UNDERSTANDING KIDNEY DISEASES

Foreword to the First Edition
	Reviews of the First Edition
		An Excellent Nephrology Textbook for Medical Students and Junior Doctors
	Customer Reviews
		A Brilliant Guide for Medical Students, and Beyond!
		Great for Students
		Book Well Worth Reading
		Great Book!
Foreword to the Second Edition
Words with Pictures: The Gift of Graphical Data Presentation
Preface
Acknowledgements
Disclaimer
Contents
About the Authors
1: Kidney Anatomy and Physiology: The Basis of Clinical Nephrology
	The Anatomy of the Kidney
	Turning Blood into Urine
	Changes in Kidney Function over a Lifetime
	References
2: Measuring Kidney Function: How to Use Laboratory Tests to Measure Glomerular Filtration Rate
	How Can Kidney Function Be Measured?
	How Can GFR Be Estimated from Serum Creatinine?
	Are eGFR Estimates Accurate and Reliable?
	Interpreting eGFR Values
	Not All Changes in Serum Creatinine Are Caused by Changes in GFR
		Dietary Creatinine
		Changes in Muscle Mass
		Tubular Secretion of Creatinine
	Serum Urea and Creatinine: Different Measures of Kidney Function
	References
3: Plot All the Dots: How Graphs Reveal the History of Someone’s Kidney Disease
	Variation in eGFR
	Interpreting Variation in an eGFR Graph
	Linking an eGFR Graph to Clinical Events over Time
	References
4: Kidney Function in Acute Illness and Acute Kidney Injury
	Kidney Function in Acute Illness: Equilibrating Creatinine
	Dealing with Missing Data
	Causes of a Sudden Drop in Kidney Function
	Fluid Balance in Acutely Ill Patients
	Acute-on-Chronic Kidney Disease: Time in Two Dimensions
	Management of Acute Kidney Injury
	References
5: How Are You Feeling? Symptoms of Kidney Disease
	Symptoms Linked to the Kidneys and Urinary Tract
		Lower Urinary Tract Symptoms
		Urinary Incontinence
		Bed Wetting: Enuresis
		Daytime Wetting: Diurnal Enuresis
	Symptoms That Develop as Kidney Function Declines
	Uraemia and the Nervous System
	Gout
	References
6: Do You Have Any Risk Factors or Long-Term Health Conditions? How Environment, Lifestyle and Other Medical Conditions Are Linked to Kidney Disease
	Risk Factors for Kidney Disease
	Diabetes Mellitus
		Risk Factors for Diabetic Nephropathy
		Treatment with Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors
		Treatment with Sodium–Glucose Cotransporter-2 (SGLT2) Inhibitors
	Atherosclerosis
		Renal Artery Stenosis
		Cholesterol Crystal Embolisation
	Liver Disease: Hepatorenal Syndrome
	Chronic Infection and Inflammation
	References
7: Are You Pregnant or Planning a Pregnancy? How Pregnancy Affects the Kidneys and Vice Versa
	Risks to the Baby
	Risks to the Mother
	Pre-eclampsia
	Antenatal Diagnosis of Kidney and Urinary Tract Abnormalities
	References
8: What Is Your Family History? The Molecular Genetics of Inherited Kidney Diseases
	The Glomerulus
		Alport Syndrome
		Congenital Nephrotic Syndrome
		Fabry or Anderson–Fabry Disease
	The Tubules
		The Proximal Tubule
		The Loop of Henle
		The Distal Tubule
		The Collecting Duct
		Uromodulin
	Cystic Kidney Diseases
	Kidney Tumours
	The Lower Urinary Tract
	References
9: What Have You Been Taking? Nephrotoxicity from Medications and Other Chemicals
	Vasoactive Drugs
		ACEI and ARBs
		NSAIDs
		Calcineurin Inhibitors: Two Sides of a Coin
		Mixing Vasoactive Drugs to Make MINT Cocktails
		Anticoagulant-Related Nephropathy
	Tubulotoxic Drugs
		Lithium
		Aminoglycoside Antibiotics: Gentamicin
	Interstitial Nephritis
	Metformin: Villain or Victim?
	Kidney Diseases Due to Toxins
		Cocaine and Heroin
		Mushroom Poisoning
		Chemical Poisoning
		Chinese Herbal Medicines
	References
10: Height and Weight: The Effects of Kidney Disease on Development; Links Between Obesity and Kidney Disease
	Growing Up with Kidney Disease
	Adolescent Care
	Obesity and Risk
	References
11: Blood Pressure: The Interactions Between Hypertension and Kidney Disease
	Diurnal Variation in Blood Pressure
	Target Organ Damage Due to High Blood Pressure
	Principles for Treating High Blood Pressure
		Diet and Lifestyle
		When to Use Antihypertensive Drugs
		Monitoring the Effect of Antihypertensive Drugs
		Choice of Antihypertensive Drugs
	Blood Pressure in Kidney Disease
	The Effect of Kidney Function on Other Cardiovascular Risk Factors
	References
12: Test the Urine: Understanding Haematuria, Proteinuria and Urinary Infection
	Haematuria
		How Red Cells Cross the Glomerular Filtration Barrier
		The Clinical Significance of Haematuria
	Myoglobinuria
	Proteinuria
	Nephrotic Syndrome
	Urine Infection
		Treatment of Urinary Tract Infection in Adults
		Diagnosis and Causes of Urinary Tract Infection in Children
		Treatment of Urinary Tract Infection in Children
		Prevention of Recurrent Urinary Tract Infection in Children
	References
13: Examine the Patient: Physical Signs Related to Kidney Diseases
	Fluid Balance
		How Salt and Water Is Distributed in the Body
		Fluid Retention in Chronic Kidney Disease
	Management of Excess Salt and Water
	How to Use Diuretics
	Physical Signs of Kidney Disease
	Examine the Abdomen
	References
14: Full Blood Count: Haematological Changes in Kidney Diseases
	Anaemia
	Erythropoietin and the Regulation of Haemoglobin Concentration
	Why Is Haemoglobin Regulated by the Kidneys?
