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A Practical Manual of Renal Medicine
Nephrology, Dialysis and Transplantation
Pages: 528- Edited by:
- Kar Neng Lai (The University of Hong Kong, Hong Kong)
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ISBN: 978-981-283-871-1 (softcover)
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ISBN: 978-981-4468-71-8 (ebook)
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This manual provides practical and accessible information on all aspects of general nephrology, dialysis, and transplantation. It outlines current therapies in straightforward language to help readers understand the treatment rationale, and does not assume extensive knowledge of anatomy, biochemistry, or pathophysiology. Consisting of 33 chapters written by 31 experts from four continents, this volume covers all the practical tips in the emergency and long-term management of patients with electrolyte disturbance, acid-base disturbance, acute renal failure, common glomerular diseases, hypertension, pregnancy-related renal disorders, chronic renal failure, and renal replacement therapy. It is thus an essential source of quick reference for nephrologists, internists, renal fellows, and renal nursing specialists, and is also suitable for graduate students and research scientists in the field of kidney diseases.
Sample Chapter(s)
Chapter 1: Assessment of Patients with Renal Diseases (822 KB)
Contents:
- General Management of Renal Patients:
- Potassium Disturbances (J C M Chan)
- Sodium and Water Disturbances (R Sam & T S Ing)
- Acute Renal Failure (K N Lai)
- Selected Problems in General Nephrology (K N Lai)
- Urinary Tract Infections (E J C Lee)
- Chronic Renal Failure and Dialysis:
- Hemodialysis (B Reddy & A K H Cheung)
- Hemofiltration and Hemodiafiltration (M K L Tong)
- Prevention and Management of Renal Osteodystrophy (D B N Lee)
- Treatment of Renal Anemia (B A Pussell & R G Walker)
- Routine Investigations for Dialysis Patients (S C W Tang)
- Renal Transplantation:
- Pretransplantation Donor and Recipient Workup (L K Chan & S-K Chan)
- Management Guidelines Peritransplantation (J R Chapman)
- Special Renal Investigations:
- Diagnosis of Renal Tubular Acidosis (J C M Chan)
- Treatment of Renal Tubular Acidosis (J C M Chan)
- Radiology in Renal Patients:
- Imaging and Interventional Treatment of Nephrological Problems (A S H Lai & F S K Chu)
- Imaging and Interventional Treatment of Dialysis-Related Problems (A S H Lai & F S K Chu)
- Drug Use in Renal Patients:
- Drug Doses in Patients with Renal Impairment (S-K Chan & L K Chan)
- Recommended Maintenance Drug Doses in Patients with Renal Impairment and in HD/CAPD/CVVH (L K Chan & S-K Chan)
- and other chapters
Readership: Nephrologists, internists, renal fellows, and renal nurses; graduate medical students and research scientists specializing in kidney diseases.
Free Access
FRONT MATTER
- Pages:i–xxv
https://doi.org/10.1142/9789812838728_fmatter
Preview Abstract
The following sections are included:
- Preface
- Contents
- List of Contributors
Part 1 General Management of Renal Patients
No Access
Assessment of Patients with Renal Diseases
- Pages:3–13
https://doi.org/10.1142/9789812838728_0001
Preview Abstract
The following sections are included:
- Urinalysis
- Physical Properties
- Biochemical Properties
- Microscopy
- Interpretation of Laboratory Tests
- Assessment of Renal Function Using Plasma Creatinine
- Assessment of Renal Function Using Plasma Cystatin C
- Renal Biopsy
- Indications
- Contraindications
- Preparation
- Complications
- Post-Renal Biopsy Care
- Suggested Reading
No Access
Acid-Base Disturbances
- Pages:15–37
https://doi.org/10.1142/9789812838728_0002
Preview Abstract
The following sections are included:
- Simple Acid-Base Disturbances
- Definition of pH
- Mixed Acid-Base Disturbances
- Metabolic Acidosis
- Normal Physiology
- High Anion Gap (or Normochloremic) Metabolic Acidosis
- Causes
- Normal Anion Gap (or Hyperchloremic) Metabolic Acidosis
- Causes
- Urinary Anion Gap (UAG−)
- Urinary Osmolal Gap (UOG)
- Clinical Consequences
- Treatment
- Estimation of HCO3− Deficit
- Correction of Normal Anion Gap Metabolic Acidosis
