Claudio Ronco

R. M. Lindsay

U. Buoncristiani

R. S. Lockridge

A. Pierratos

G. O. Ting

As the frequency of hemodialysis sessions has always been a concern, it is not astonishing that interest in quotidian (daily) hemodialysis appears to be growing worldwide. The main reasons for more frequent dialysis are to maximize well-being and minimize both intra- and interdialytic symptoms, as well as to improve the treatment of patients with severe underlying medical problems, particularly cardiovascular disease. Moreover, studies also indicate overall potential cost savings as compared with current conventional hemodialysis. There are two options available, namely short daily and long nightly treatments. The main difference centers on the ability of the nightly regimen to remove greater amounts of phosphate and beta-2-microglobulin. Even so, there is no doubt that both treatments are highly preferable to conventional three times weekly dialysis. Further issues which are discussed include the requirements necessary to run dialysis programs, vascular access requirements, and the management of complications and risks such as calcium and phosphorus control. This is the first publication devoted solely to daily hemodialysis therapies: Concentrating on clinical and technical issues, it is an important contribution to the practical development of daily hemodialysis and is highly recommended to nephrologists, nurses, managers of renal programs and others involved in renal care.

Daily and Nocturnal Hemodialysis

John A. Kellum

Rinaldo Bellomo

Continuous Renal Replacement Therapy (CRRT) is the standard of care for management of critically ill patients with acute renal failure. Part of the Pittsburgh Critical Care series, Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice. Organized into sections on theory, practice, special situations, and organizational issues, this volume provides a complete view of CRRT theory and practice. Tables summarize and highlight key points, and key studies and trials are included in each chapter. The second edition has been updated to include a new chapter on the use of biomarkers to aid in patient selection and timing, extensive revisions on terminology and nomenclature to match current standards, and the most up-to-date information on newly developed CRRT machines.

Continuous Renal Replacement Therapy

John Kellum

In the past decade, CRRT has moved from a niche therapy within specific specialty centers to the standard of care for management of critically ill patients with acute renal failure. Continuous Renal Replacement Therapy provides concise, evidence-based, to-the-point bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice. Organized into sections on Theory; Pratice; Special Situations; and Organizational Issues, Continuous Renal Replacement Therapy provides a complete view of CRRT theory and practice. Generous tables summarize and highlight key points, and key studies and trials are listed in each chapter.

Roberto Dell'Aquila

Maria Pia Rodighiero

Even though peritoneal dialysis (PD) is by now well established and its advantages in terms of clinical efficacy, social impact and individual tolerance are acknowledged, it is still underutilized on a global scale. In view of this fact, the publication at hand has two objectives, namely to provide help to identify possible obstacles to a wider application of PD and to advance a project called USS PD: Understanding, Starting and Sustaining Peritoneal Dialysis (initiated by the Department of Nephrology, Dialysis and Transplantation of the St. Bortolo Hospital in Vicenza, Italy).The initial part of this book is thus dedicated to basic principles of PD, as understanding how this technique works is one of the prerequisites to improve the quality of its application and, ultimately, its outcomes. In the second part, in-depth reviews help the physician to identify the benefits and problems involved in a PD program, facilitating the initiation of a new program or the start of new patients on PD. The third part, finally, is dedicated to potential complications and technical solutions designed to solve the problems of the different techniques. This helps physicians to sustain the use of PD after having acquired the know how and the capacity of starting the program. Everyone interested in understanding and implementing PD will highly profit from the papers presented in this publication.

A Clinical Update

Peritoneal Dialysis

Edgar V. Lerma

Janani Rangaswami

Extending from the outpatient management of cardiovascular and kidney disease, to hospital-based decision making in patients with cardio-renal disease and complex interfaces such as hemodialysis in patients with ventricular assist device support, this book serves as a single reference point for cardiology and nephrology clinicians and researchers dealing with the significant overlap areas between these two specialties. Chapters cover the physiology, biomarkers, therapeutic agents and full spectrum of these comorbidities and feature separate sections on cardiovascular and CKD evaluations, stratification of kidney transplant patients, lipid management in CKD, interventional strategies and hypertension. Leaders in cardiology, nephrology, hypertension and lipidology bring together the latest evidence with their collective clinical experience into this invaluable resource.This textbook is an essential resource for physicians and allied professionals practicing cardiology, nephrology, students and physician trainees, to deepen their understanding of this crucial field.

