Mediated Rejection......Page 1191
Prognosis......Page 1192
References......Page 1193
Months 1 to 6......Page 1195
Clinical Manifestations......Page 1196
Prevention and Treatment......Page 1197
BK Infection......Page 1198
Gastrointestinal Disease......Page 1199
Colon Disorders......Page 1201
Transplant-Associated Malignant Neoplasms......Page 1202
Post-Transplantation Lymphoproliferative Disorder......Page 1203
References......Page 1205
Post-transplantation Hypertension......Page 1207
Post-transplantation Dyslipidemia......Page 1208
Drug Therapy for Hypertriglyceridemia and Non–High- Density Lipoprotein Cholesterol......Page 1209
Management of NODAT......Page 1210
Obesity......Page 1211
Hyperkalemia......Page 1212
Abnormal Liver Function Test Results......Page 1213
Post-transplantation Bone Disease......Page 1214
Gout......Page 1215
References......Page 1216
Banff Classification of Chronic Renal Allograft Pathology......Page 1218
Transplant Glomerulopathy......Page 1219
Pathogenesis......Page 1220
Donor Age and Donor-Recipient Size Mismatching......Page 1221
Delayed Graft Function......Page 1222
Cardiovascular Risk Factors......Page 1223
Mechanisms of Graft Injury......Page 1224
Intrinsic Renal Causes......Page 1225
Proteinuria......Page 1226
References......Page 1227
Recurrent Glomerulonephritis......Page 1229
Clinical Features and Differential Diagnosis......Page 1230
IgA Nephropathy and Henoch-Schönlein Purpura......Page 1231
Membranous Nephropathy......Page 1232
Focal Segmental Glomerulosclerosis......Page 1233
Membranoproliferative Glomerulonephritis Type I......Page 1234
Lupus Nephritis......Page 1235
Amyloidosis......Page 1236
Recurrence of Virus-Associated Nephropathies and Tumors in the Transplanted Kidney......Page 1237
References......Page 1238
Survival Advantage for Transplantation over Dialysis......Page 1240
Patient and Graft Survival in Kidney Transplantation......Page 1241
Graft Survival......Page 1242
Deceased Versus Living Donor......Page 1243
Recipient Age......Page 1244
Recipient Compliance......Page 1245
HLA Matching......Page 1246
Center Effect......Page 1247
References......Page 1248
Medical Evaluation......Page 1250
Immunosuppression......Page 1252
Graft Monitoring......Page 1253
Surgical Complications......Page 1255
Urinary Tract Infections......Page 1256
Impact of Pancreas Transplantation on Diabetic Complications......Page 1257
Nephropathy......Page 1258
Islet After Kidney Transplantation......Page 1259
Technique of Islet Transplantation......Page 1260
References......Page 1261
Nephrotoxicity of Calcineurin Inhibitors......Page 1263
Acute Kidney Injury in the Early Post-transplantation Period......Page 1264
Chronic Kidney Disease......Page 1265
BK Virus Nephropathy......Page 1266
Kidney Disease in Cardiac Transplantation......Page 1267
Acute Kidney Injury After Hematopoietic Cell Transplantation......Page 1268
Thrombotic Microangiopathy......Page 1270
Glomerular Disease......Page 1271
References......Page 1272
A......Page 1275
C......Page 1278
D......Page 1281
F......Page 1283
G......Page 1284
H......Page 1286
I......Page 1288
K......Page 1289
L......Page 1290
M......Page 1291
N......Page 1293
P......Page 1295
R......Page 1297
S......Page 1300
T......Page 1301
U......Page 1303
Y......Page 1304