- Metabolic Acidosis in Renal Patients
- Metabolic Alkalosis
- Pathogenetic Mechanism
- Generation Phase
- Maintenance Phase
- Assessment of Urinary Chloride
- Clinical Consequences
- Treatment
- Metabolic Alkalosis in Renal Patients
- Pathogenetic Mechanism
- Combined Metabolic Acidosis and Metabolic Alkalosis
- Respiratory Acid-Base Disturbances in Renal Patients
- Suggested Reading
No Access
Potassium Disturbances
- Pages:39–44
https://doi.org/10.1142/9789812838728_0003
Preview Abstract
The following sections are included:
- Introduction
- Hyperkalemia
- Significant Consequences
- Myocardial
- Neuromuscular
- Diagnostic Workup
- Treatment
- Rapid Removal
- Removal of Potassium from the Body over Several Hours
- Significant Consequences
- Hypokalemia
- Treatment
- Potassium Homeostasis
- In Hyperkalemia
- In Hypokalemia
- Acknowledgment
- Suggested Reading
No Access
Sodium and Water Disturbances
- Ramin Sam and
- Todd S. Ing
- Pages:45–79
https://doi.org/10.1142/9789812838728_0004
Preview Abstract
The following sections are included:
- Urinary Dilution and Concentration
- The Countercurrent Exchange Mechanism
- Proximal Convoluted Tubule
- Descending Limb of Loop of Henle
- Thin Ascending Limb of Loop of Henle
- Thick Ascending Limb of Loop of Henle
- Distal Convoluted Tubule
- Collecting Ducts
- Vasculature and Juxtamedullary Nephrons
- The Role of Urea
- The Role of the Vasa Recta
- Arginine Vasopressin
- Water Channels or Aquaporins
- Free (or Solute-Free) Water and Osmolal Clearances
- In the Case of a Dilute Urine
- In the Case of a Concentrated Urine
- Electrolyte Free Water Clearance versus Free Water Clearance
- The Role of GFR and Proximal Tubular Reabsorption in the Formation of a Dilute or a Concentrated Urine
- How Does the Body Make a Dilute Urine?
- How Does the Body Make a Concentrated Urine?
- The Countercurrent Exchange Mechanism
- Diseases of Urinary Concentration and Dilution
- Inability to Concentrate Urine (i.e. Passage of a Dilute Urine)
- Inability to Dilute Urine
- Hyponatremia
- Definition (Table 4.1)
- Incidence and Associated Findings
- Mechanism of Development
- Pseudohyponatremia (a.k.a. Spurious Hyponatremia)
- True Hyponatremias
- Translocational Hyponatremia
- Euvolemic Hyponatremia
- Hypovolemic Hyponatremia
- Hypervolemic Hyponatremia
- Complications of Hyponatremia
- Risk Factors for Hyponatremic Encephalopathy
- Treatment of Hyponatremias (Other than Translocational Hyponatremia)
- Euvolemic Hyponatremia
- Symptomatic Euvolemic Hyponatremia
- Asymptomatic Euvolemic Hyponatremia
- Hypovolemic Hyponatremia
- Hypervolemic Hyponatremia
- Euvolemic Hyponatremia
- Hypernatremia
- Definition (Table 4.1)
- Incidence
- Prognosis
- Mechanism of Development
- Spurious Hypernatremia
- True Hypernatremia
- Euvolemic Hypernatremia
- Hypovolemic Hypernatremia
- Hypervolemic Hypernatremia
- Common Causes (Table 4.2)
- Adaptation of Brain to Chronic Hypernatremia
- Complications
- Treatment
- Euvolemic Hypernatremia
- Hypovolemic Hypernatremia
- Hypervolemic Hypernatremia
- General Therapeutic Recommendations
- Suggested Reading
No Access
Hypercalcemia, Hypocalcemia, and Hypomagnesemia
- Pages:81–87
https://doi.org/10.1142/9789812838728_0005
Preview Abstract
The following sections are included:
- Introduction
- Hypercalcemia
- Clinical Manifestations
- Management — General Principles
- Management of Acute, Symptomatic Hypercalcemia
- Hypocalcemia
- Clinical Manifestations
- Management
- Hypomagnesemia
- Clinical Manifestations
- Management
- Suggested Reading
No Access
Acute Renal Failure
- Pages:89–107
https://doi.org/10.1142/9789812838728_0006
Preview Abstract
The following sections are included:
- Definition
- Incidence and Prevalence
- Classification and Causes
- Diagnosis
- Biomarkers for Early ARF
- Management
- Prerenal ARF
- True Volume Depletion or Hypovolemia
- Effective Volume Depletion from Arterial Underfilling
- Postrenal ARF
- Intrinsic Renal ARF
- Primary Renal Diseases: Glomerulonephritis and Vasculitis
- Acute Interstitial Nephritis
- Supportive Therapy for All Forms of Established ARF
- Fluid Balance
- Hyperkalemia
- Fever
- Drug Dosage
- Nutrition
