Brenner and Rector’s The Kidney

Brenner & Rector’s The Kidney......Page 2
Copyright Page......Page 3
Dedication......Page 4
Contributors......Page 5
Foreword......Page 20
Preface......Page 22
Development of the Urogenital System......Page 24
Development of the Metanephros......Page 25
Development of the Nephron......Page 26
Renal Stroma and Interstitial Populations......Page 27
The Kidney Organ Culture System: Classic Studies......Page 28
Antisense Oligonucleotides and siRNA in Organ Culture......Page 29
Transgenic and Knockout Mouse Models......Page 31
Nonmammalian Model Systems for Kidney Development......Page 41
Early Lineage Determination of the Metanephric Mesenchyme......Page 43
Ureteric Bud Induction: Transcriptional Regulation of GDNF......Page 44
Genes Required by the Ureteric Bud in Early Kidney Development......Page 45
Formation of the Collecting System......Page 47
Positioning of the Ureteric Bud......Page 49
Molecular Analysis of the Nephrogenic Zone......Page 50
Molecular Biology of Nephron Development: Tubulogenesis......Page 52
Molecular Genetics of the Stromal Cell Lineage......Page 53
Molecular Genetics of Vascular Formation......Page 54
The Juxtaglomerular Apparatus and the Renin Angiotensin Aldosterone System......Page 57
Glomerular Epithelial Development......Page 58
Maturation of Glomerular Endothelial Cells and Glomerular Basement Membrane......Page 61
Key References......Page 62
References......Page 64
Gross Features......Page 76
The Nephron......Page 78
Renal Corpuscle......Page 79
Endothelial Cells......Page 80
Glomerular Basement Membrane......Page 82
Visceral Epithelial Cells......Page 83
Mesangial Cells......Page 85
Parietal Epithelial Cells......Page 86
Extraglomerular Mesangium......Page 87
Autonomic Innervation......Page 88
Pars Convoluta......Page 89
Pars Recta......Page 94
Thin Limbs of the Loop of Henle......Page 95
Thick Ascending Limb......Page 97
Distal Convoluted Tubule......Page 99
Connecting Tubule......Page 102
Collecting Duct......Page 103
Cortical Collecting Duct......Page 104
Outer Medullary Collecting Duct......Page 107
Inner Medullary Collecting Duct......Page 108
Interstitium......Page 109
Cortical Interstitium......Page 111
Medullary Interstitium......Page 112
Innervation......Page 114
Key References......Page 115
References......Page 117
Major Arteries and Veins......Page 125
Total Renal Blood Flow......Page 127
Cortical Blood Flow......Page 129
Peritubular Capillary Dynamics......Page 131
Vascular Patterns......Page 132
Structure of the Glomerular Microcirculation......Page 134
Glomerular Capillary Hydraulic and Colloid Osmotic Pressure Profiles......Page 136
Determination of the Ultrafiltration Coefficient......Page 138
Transcapillary Hydraulic Pressure Difference......Page 139
Vasomotor Properties of the Renal Microcirculations......Page 140
Role of the Renin-Angiotensin System in the Control of Renal Blood Flow and Glomerular Filtration Rate......Page 141
Nitric Oxide......Page 143
Endothelin......Page 145
Renal Autoregulation......Page 146
The Myogenic Mechanism for Autoregulation......Page 147
Autoregulation Mediated by Tubuloglomerular Feedback......Page 148
Mechanisms of Tubuloglomerular Feedback Control of Renal Blood Flow and Glomerular Filtration Rate......Page 150
Autoregulation Mediated By Metabolic Mechanisms......Page 151
Key References......Page 152
References......Page 154
Biologic Functions of Podocytes......Page 162
Glomerular Diseases in Which Podocytes are the Primary Glomerular Cell Type Injured......Page 163
Minimal Change Nephropathy......Page 164
Diabetic Kidney Disease......Page 166
Effacement: A Histologic Change In Podocyte Shape Mediated by the Actin Cytoskeleton......Page 167