	Iron Metabolism in Kidney Disease
	The Pros and Cons of Anaemia in Kidney Disease
	Kidney Diseases Linked to Causes of Anaemia
	References
15: Acid, Base and the Kidneys: The Role of the Kidneys in Acid-Base Disorders
	A Brief Reminder of Acid-Base Chemistry and Homeostasis
	How the Kidney Tubules Regulate Serum Bicarbonate and Acid Excretion
	How to Interpret Acid-Base Laboratory Results
	The Anion Gap
	Normal Anion Gap Metabolic Acidosis (NAGMA)
	Renal Tubular Acidosis
		Type 1: Distal Renal Tubular Acidosis
		Type 2: Proximal Renal Tubular Acidosis
		Type 4: Hyperkalaemic Renal Tubular Acidosis
	High Anion Gap Metabolic Acidosis (HAGMA)
	Acidosis in Chronic Kidney Disease
	Metabolic Alkalosis
	References
16: Calcium, Phosphate and Bones: How Bone and Mineral Metabolism is Altered in Kidney Disease
	Minerals and Bones: Interactions Between Magnesium, Phosphate, Calcium, PTH, Vitamin D and FGF-23
		Magnesium
		Phosphate
			Calcium, Parathyroid Hormone, Vitamin D and FGF-23
		Vitamin D
		Why Is Vitamin D Activated in the Kidneys?
	Hyperparathyroidism
		Parathyroidectomy
	Hypercalcaemia
	References
17: Immunology: Serological Tests That Help Diagnose Kidney Diseases
	Do the Right Test on the Right Patient
	Immunoglobulins, Protein Electrophoresis, Free Light Chains in Serum and Urine
		Multiple Myeloma
		Amyloidosis
	Anti-nuclear Antibody, Anti-dsDNA Antibody
	Complement C3 and C4
	Anti-streptolysin O (ASO) and Anti-DNAse B Antibodies
	Anti-neutrophil Cytoplasmic Antibody (ANCA)
	Anti-glomerular Basement Membrane Antibody (Anti-GBM ab)
	Anti-phospholipase A2 Receptor Antibody (Anti-PLA2R ab)
	References
18: Image the Urinary Tract: Strengths and Weaknesses of Different Radiology Modalities
	Ultrasound
		Abnormal Appearances on Kidney Ultrasound Scans
		Urinary Tract Obstruction
	Isotope Renography
	Computed Tomography
	The Risks and Benefits of Using Contrast Media
	References
19: Should We Do a Kidney Biopsy? Balancing the Diagnostic Benefits Against the Clinical Risks
	‘Primum Non Nocere’: First, Do No Harm
	Is It Diabetic Nephropathy?
	Kidney Biopsy in Nephrotic Syndrome and Vasculitis
	References
20: Kidney Stone Disease: A Link Between Nephrology and Urology
	How Stones Form
	Investigating Someone with a Kidney Stone
	Management of Kidney Stone Disease
		Fluid and Diet
		Medication
		Surgery
	References
21: Make a Plan: When and How to Prepare for End-Stage Kidney Disease
	Understanding Risk
		Kidney Failure Risk
		Mortality Risk
	Association or Causation?
	Competing Risks: Dialysis or Death?
	The Gender Paradox
	Predicting the Future
	Prognostication: “Be Prepared”
	Writing Letters to Patients
	Choosing Treatment: Transplant, Haemodialysis, Peritoneal Dialysis or No Dialysis?
	When Should Dialysis Be Started?
	Care of the Whole Person
	Death: Not the End of the Story
	References
22: Kidney Replacement Therapy: Common Problems in Dialysis and Transplant Patients
	Haemodialysis
		Vascular Access
		Complications of a Haemodialysis Catheter
		The Effects of Haemodialysis Treatment
		Fluid Balance in a Haemodialysis Patient
	Peritoneal Dialysis
	Kidney Transplant
		Causes of a Decline in Transplant Function
		Infection
		Malignancy
	References
Frequently Asked Questions
	Measuring Kidney Function
	Symptoms
	Pregnancy
	Polycystic Kidney Disease
	Drugs
	High Blood Pressure
	Fluid Intake
	Potassium
	Protein
	Anaemia
	Bone Disease
	Kidney Stones
	Kidney Replacement Therapy
Multiple Choice Questions
	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 20
	Chapter 21
	Chapter 22
Answers
Case Reports
Index