- Dialysis
- Prerenal ARF
- Prevention and What to Avoid
- Protection of Renal Perfusion
- Therapy with No Proven Benefit in ATN or Established Renal Failure
- Recovery from Acute Tubular Necrosis
- Prognosis
- Future Novel Treatments
- Suggested Reading
No Access
Selected Glomerular Disorders
- Pages:109–126
https://doi.org/10.1142/9789812838728_0007
Preview Abstract
The following sections are included:
- Minimal Change Nephropathy (MCN)
- Consequences of Proteinuria Complicating Nephrotic Syndrome
- Treatment
- First Attack
- Steroid-Resistant and Frequently Relapsing MCN
- Idiopathic Membranous Nephropathy
- Treatment
- Cytotoxic Agents
- Calcineurin Inhibitor
- Mycophenolate Mofetil
- Rituximab
- Treatment
- Focal Segmental Glomerulosclerosis (FSGS)
- Specific Treatment
- First Attack
- Specific Treatment
- IgA Nephropathy (IgAN)
- Treatment
- Corticosteroids
- Cytotoxic Drugs (Cyclophosphamide)
- Fish Oil
- Mycophenolate Mofetil
- Coagulation-Modifying Agents
- Treatment
- Lupus Nephritis (LN)
- Treatment
- Class IV Diffuse Proliferative LN
- Class V Membranous LN
- Treatment
- Diabetic Nephropathy (DN)
- Treatment
- Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Systemic Vasculitis (AASV)
- Treatment
- Corticosteroids
- Intolerance of Cyclophosphamide
- Mycophenolate Mofetil
- Plasma Exchange
- Rituximab
- Alemtuzumab (Campath-1H)
- Co-trimoxazole
- Treatment
- Suggested Reading
No Access
Hypertension and Renal Disease in Pregnancy
- Pages:127–136
https://doi.org/10.1142/9789812838728_0008
Preview Abstract
The following sections are included:
- Hypertension in Pregnancy
- Classification
- Preeclampsia
- Chronic Hypertension
- Chronic Hypertension with Superimposed Preeclampsia
- Gestational Hypertension
- Secondary Hypertension
- Management
- Home Blood Pressure Monitoring
- Antihypertensive Drugs
- Treatment of Severe Hypertension
- Hydralazine
- Labetalol
- Nifedipine
- Classification
- Renal Disease in Pregnancy
- Lupus Nephritis
- Other Renal Diseases
- Renal Transplant
- Dialysis
- Indications for Biopsy
- Acute Renal Failure (Table 8.4)
- Suggested Readings
No Access
Selected Problems in General Nephrology
- Pages:137–147
https://doi.org/10.1142/9789812838728_0009
Preview Abstract
The following sections are included:
- Hepatorenal Syndrome (HRS)
- Pathophysiology
- Management
- Prevention
- Pharmacologic Treatment
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Renal Replacement Therapy
- Molecular Adsorbent Recirculating System (MARS)
- Liver Transplantation
- Contrast-Induced Nephropathy (CIN)
- Preventive Measures
- General
- Hydration
- Antioxidants
- Suggested Management Strategy
- Preventive Measures
- Rhabdomyolysis
- Management
- ARF in Hematopoetic Cell Transplant (HCT)
- Suggested Reading
No Access
Urinary Tract Infections
- Pages:149–154
https://doi.org/10.1142/9789812838728_0010
Preview Abstract
The following sections are included:
- Asymptomatic Bacteriuria
- Screening for Bacteriuria
- Acute Cystitis
- Clinical Symptoms
- Diagnosis
- Treatment
- Recurrent Cystitis
- Recurrent Cystitis in Women
- Prevention of Recurrent Cystitis in Women
- Recurrent Cystitis in Men
- Acute Pyelonephritis
- Diagnosis
- Treatment
- Infection Associated with Obstruction or Stones
- Infection Associated with Urinary Catheters
- Suggested Reading
Part II Chronic Renal Failure and Dialysis
No Access
Principle of Management for Patients with Chronic Kidney Disease
- Pages:157–167
https://doi.org/10.1142/9789812838728_0011
Preview Abstract
The following sections are included:
- Background
- Detection of CKD
- Referral of Patients to Nephrology Centers
- Interventions Aimed at Slowing the Progression of CKD
- Slowing the Progression of CKD
- Interventions Aimed at Reducing CKD Complications
- Preparation of Patients for Renal Replacement Therapy (RRT)
- Conclusion
- Suggested Reading
No Access
Acceptance into the Chronic Dialysis Program
- Pages:169–174
https://doi.org/10.1142/9789812838728_0012
Preview Abstract
The following sections are included:
- Criteria for Acceptance into the Chronic Dialysis Program
- Subjective Symptoms
- Objective Parameters
- Evaluation and Management of Comorbidity