Glomerulosclerosis and Reduced Kidney Function: A Correlation with Depletion in Podocyte Number......Page 168
Renin Angiotensin Aldosterone System Inhibitors......Page 169
Key References......Page 170
References......Page 172
Chapter Outline......Page 175
Application of the Laws of Thermodynamics to Kidney Function......Page 176
Pump-Leak Process and the Sodium Potential......Page 177
Harnessing the Sodium Potential for Work......Page 178
Metabolism Basics......Page 179
Whittam Model......Page 180
Energy Requirements and Substrate Use along the Nephron......Page 181
Renal Gluconeogenesis and Lactate Handling......Page 183
Thick Ascending Limb......Page 185
Renal Blood Flow and Oxygen Consumption......Page 186
Metabolic Cost of Sodium Reabsorption......Page 188
Physiologic Regulation: Filtration Fraction and Oxygen Consumption......Page 191
Hypoxia and Ischemia......Page 192
Adenosine Monophosphate–Activated Protein Kinase......Page 193
Key References......Page 195
References......Page 197
Proximal Tubule......Page 201
Paracellular Na+-Cl− Transport......Page 204
Apical Mechanisms......Page 205
Glomerulotubular Balance......Page 207
Neurohumoral Influences......Page 209
Regulation of Proximal Tubular Transporters......Page 211
Na+-Cl− Transport by the Thin Ascending Limb......Page 213
Apical Na+-Cl− Transport......Page 215
Apical K+ Channels......Page 216
Basolateral Mechanisms......Page 217
Activating Influences......Page 219
Inhibitory Influences......Page 221
Distal Convoluted Tubule, Connecting Tubule, and Collecting Duct......Page 222
Mechanisms of Na+-Cl− Transport in the Distal Convoluted Tubule......Page 223
Regulation of Na+-Cl− Transport in the Distal Convoluted Tubule......Page 224
Apical Na+ Transport......Page 226
Cl− Transport......Page 227
Aldosterone......Page 228
Vasopressin and Other Factors......Page 230
Potassium Transport......Page 231
Loop of Henle and Medullary K+ Recycling......Page 232
K+ Secretion by the Distal Convoluted Tubule, Connecting Tubule, and Cortical Collecting Duct......Page 233
K+ Reabsorption by the Collecting Duct......Page 235
Aldosterone and K+ Loading......Page 236
K+ Deprivation......Page 237
Integrated Na+-Cl− and K+ Transport in the Distal Nephron......Page 239
Key References......Page 240
References......Page 242
Role of Calcium in Cellular Processes......Page 254
Calcium Present in Serum in Bound and Free Forms......Page 255
Reabsorption of Calcium Along the Tubule......Page 256
Ca2+ Reabsorption in the Loop of Henle......Page 257
Diuretics......Page 258
Structures of Proteins Involved in the Transport of Calcium......Page 260
Regulation of Magnesium Homeostasis......Page 262
Reabsorption of Magnesium Along the Tubule......Page 263
Structures of Proteins Involved in the Transport of Magnesium......Page 264
Phosphorus Present in Blood in Multiple Forms......Page 265
Regulation of Phosphate Homeostasis: An Integrated View......Page 266
Reabsorption of Phosphate Along the Nephron......Page 267
Dietary Phosphate......Page 268
Renal Nerves, Catecholamines, Dopamine, and Serotonin......Page 269
Phosphatonins (FGF-23, sFRP-4)......Page 270
Key References......Page 271
References......Page 273
Physiology of Renal Glucose Transport......Page 284
SGLT1.......Page 285
SGLT2.......Page 286
Renal Glycosuria......Page 287
Pharmacologic Manipulation of Sodium-Glucose–Linked Cotransporters......Page 289
Basolateral Organic Cation Entry......Page 290
Basolateral Organic Cation Transporters: OCT1, OCT2, and OCT3......Page 291
Organic Cation Transporter Structure......Page 293
Apical Organic Cation Transporters: MATE1 and MATE2/2-K......Page 294
Physiology of Organic Anion Transport......Page 295
Molecular Biology of Organic Anion Transport......Page 296