Confluence of the Heart and Kidney in Clinical Practice

Cardio-Nephrology

Over the last 10 years the syndrome of severe acute renal failure has progressively changed in its epidemiology. It is now most frequently seen in critically ill patients, typically in the context of sepsis and multiorgan failure. This epidemiologic change has meant that intensive care physicians and nephrologists must now work in close cooperation at all times and must take many com plex issues of prevention, pathogenesis, and management into account that they did not previously have to tackle. Simultaneously, the last 10 years have seen the development of major technical and conceptual changes in the field of renal replacement therapy. There are now previously unavailable therapeutic options that provide physicians with a flexible and rapidly evolving armamentarium. The nutrition of these patients, previously limited by the par tial efficacy of renal replacement therapies, has also become more aggressive and more in tune with the needs of critically ill patients. Increased understanding of the pathogenesis of the multi organ failure syndrome has focused on the role of many soluble "mediators of injury" (cytokines, leukotrienes, prostanoids etc.). These molecules are likely to participate in the pathogenesis of acute renal failure. Their generation and disposal is also affected by different techniques of artificial renal support.

Acute Renal Failure in the Critically Ill

Francesco Rodeghiero

Uric acid disorders are involved in both nephrological and hematological diseases. One of these crystal-associated diseases which has been known since antiquity is gout. More recently, tumor Lysis syndromes have been identified which affect patients with cancer, especially in the phase of cellular destruction after chemotherapy. The detection of these hyperuricemic syndromes, together with the improved understanding of urate handling by the kidney, have spurred new interest in the pathophysiology of hyperuricemic states, their clinical consequences and management. Moreover, the recent development of a recombinant form of urate oxidase transforming uric acid into allantoin (Rasburicase) has caused new interest in the pathophysiology of hyperuricemia and the potential applications of this new drug. The multidisciplinary approach of this book offers new insights into the metabolic syndromes in question by uniting authors from the fields of biochemistry, pharmacology, rheumatology, onco-hematology, and nephrology. The result is a compendium of the present knowledge in the field, which will also be very useful as a reference tool for professionals and students who want to expand their knowledge on this topic.

Pathophysiology and Therapy

Hyperuricemic Syndromes

Zaccaria Ricci

Comprehensive and clinically relevant, the 3rd Edition of Critical Care Nephrology provides authoritative coverage of the latest advances in critical care procedures for patients with renal diseases or disorders. Using common guidelines and standardized approaches to critically ill patients, this multidisciplinary reference facilitates better communication among all physicians who care for critically ill patients suffering from kidney disease, electrolyte and metabolic imbalances, poisoning, severe sepsis, major organ dysfunction, and other pathological events. Offers detailed discussions of different forms of organ support, artificial organs, infections, acute illness occurring in chronic hemodialysis patients, and much more. Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool. Presents information clearly, in a format designed for easy reference – from basic sciences to clinical syndromes to diagnostic tools. Covers special populations such as children, diabetic patients, and the elderly. An exceptional resource for nephrologists, intensivists, surgeons, or critical care physicians – anyone who treats critically ill renal patients. Shares a combined commitment to excellence lead by Drs. Claudio Ronco, Rinaldo Bellomo, John Kellum, and Zaccaria Ricci – unparalleled leaders in this field. Addresses key topics with expanded coverage of acute kidney injury, stress biomarkers, and sepsis, including the latest developments on mechanisms and management. Provides up-to-date information on extracorporeal therapies from new editor Dr. Zaccaria Ricci.