- Choice of Modality
- Timing of Dialysis Initiation
- Socioeconomic Status
- Cultural Influences
- Clinical Indications for Commencing Dialysis
- Suggested Reading
No Access
Peritoneal Dialysis — Management of Tenckhoff Catheter and Ultrafiltration Problems
- Pages:175–189
https://doi.org/10.1142/9789812838728_0013
Preview Abstract
The following sections are included:
- Introduction
- Peritoneal Dialysis Catheter — Tenckhoff Catheter
- Specification for Catheter Implantation
- Tenckhoff Catheter Implantation Technique under Local Anesthesia
- Implantation with Trocar
- Surgical Mini-laparotomy
- Seldinger Technique — With or Without Laparoscopic Assistance
- Peritoneoscopic Approach
- Postoperative Care
- Common Complications of Implantation
- Tenckhoff Catheter Exit-Site Infection
- Prevention
- Management
- Ultrafiltration Problems
- Causes and Management
- Mechanical Causes
- Medical Causes
- Mechanism
- Causes and Management
- Peritoneal Equilibration Test (PET)
- Interpretation
- Application
- Dialysis Prescription Modification to Increase Ultrafiltration in High Peritoneal Transport
- Suggested Reading
No Access
Management of CAPD-Related Peritonitis
- Pages:191–199
https://doi.org/10.1142/9789812838728_0014
Preview Abstract
The following sections are included:
- Diagnosis
- Peritonitis Rate
- Organisms for Peritonitis
- Management
- Complications
- Prevention
- Contamination Protocols
- Iatrogenic Peritonitis
- Continuous Quality Improvement
- Suggested Reading
No Access
Hemodialysis
- Pages:201–226
https://doi.org/10.1142/9789812838728_0015
Preview Abstract
The following sections are included:
- Mechanisms of Solute Transport
- Diffusion
- Convection
- Adsorption
- Hemodialysis Membranes
- Composition of Membrane
- Membrane Efficiency and Membrane Flux (Table 15.1)
- Biocompatibility
- Dialysate
- Sodium
- Potassium
- Calcium
- Base
- Magnesium
- Dextrose
- Hemodialysis Apparatus
- Blood Circuit
- Dialysate Circuit
- Advanced Control Options
- Vascular Access
- Non-cuffed Catheters (Temporary Catheters)
- Cuffed Dialysis Catheters
- Arteriovenous Fistula (AVF)
- Arteriovenous Graft (AVG)
- Complications of Arteriovenous Access
- Arteriovenous Access Stenosis and Thrombosis
- Distal Ischemia
- Arteriovenous Access Infection
- Heart Failure
- Aneurysm and Pseudoaneurysm
- Anticoagulation
- Anticoagulation in Hemodialysis Patients at Risk for Bleeding
- Heparin-Induced Thrombocytopenia (HIT)
- Chronic Hemodialysis Prescription
- Suggested Reading
No Access
Hemofiltration and Hemodiafiltration
- Pages:227–233
https://doi.org/10.1142/9789812838728_0016
Preview Abstract
The following sections are included:
- Introduction
- Hemofiltration versus Hemodialysis
- Technical Requirements for Hemofiltration and Hemodiafiltration
- Evolution for Hemodiafiltration
- Evidence for Clinical Efficacy in Hemofiltration and Hemodiafiltration
- Blood Purification
- Management of Anemia
- Intratreatment Tolerance
- Intertreatment Tolerance
- Residual Renal Function
- Hospitalization
- Mortality
- Potential Complications and Drawbacks
- Indications for Hemofiltration/Hemodiafiltration
- Prescription
- Predilution versus Postdilution Mode
- On-line Preparation of Sterile Nonpyrogenic Replacement Solution and Dialysis Solution
- Hemofilter
- Flow Parameters
- Substitution Volume
- Anticoagulant
- Suggested Reading
No Access
Adequacy of Dialysis and Dietary Advice
- Pages:235–250
https://doi.org/10.1142/9789812838728_0017
Preview Abstract
The following sections are included:
- Adequacy of Dialysis
- Measuring Small-Solute Clearance
- Hemodialysis: Urea Reduction Ratio (URR) and Kt/V
- Peritoneal Dialysis: Kt/V and Creatinine Clearance
- Residual Renal Function (RRF)
- Present Strategy for Achieving Adequate Dialysis
- Hemodialysis
- K (Clearance)
- t (Time)
- V (Volume of Distribution)
- Peritoneal Dialysis
- Dialysate Volume
- Membrane Solute Transport Rate
- V (Volume of Distribution)
- Hemodialysis
- Protein Catabolic Rate (PCR) or Normalized Protein Nitrogen Appearance (nPNA) Rate
- Dietary Advice
- Assessing Nutritional Status and Dietary Intake
- Recommendations for Daily Intake
- Dialysis
- Dietary Restrictions: What and How?