NaDC3......Page 297
OAT Family......Page 298
Disorders of Citrate Transport......Page 299
Uric Acid......Page 300
Drugs That Affect Renal Urate Handling......Page 301
Hartnup’s Disorder.......Page 302
TauT (SLC6A6).......Page 304
4F2hc/LAT2 (SLC3A2/SLC7A9).......Page 305
Apical Transporters......Page 306
Oligomeric Structure and Biogenesis of rBAT/b0,+AT.......Page 307
EAAT3 (SLC1A1).......Page 308
SLC6 Transporters......Page 309
Heteromeric Amino Acid Transporters......Page 311
Key References......Page 312
References......Page 314
General Transport Mechanisms......Page 323
H+-ATPase......Page 324
Electroneutral Sodium-Bicarbonate Cotransporter......Page 325
Parathyroid Hormone......Page 326
Distal Convoluted Tubule......Page 327
Type A Intercalated Cell......Page 328
Connecting Tubule and Initial Collecting Tubule......Page 330
H+-K+-ATPase......Page 331
Sodium-Bicarbonate Cotransporters......Page 332
Hormonal Regulation of Collecting Duct Acid-Base Transport......Page 333
Cellular Adaptations to Acid-Base Perturbations......Page 334
Phosphate as a Titratable Acid......Page 335
Citrate Excretion......Page 336
Ammonia Production......Page 337
Glutamine Transport in Ammoniagenesis......Page 338
Ammonia Transport......Page 340
Glutamate Dehydrogenase......Page 342
Carbonic Anhydrase......Page 343
Sulfatides......Page 344
Key References......Page 345
References......Page 347
Independent Regulation of Water and Salt Excretion......Page 356
Loops of Henle......Page 357
Distal Tubule Segments in the Cortical Labyrinth......Page 359
Medullary Interstitium......Page 360
Sites of Urine Concentration and Dilution......Page 362
Generation of the Axial Sodium Chloride Gradient in the Renal Outer Medulla......Page 363
Accumulation of Urea in the Renal Inner Medulla......Page 366
Collecting Duct Water Absorption and Osmotic Equilibration......Page 368
An Unresolved Question: Concentration of Sodium Chloride in the Renal Inner Medulla......Page 369
Concentrating Mechanism Driven by External Solute......Page 370
Aquaporin-1 Knockout Mice......Page 371
UT-A1/3 Urea Transporter Knockout Mice......Page 374
Type 2 Vasopressin Receptor Knockout Mice......Page 376
Key References......Page 377
References......Page 379
Chapter Outline......Page 384
Interaction of Type 2 Vasopressin Receptor with Heterotrimeric G Proteins and β-Arrestin......Page 385
Fate of the Type 2 Vasopressin Receptor after Internalization—Delivery to Lysosomes......Page 387
Nephrogenic Diabetes Insipidus......Page 388
Aquaporin-2: the Vasopressin-Sensitive Collecting Duct Water Channel......Page 389
An Overview of Vasopressin-Regulated Aquaporin-2 Trafficking in Collecting Duct Principal Cells......Page 390
Transfected Polarized Cells Expressing Exogenous Aquaporin-2......Page 391
Expression of Multiple Basolateral Aquaporins (Aquaporin-2, Aquaporin-3, And/or Aquaporin-4) in Principal Cells......Page 392
A Role of Basolateral Aquaporin-2 in Cell Migration and Tubule Morphogenesis......Page 393
Regulation of Aquaporin-2 Trafficking......Page 394
Role of Kinases and a-Kinase Anchoring Proteins in Aquaporin-2 Trafficking......Page 395
Phosphorylation of S256 Modulates Aquaporin-2 Interaction with Endocytotic Proteins......Page 396
Identification of Actin-Associated Proteins Potentially Involved in Aquaporin-2 Trafficking......Page 397
SNARE Proteins and Aquaporin-2 Trafficking......Page 398
Long-Term Regulation of Water Balance......Page 399
Lithium Treatment......Page 400
Liver Cirrhosis and Congestive Heart Failure......Page 402
Phosphodiesterase Inhibitors......Page 403
Heat Shock Protein 90......Page 404
Key References......Page 405
References......Page 406
Chapter Outline......Page 415