Critical Care Nephrology E-Book

José A. Moura-Neto

José Carolino Divino-Filho

This book presents contributions from leading international experts in the field of nephrology. Each chapter is independent and discusses nephrology in the author’s country, including the history of nephrology development, kidney disease epidemiology, clinical nephrology, dialysis practice in acute and chronic renal failure settings (hemodialysis, hemodiafiltration, peritoneal dialysis), pediatric nephrology, and kidney transplantation. In addition, the book covers topics such as the job market for nephrologists, reimbursement, nephrology education, and the number of professionals in the private and public sectors. With 53 chapters and more than 300 authors from all continents offering a unique perspective on nephrology practice, it provides a much-needed information source for nephrologists around the globe. The reader will be able to travel through “Nephrology Worldwide”, a pleasant reading experience with not only relevant information and updated data, but also a comprehensive look at the history, countries’ peculiarities, and a critical analysis of the scenario of nephrology and renal replacement therapy. A valuable resource for healthcare professionals and other stakeholders interested in learning about the status quo of Nephrology Worldwide. “Both the failings and the successes are outlined in a way that should make this book a compelling read, not just for the well-informed renal physician, but also for planners and policy makers whose thinking and actions are integral to the way we practice medicine.” - Sir Peter J. Ratcliffe, Nephrologist and 2019 Nobel Prize Winner More information on the Nephrology Worldwide initiative can be found at www.nephrologyworldwide.com.

Nephrology Worldwide

While continuous ambulatory peritoneal dialysis (CAPD) has been the standard peritoneal procedure since the seventies, different schedules of automated peritoneal dialysis (APD) have emerged during the eighties. Today, APD is considered a valuable tool in the management of ESRD patients, together with CAPD and hemodialysis. However, despite its frequent use, APD has not yet been well assessed, and most pathophysiological and clinical studies on PD refer to CAPD. In this book, major experts in the field therefore discuss and evaluate the insights gained on APD up to now, presenting a comprehensive review of all experimental, technical and clinical aspects related to the various treatments grouped under the definition of APD. The recent developments presented are divided into four sections: membrane permeability, transport mechanisms and kinetic modeling applied to APD; prescription and adequacy of different APD treatment schedules; dialysis machines and solutions for APD, and, lastly, different clinical aspects such as the possibility to maintain APD program and residual renal function. Physicians involved in ESRD care, renal fellows and scientists both in the academic world and in the hospital setting will undoubtedly profit from this timely publication.

Automated Peritoneal Dialysis

Nacida sin función renal, la vida del bebé Lisa está en manos de Claudio Ronco, médico, científico e inventor de CARPEDIEM, un dispositivo médico para diálisis infantil. Esta notable y conmovedora historia detalla las experiencias de la larga y productiva vida de un médico mientras lucha para darle a un bebé recién nacido una oportunidad al mismo tiempo. Esta es también la historia de la nueva máquina revolucionaria que proporciona soporte vital para los bebés y el equipo de talentosos médicos de Ronco que a través de la creatividad el trabajo en equipo y la determinación superan los desafíos clínicos que solían considerarse insuperables.

La historia de una bebé, un médico y una máquina

Carpediem

Achim Jörres

Acute kidney failure is an important clinical area in the intensive care unit setting. An estimated 5–20% of critically ill patients experience an episode of acute kidney failure during the course of their illness, and about 5% of patients admitted to an ICU will eventually require renal replacement therapy. In these patients, in-hospital mortality is extremely high, exceeding 50%. Thus, the early detection and causal treatment of acute kidney problems is vitally important for a successful outcome. Written by internationally renowned experts, this clinical reference offers helpful advice with the most recent information on the definition, epidemiology, pathophysiology, and clinical causes of acute kidney failure as a fundamental prerequisite for prevention of this disorder. Moreover, it also covers differential diagnostic approaches for patients with acute renal failure and provides a detailed outline of important measures for their clinical management. Finally, separate chapters are dedicated to various key aspects related to the adequate delivery of acute renal replacement therapy. It is intended as a helpful guide for all clinicians involved in the care of patients at risk of developing acute kidney problems.

Management of Acute Kidney Problems

Peter A. McCullough

This textbook provides a practical and board-driven resource to describe and define the emerging field of cardiorenal medicine. Covering all aspects of the topic with depth and relevance, this groundbreaking reference brings together experts at the nexus between cardiovascular and renal medicine to provide an exception reference to educate in this critical area of modern medicine. It describes how the heart and kidneys are inextricably linked via hemodynamic, neural, hormonal and cellular signaling systems and, concentrating on disease-based coverage, goes on to review emerging concepts in epidemiology, pathogenesis, screening, diagnosis and the management of cardiorenal syndromes, all extensively illustrated and containing features to support scholarship in the field. Textbook of Cardiorenal Medicine provides consistent chapter organization, clear design and engaging text to define the diagnosis, treatment, intervention and surgical aspects of the full range of conditions encountered within this area of medicine. It is therefore an essential resource to all involved in the management of cardiorenal disease.