- Dietary Supplements: What and When?
- Appendix
- Suggested Reading
No Access
Prevention and Management of Renal Osteodystrophy
- Pages:251–281
https://doi.org/10.1142/9789812838728_0018
Preview Abstract
The following sections are included:
- Introduction
- Renal Osteodystrophy: Classification
- Histological
- Clinical
- Predialysis Patients
- Dialysis Patients
- Factors Which Can Modify CKD Bone Disease
- CKD-related Factors
- General Factors
- Osteoporosis and β2-Microglobulin Amyloidosis
- Renal Osteodystrophy: Diagnostic Tests
- Bone Biopsy
- Deferoxamine (DFO) Test
- Imaging Techniques
- Treatment of Hyperparathyroidism
- General Schematic
- Note on Intact PTH Measurement
- Management Strategy
- Step 1: Vitamin D Insufficiency and Deficiency
- Step 2: Control of P Retention and Hyperphosphatemia
- Step 3: Use of Activated Vitamin D Sterols and Calcimimetics (CaM)
- Parathyroidectomy
- Indications
- Clinical Aspects of Refractory Hyperparathyroidism
- Relative Contraindication
- Parathyroid Imaging
- Operative Options
- Surgical Parathyroidectomy
- Chemical/Pharmacological Parathyroidectomy
- Hungry Bone Syndrome
- Indications
- Treatment of Hypercalcemia in Dialysis Patients
- Hypercalcemia Caused by Factors Related to Dialysis
- Calcium Loading and D Sterols
- Severe Hyperparathyroidisim
- Low Bone Turnover Osteodystrophy
- Causes for Hypercalcemia Not Specifically Related to CKD
- Other Treatment Modalities
- Hypercalcemia Caused by Factors Related to Dialysis
- Other Components of Renal Osteodystrophy
- Adynamic Bone Disease
- Aluminum Bone Disease and Osteomalacia
- Aluminum (Al) Toxicity and Al Bone Disease
- Other Causes of Osteomalacia in CKD
- Metabolic Acidosis
- Osteoporosis
- Treatment
- Apparent Similarities Between Osteoporosis and Low Bone Volume ABD
- β2-Microglobulin Amyloidosis
- Clinical Aspects
- Management
- Use of Low-Calcium Dialysate
- Historical Vignettes
- Therapeutic Applications
- Adynamic Bone Disease
- Hypercalcemia
- Monitoring
- Notes on Acute Dialysis
- Suggested Reading
No Access
Treatment of Renal Anemia
- Pages:283–291
https://doi.org/10.1142/9789812838728_0019
Preview Abstract
The following sections are included:
- Causes of Anemia in CKD
- ESA Prescription
- ESA Preparations and Dosing
- Route of Administration
- Precautions/Side-Effects
- Target Levels for Hemoglobin
- What the Guidelines Say
- Australian Guidelines
- Japanese Society for Dialysis Therapy
- North American Guidelines
- United Kingdom Guidelines
- European Guidelines
- Canadian Guidelines
- Recent and Relevant Trials
- What the Guidelines Say
- Failure to Respond to ESAs
- Iron Use in Anemia of CKD
- Hemoglobin Variability
- Suggested Reading
No Access
Bleeding Tendency and Hepatitis B Vaccination
- Pages:293–299
https://doi.org/10.1142/9789812838728_0020
Preview Abstract
The following sections are included:
- Management of Bleeding Tendency in Dialysis/Uremic Patients
- Factors Contributing to Bleeding Tendency