General Introduction to Aldosterone and Mineralocorticoid Receptors......Page 416
Aldosterone Synthesis......Page 417
Mineralocorticoid Receptor Function as a Hormone-Regulated Transcription Factor: General Features and Subcellular Localization......Page 418
DNA-Binding Domain......Page 419
Ligand/Hormone-Binding Domain......Page 420
General Model of Aldosterone Action......Page 422
Aldosterone and Epithelial Sodium Channel Trafficking......Page 423
Potassium Secretion and Aldosterone......Page 424
Electroneutral Versus Electrogenic Sodium Reabsorption......Page 425
Aldosterone-Independent ENaC-Mediated Sodium Reabsorption in the Distal Nephron......Page 426
Nonrenal Aldosterone-Responsive Tight Epithelia......Page 427
Colon......Page 428
Induction of SGK1 by Aldosterone......Page 429
SGK1 Inhibits the Ubiquitin Ligase Nedd4-2......Page 430
SGK1 Stimulates Potassium Secretion in the Aldosterone-Sensitive Distal Nephron......Page 431
Role of 11β-HSD2 in blood vessels......Page 432
Primary Aldosteronism......Page 433
Nonepithelial Actions of Aldosterone......Page 434
Key References......Page 435
References......Page 437
Renin-Angiotensin-Aldosterone System......Page 446
Renin......Page 447
Tubular Control......Page 448
Angiotensin Type 1 Receptor......Page 449
Tyrosine Kinases......Page 450
Physiologic Effects of Angiotensin II in the Kidney......Page 451
(Pro)Renin Receptor......Page 452
Angiotensin IV, or Angiotensin-(3-8)......Page 453
Intracrine Renin-Angiotensin-Aldosterone System......Page 454
Diabetes Paradox......Page 455
Structure, Synthesis, and Secretion of the Endothelins......Page 456
Role of Endothelin in Essential Hypertension......Page 457
Endothelin System in Chronic Kidney Disease and Diabetic Nephropathy......Page 458
Safety Profile of Endothelin Receptor Antagonists......Page 459
Atrial Natriuretic Peptide......Page 460
Dendroaspis Natriuretic Peptide......Page 461
Neutral Endopeptidase......Page 462
Other Effects of the Natriuretic Peptides......Page 463
Role of Brain Natriuretic Peptide and N-Terminal Pro–Brain Natriuretic Peptide as Biomarkers in Renal Disease......Page 464
Therapeutic Uses of Other Natriuretic Peptides......Page 465
Combination Angiotensin Receptor Blockers and Neutral Endopeptidase Inhibitors......Page 466
Kallikrein......Page 467
Plasma and Tissue Kallikrein-Kinin System......Page 468
Renal Kallikrein-Kinin System......Page 469
Diabetic Nephropathy......Page 470
Antineutrophil Cytoplasmic Antibody–Associated Vasculitis......Page 471
Physiologic Role of Urotensin II......Page 472
Key References......Page 473
References......Page 475
Chapter Outline......Page 486
Molecular Biology......Page 487
COX-2 Expression in the Renal Cortex......Page 489
COX-2 Expression in the Renal Medulla......Page 492
Na+ Retention, Edema, and Hypertension......Page 493
Acute Kidney Injury......Page 494
Increased Cardiovascular Thrombotic Events......Page 495
Sources and Nephronal Distribution of Cyclo-Oxygenase Products......Page 496
Prostaglandin 9-Ketoreductase......Page 497
TP Receptors......Page 498
FP Receptors......Page 501
EP2 Receptors......Page 502
EP3 Receptors......Page 503
Renin Release......Page 504
Loop of Henle......Page 505
Cyclopentenone Prostaglandins......Page 506
Glomerular Inflammatory Injury......Page 507
Glomerular Noninflammatory Injury......Page 508
Urinary Tract Obstruction......Page 509
Pregnancy......Page 510
Lipoxygenase Pathway......Page 511
Involvement of Lipoxygenase Products in Renal Pathophysiology......Page 513
Cytochrome P450 Pathway......Page 514
Epoxides......Page 515
Proximal Tubule......Page 516
Acknowledgments......Page 517
Key References......Page 518
References......Page 520
Physiology......Page 532