Textbook of Cardiorenal Medicine

Dinna N. Cruz

Carlo Crepaldi

The importance of peritoneal dialysis (PD) in the therapy of chronic kidney disease has been steadily increasing. The simultaneous advancement in clinical practice and basic research has increased overall knowledge and led to significant progress in the safe and adequate application of PD. Moreover, integration with other techniques in the therapy of uremia represents an important step in the optimization of the whole program of renal replacement therapy.Leading experts in the field have contributed to this volume, discussing topics such as the biology of the peritoneal membrane, dialysis solutions, inflammation and nutrition, PD adequacy, or complications and their management or PD in special settings. This compilation updates and expands the information on PD published in previous volumes of the series 'Contributions to Nephrology'. It represents an important source of information for beginners and experts, basic scientists and clinical physicians, students and investigators who want to have a true update on current research and clinical practice in peritoneal dialysis.

From Basic Concepts to Clinical Excellence

Because of the increase in serious kidney diseases, including end-stage renal disease, your role as a nephrologist, intensivist, surgeon, or critical care physician is quickly expanding. Well received in its 1st edition, this 2nd edition continues to provide comprehensive coverage of the latest advances in critical care procedures for the adult or pediatric patient with renal diseases or disorders. Presents a common language and standardized guidelines to help multi-disciplinary physicians caring for the critically ill communicate more effectively. A new US editor, detailed discussions of different forms of organ support, artificial organs, infections, acute illness occurring in chronic hemodialysis patients, and much more make this book an exceptional resource for anyone who treats critically ill renal patients. And, as an Expert Consult title, this meticulously updated 2nd edition comes with access to the complete contents online, fully searchable. Presents a multi-disciplinary and international approach to critical renal care for a thorough and integrated presentation of how to care for critically ill patients with renal disease or complications. Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure. Provides details on different forms of organ support, including liver, lung, and cardiac therapy. Defines common guidelines in nephrology and critical care medicine for better communication among clinicians. Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool. Features a new US editor, Dr. John Kellum, who incorporates his expertise in critical care medicine to the 2nd edition and extends the breadth of coverage with a North American perspective. Includes access to the complete fully searchable contents online for convenient referencing. Discusses new techniques in the field providing you with a comprehensive review of the experimental and clinical work being done. Features a new 2-color design and shorter, more focused chapters to help you access key facts quicker. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. If the next edition is published less than one year after your purchase, you will be entitled to online access for one year from your date of purchase. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should access to the web site be discontinued.

Critical Care Nephrology

Because of the increase in serious kidney diseases, including end-stage renal disease, your role as a nephrologist, intensivist, surgeon, or critical care physician is quickly expanding. Well received in its 1st edition, this 2nd edition continues to provide comprehensive coverage of the latest advances in critical care procedures for the adult or pediatric patient with renal diseases or disorders. Presents a common language and standardized guidelines to help multi-disciplinary physicians caring for the critically ill communicate more effectively. A new US editor, detailed discussions of different forms of organ support, artificial organs, infections, acute illness occurring in chronic hemodialysis patients, and much more make this book an exceptional resource for anyone who treats critically ill renal patients. Presents a multi-disciplinary and international approach to critical renal care for a thorough and integrated presentation of how to care for critically ill patients with renal disease or complications. Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure. Provides details on different forms of organ support, including liver, lung, and cardiac therapy. Defines common guidelines in nephrology and critical care medicine for better communication among clinicians. Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool. Features a new US editor, Dr. John Kellum, who incorporates his expertise in critical care medicine to the 2nd edition and extends the breadth of coverage with a North American perspective. Discusses new techniques in the field providing you with a comprehensive review of the experimental and clinical work being done. Features shorter, more focused chapters to help you access key facts quicker.

Claudio Ronco

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