- Clinical Manifestations
- Prevention and Treatment
- Prevention
- Treatment
- Hepatitis B Vaccination
- Suggested Reading
No Access
Routine Investigations for Dialysis Patients
- Pages:301–305
https://doi.org/10.1142/9789812838728_0021
Preview Abstract
The following sections are included:
- Predialysis Workup
- Patient Selection
- Patient Education
- Investigations
- Routine Investigations During Maintenance Dialysis
- Assessment of Suitability for Kidney Transplantation
- Cause of Renal Failure
- Comorbidities
- Laboratory Investigations
Part III Renal Transplantation
No Access
Pretransplantation Donor and Recipient Workup
- Pages:309–339
https://doi.org/10.1142/9789812838728_0022
Preview Abstract
The following sections are included:
- Recipient Selection and Pretransplant Evaluation
- General Considerations
- Patient Education and General Evaluations
- Risk Factors
- Age
- Obesity
- Prior Kidney Transplantation
- Specific Evaluations of Recipients
- Immunologic Evaluation
- Cardiovascular Evaluation
- Gastrointestinal Evaluation
- Genitourinary Evaluation
- Hepatitis B Surface Antigen (HBsAg) Screening
- Hepatitis C Virus (HCV) Screening
- HIV Screening
- Underlying Renal Diseases
- Oxalosis
- Amyloidosis
- Alport syndrome
- Focal Segmental Glomerulosclerosis (FSG)
- Anti-Glomerular Basement Membrane (Anti-GBM) Disease
- Hemolytic-Uremic Syndrome (HUS)
- Type I Membranoproliferative Glomerulonephritis (MPGN)
- Type II MPGN (Dense Deposit Disease)
- IgA Nephropathy (IgAN)
- Diabetes Mellitus
- Live Donor Evaluation
- Background
- Aim of Live Donor Evaluation
- Process of Live Donor Evaluation
- Evaluation of Donor Risk
- Medical Assessment of Donors
- Informed Consent
- Principles of Informed Consent in Live Kidney Donation
- Process of Informed Consent
- Donor Nephrectomy
- Standard Open Nephrectomy
- Laparoscopic Nephrectomy
- Expansion of Living Donor Pool
- Deceased (Cadaver) Donor Evaluation
- Background
- Aim of Cadaveric Kidney Donor Evaluation
- Brain-Dead Donors versus Donation After Cardiac Death
- Definition of Brain Death
- Diagnostic Procedure
- Organ Harvesting and Preservation Before Transplant
- Donor Preservation
- Renal Preservation
- Deceased Kidney Donor Classification
- Procedure of Cadaveric Donor Evaluation
- History and Physical examination
- Post-retrieval Biopsy
- Contraindications to Deceased Kidney Donation
- Key Issues in Deceased Kidney Allocation
- Suggested Reading
No Access
Management Guidelines Peritransplantation
- Pages:341–363
https://doi.org/10.1142/9789812838728_0023
Preview Abstract
The following sections are included:
- The Recipient Before Transplantatio
- Previous Medical History
- Physical Examination
- Pretransplant Investigation
- Tests Required for a Safe Anesthetic
- Tests Required for a Safe Transplant
- Tests Required as Baselines for Postoperative Monitoring
- Informed Consent
- Is It Safe to Send the Patient to the Theater?