Sodium Balance......Page 533
Effective Arterial Blood Volume......Page 535
Atrial Sensors.......Page 536
Ventricular and Pulmonary Sensors.......Page 537
Renal Sensors.......Page 538
Intestinal Natriuretic Hormones: Guanylin Peptides.......Page 539
Integration of Changes in Glomerular Filtration Rate and Tubular Reabsorption......Page 540
Tubuloglomerular Feedback......Page 541
Peritubular Capillary Starling Forces.......Page 542
Medullary Hemodynamics and Interstitial Pressure in the Control of Sodium Excretion: Pressure Natriuresis.......Page 544
Neural Mechanisms: Renal Nerves and Sympathetic Nervous System......Page 547
Renin-Angiotensin-Aldosterone System.......Page 549
Vasopressin.......Page 551
Prostaglandins.......Page 553
Atrial Natriuretic Peptide.......Page 555
C-Type Natriuretic Peptide.......Page 556
Endothelin.......Page 557
Nitric Oxide.......Page 558
Kinins.......Page 559
Urotensin.......Page 560
Apelin.......Page 561
Novel Factors......Page 562
Extrarenal.......Page 563
Renal.......Page 564
Urine Biochemical Parameters.......Page 565
Composition of Replacement Fluids.......Page 566
Primary Renal Na+ Retention......Page 567
Reduced Effective Arterial Blood Volume.......Page 568
Abnormalities of Sensing Mechanisms in Heart Failure.......Page 569
Abnormalities of Effector Mechanisms in Heart Failure.......Page 570
Renin-Angiotensin-Aldosterone System......Page 571
Vasopressin......Page 574
Brain Natriuretic Peptide.......Page 575
C-Type Natriuretic Peptide.......Page 576
Nitric Oxide......Page 577
Prostaglandins......Page 578
Urotensin......Page 579
Peroxisome Proliferator–Activated Receptors......Page 580
Abnormalities of Sensing Mechanisms in Cirrhosis.......Page 581
Renin-Angiotensin-Aldosterone System......Page 586
Sympathetic Nervous System......Page 587
Apelin......Page 588
Brain Natriuretic Peptide and C-Type Natriuretic Peptide.......Page 589
Prostaglandins......Page 590
Diagnosis......Page 591
Loop Diuretics.......Page 592
Inhibition of the Renin-Angiotensin-Aldosterone System......Page 593
Endothelin Antagonists......Page 594
Neutral Endopeptidase Inhibitors and Vasopeptidase Inhibitors......Page 595
Vasopressin Receptor Antagonists......Page 596
Vasopressin V1 Receptor Analogues......Page 597
Vasopressin V2 Receptor Antagonists......Page 598
Renal Replacement Therapy......Page 599
Key References......Page 600
References......Page 602
Body Fluids: Compartmentalization, Composition, and Turnover......Page 618
Vasopressin Synthesis and Secretion......Page 620
Structure and Synthesis......Page 621
Osmotic Regulation......Page 622
Hemodynamic Stimuli......Page 625
Drinking......Page 626
Nausea......Page 627
Hypoxia and Hypercapnia......Page 628
Osmotic Thirst......Page 629
Integration of Vasopressin Secretion and Thirst......Page 630
Causes......Page 631
Pathophysiology......Page 634
Causes......Page 635
Pathophysiology......Page 636
Causes......Page 638
Pathophysiology......Page 640
Differential Diagnosis of Polyuria......Page 641
Arginine Vasopressin......Page 644
Central Diabetes Insipidus......Page 645
Nephrogenic Diabetes Insipidus......Page 647
Relationship Between Hypo-Osmolality and Hyponatremia......Page 648
Pathogenesis and Causes of Hyponatremia......Page 649
Hyponatremia with Extracellular Fluid Volume Depletion......Page 650
Congestive Heart Failure......Page 651
Nephrotic Syndrome......Page 652
Hypothyroidism......Page 653
Desmopressin......Page 654
Syndrome of Inappropriate Antidiuretic Hormone Secretion......Page 655
Clinical Settings......Page 656
Hyponatremia Symptoms, Morbidity, and Mortality......Page 658
Isotonic Saline......Page 661
Arginine Vasopressin Receptor Antagonists......Page 662
Mild or Absent Symptoms......Page 664