- Investigations After Renal Transplantation
- Immediate Assessment and Management
- History of the Operation
- Physical Examination
- Investigations
- Problems Faced Immediately After Surgery
- No Urine Flowa
- Hypoxic/Low Blood Oxygen Saturation
- Hypotension
- Failure of Plasma Creatinine to Fall in the First 24 h Despite Urine Output
- Electrolyte Disorders
- Immediate Assessment and Management
- Prophylactic Immunosuppression
- Anti-interleukin 2 (IL2) Receptor Antibodies
- Standard Triple Therapy
- Corticosteroids
- Calcineurin Inhibitors
- Antiproliferatives
- Sirolimus/Everolimus
- Highly Sensitized Recipients
- Assessment of the Sensitized Patient
- Approaches to Transplantation of the Sensitized Patient
- Other Prophylactic Measures
- Prophylaxis for Pneumocystis Pneumonia
- Prophylaxis for Cytomegalovirus
- Prophylaxis for Mycobacterium Tuberculosis
- Prophylaxis for Gastrointestinal Disease
- Prophylaxis for Cardiovascular Disease
- Checklist When Discharging the Patient from the Ward
- Suggested Reading
No Access
Prophylaxis, Monitoring, and Preemptive Therapy for Potential Complications After Renal Transplantation
- Pages:365–371
https://doi.org/10.1142/9789812838728_0024
Preview Abstract
The following sections are included:
- Prophylaxis Against Peptic Ulceration
- Prophylaxis and Treatment of Tuberculosis
- Prophylaxis and Treatment of Candidiasis
- Prophylaxis and Treatment of Pneumocystis Pneumonia
- Monitoring and Preemptive Therapy for Cytomegalovirus Disease
- Suggested Reading
No Access
Medical Complications After Renal Transplantation
- Pages:373–385
https://doi.org/10.1142/9789812838728_0025
Preview Abstract
The following sections are included:
- Acute Rejection
- Infective Complications
- Cytomegalovirus (CMV) Disease
- Practical Points
- Prophylactic Treatment
- Treatment Options
- Pneumocystis jirovecii Pneumonia
- Viral Hepatitis B and C
- Points to Note in the Management of Viral Hepatitis B or C in Kidney Transplant Recipients
- Specific Points in the Management of Hepatitis B in Kidney Transplant Recipients
- Polyoma BK Virus Disease
- Varicella Zoster Virus Infection, Tuberculosis, and Candidiasis
- Cytomegalovirus (CMV) Disease
- Chronic Renal Allograft Dysfunction
- Factors that Affect Long-Term Renal Allograft Function
- Gastrointestinal Complications
- Graft Renal Artery Stenosis
- Malignancies and Posttransplant Lymphoproliferative Disorder (PTLD)
- Metabolic Complications
- Cardiovascular Complications and Hypertension
- Erythrocytosis and Anemia
- Hyperparathyroidism, Renal Osteodystrophy, and Osteoporosis
- Suggested Reading
Part IV Special Renal Investigations
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Diagnosis of Renal Tubular Acidosis
- Pages:389–400
https://doi.org/10.1142/9789812838728_0026
Preview Abstract
The following sections are included:
- Introduction
- Classification of RTA
- Primary Type 1 RTA
- Primary Type 2 RTA
- Primary Type 4 RTA
- Clinical Picture
- Clinical Features of Type 1 and Type 2 RTA
- Differences in Clinical Features between Pediatric and Adult RTA
- Clinical Features of Type 4 RTA
- Laboratory Measurements in Diagnosing RTA
- Acid loading Test
- Furosemide Test
- Diagnostic Approach
- Hyperkalemic Metabolic Acidosis
- Hypokalemic Metabolic Acidosis
- Acknowledgments
- Suggested Reading
No Access
Treatment of Renal Tubular Acidosis
- Pages:401–403
https://doi.org/10.1142/9789812838728_0027
Preview Abstract
The following sections are included:
- Treatment of Type 1 and Type 2 Renal Tubular Acidosis (RTA)
- Bicarbonate Replacement
- Potassium Replacement
- Treatment of Type 4 RTA
- Suggested Reading
Part V Radiology in Renal Patients
No Access
Imaging and Interventional Treatment of Nephrological Problems
- Pages:407–421
https://doi.org/10.1142/9789812838728_0028
Preview Abstract
The following sections are included:
- Deranged Renal Function
- Ultrasound
- Nuclear Medicine
- Excretion by Glomerular Filtration
- Tubular Secretion Agents
- Renal Cortical Agent
- Urinary Tract Infection (UTI)
- Stone Disease and Renal Colic
- Intravenous Urography
- Non-contrast Computed Tomography
- Ultrasound
- Magnetic Resonance (MR) Urography
- Hematuria
- Hypertension
- Renal Artery Stenosis
- MR Angiography (MRA)
- Digital Subtraction Angiography (DSA)
- Angioplasty/Stenting
- Renal Osteodystrophy
- Plain Radiograph
- Bone Densitometry
- Quantitative Ultrasound
- Hyperparathyroidism
- Ultrasound
- Scintigraphy
- Combination of Sonography and Scintigraphy
- Other Imaging and Interventional Techniques
- Percutaneous Ablation
- Contrast CT and Contrast MR
- Complications of Contrast Imaging in Renal Patients
- Iodinated Contrast-Induced Nephropathy
- Prophylactic Treatment for Subjects at Risk
- Gadolinium Contrast — Nephrogenic Systemic Fibrosis
- Suggested Reading
No Access
Imaging and Interventional Treatment of Dialysis-Related Problems
- Pages:423–432
https://doi.org/10.1142/9789812838728_0029
Preview Abstract
The following sections are included:
- Temporary and Tunneled Catheter Access
- Simple/Straightforward Cases
- Difficult Cases
- Ultrasound and Doppler Ultrasound
- Venogram
- Tunneled Catheter Failure
- Fluoroscopy/Venogram
- Stripping of Tunneled Catheter
- Alternatives to Fibrin Sheath Stripping
- Pre-arteriovenous Fistula Workup
- Venous Anatomy
- Arterial Anatomy
- Poor Flow in Arteriovenous Fistula or Polytetrafluoroethylene (PTFE) Graft
- Acute Thrombosis (Fresh Clot)
- Focal Stenosis
- Chronic Thrombosis
- Complications Related to Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Fluoroscopy
- Ultrasound
- Peritoneogram
- Suggested Reading
No Access
Imaging and Interventional Treatment of Renal Transplant-Related Problems
- Pages:433–441
https://doi.org/10.1142/9789812838728_0030
Preview Abstract
The following sections are included:
- Imaging of the Donor
- Imaging of the Recipient
- Graft Dysfunction and Other Graft Problems
- Complications Related to Graft Renal Parenchyma
- Hyperacute Rejection
- Acute Rejection
- Chronic Rejection
- Acute Tubular Necrosis
- Cyclosporine Nephrotoxicity
- Complications Related to Graft Renal Parenchyma
- Surgical Complications of Graft Kidneys
- Obstructive Uropathy
- Perinephric Collection
- Vascular Complications of Graft Kidney
- Renal Arterial Occlusion
- Renal Arterial Stenosis
- Renal Vein Stenosis and Thrombosis
- Arteriovenous Fistula (AVF) and Pseudoaneurysm
- Suggested Reading
Part VI Drug Use in Renal Patients
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Drug Doses in Patients with Renal Impairment
- Pages:445–450
https://doi.org/10.1142/9789812838728_0031
Preview Abstract
The following sections are included:
- Influence of Renal Impairment on Drug Absorption and Bioavailability
- Influence of Renal Impairment on Volume of Distribution and Protein Binding
- Influence of Renal Impairment on Drug Elimination
- Dosing of Drugs in the Presence of Renal Impairment
- Calculation of Initial Dose
- Calculation of Dose Fraction of Maintenance Dose
- The Cockcroft–Gault Equation for Estimating Creatinine Clearance
- Drug Removal During Hemodialysis and Peritoneal Dialysis
- Drug Removal During Continuous Renal Replacement Therapy (CRRT)
- Therapeutic Drug Monitoring
- Suggested Reading
No Access
Recommended Maintenance Drug Doses in Patients with Renal Impairment and in HD/CAPD/CVVH
- Pages:451–483
https://doi.org/10.1142/9789812838728_0032
Preview Abstract
The following sections are included:
- Antibiotics
- Aminoglycoside Antibiotics
- Cephalosporin
- Penicillin (Oral)
- Penicillin (IV)
- Quinolones
- Macrolides
- Carbapenem
- Other Antibiotics
- Antituberculosis Antibiotics
- Antifungal Agents
- Antiviral Agents
- Analgesics
- Antihypertensive Drugs and Diuretics
- ACE Inhibitors
- Angiotensin II Receptor Blockers
- Beta Blockers
- Calcium Channel Blockers
- Diuretics
- Alpha Blockers
- Other Antihypertensive Drugs
- Antiarrhythmic Agents
- Oral Hypoglycemic Agents
- Lipid-Lowering Agents
- Gastrointestinal Agents
- Neurological Agents/Anticonvulsants
- Arthritis and Gout
- NSAIDs
- Sedatives
- Barbiturates
- Benzodiazepines
- Benzodiazepine Antagonist
- Lithium
- Antipsychotics
- Antidepressants
- Anticoagulants
- Antihemophilic Agent
- Chemotherapy
- Iron-Chelating Agent
- Immunosuppressants
No Access
Drug Interactions with Commonly Used Immunosuppressants
- Pages:485–493
https://doi.org/10.1142/9789812838728_0033
Preview Abstract
The following sections are included:
- Cyclosporine
- Tacrolimus
- Mycophenolic Acid (MMF or Myfortic)
- The TOR Inhibitors: Sirolimus and Everolimus
- Potential Drug Interactions Among Commonly Used Immunosuppressants
- Suggested Reading
Free Access
BACK MATTER
- Pages:495–501
https://doi.org/10.1142/9789812838728_bmatter
Preview Abstract
The following sections are included:
- Index
Sample Chapter(s)
Chapter 1: Assessment of Patients with Renal Diseases (822k)