Future of Hyponatremia Treatment......Page 666
Key References......Page 667
References......Page 669
Chapter Outline......Page 680
Chemical Equilibria of Physicochemical Buffer Systems......Page 681
Regulation of Buffers......Page 682
Renal Regulation......Page 683
Acute Response: Generation of Respiratory Acidosis or Alkalosis......Page 684
Sources of Endogenous Acids......Page 685
Hepatic and Renal Roles in Acid-Base Homeostasis......Page 686
Renal Excretion......Page 687
With Extracellular Volume Expansion......Page 688
Stepwise Approach to the Diagnosis of Acid-Base Disorders......Page 689
Step 3: Define the Limits of Compensation to Distinguish Simple from Mixed Acid-Base Disorders......Page 690
Step 4: Calculate the Anion Gap......Page 692
Step 7: Compare Delta Values......Page 693
Respiratory Acidosis......Page 694
Respiratory Alkalosis......Page 696
Non–Anion Gap (Hyperchloremic) Metabolic Acidoses......Page 697
Pathogenesis—Inherited and Acquired Forms......Page 699
Diagnosis......Page 701
Pathophysiology......Page 702
Clinical Spectrum and Associated Features......Page 703
Treatment......Page 704
Disorders of Impaired Net Acid Excretion with Hyperkalemia: Generalized Distal Nephron Dysfunction (Type 4 Renal Tubular Acidosis)......Page 705
Isolated Hypoaldosteronism in Critically Ill Patients......Page 707
Resistance to Mineralocorticoid and Voltage Defects......Page 708
Inhibitors of Potassium Secretion in the Collecting Duct.......Page 709
Disorders of Impaired Net Acid Excretion and Impaired Bicarbonate Reclamation with Normokalemia: Acidosis of Progressive Renal Failure......Page 710
High Anion Gap Acidoses......Page 712
Physiology......Page 713
General Supportive Care.......Page 714
Treatment.......Page 715
Salicylate......Page 716
Methanol.......Page 717
Treatment of Acidosis of Chronic Kidney Disease.......Page 718
Diagnosis of Simple and Mixed Forms of Metabolic Alkalosis......Page 719
Bicarbonate and Bicarbonate- Precursor Administration......Page 721
Posthypercapnia......Page 722
Gitelman’s Syndrome......Page 723
Glucocorticoid-Remediable Hyperaldosteronism.......Page 724
Treatment......Page 725
Key References......Page 726
References......Page 728
Normal Potassium Balance......Page 731
Potassium Transport Mechanisms......Page 732
Sympathetic Nervous System......Page 734
Potassium Transport in the Distal Nephron......Page 735
Aldosterone......Page 737
Integrated Regulation of Distal Sodium Absorption and Potassium Secretion......Page 738
Regulation of Renal Renin and Adrenal Aldosterone......Page 740
Excitable Tissues: Muscle and Heart......Page 741
Excitable Tissues: Muscle and Heart......Page 742
Renal Consequences......Page 743
Redistribution and Hypokalemia......Page 744
Hypokalemic Periodic Paralysis......Page 745
Drugs......Page 746
Hyperaldosteronism......Page 747
Syndromes of Apparent Mineralocorticoid Excess......Page 749
Bartter’s Syndrome.......Page 750
Renal Tubular Acidosis......Page 752
Clinical Approach to Hypokalemia......Page 753
Treatment of Hypokalemia......Page 755
Pseudohyperkalemia......Page 757
Redistribution and Hyperkalemia......Page 758
Hypoaldosteronism......Page 760
Hereditary Tubular Defects and Potassium Excretion......Page 761
Epithelial Sodium Channel Inhibition......Page 762
Angiotensin-Converting Enzyme Inhibitors and Mineralocorticoid and Angiotensin Antagonists......Page 763
Treatment of Hyperkalemia......Page 764
Antagonism of Cardiac Effects......Page 765
β2-Adrenergic Agonists......Page 766
Mineralocorticoids......Page 767
Cation Exchange Resins......Page 768
Novel Intestinal Potassium Binders......Page 769
Dialysis......Page 770
Key References......Page 771
References......Page 773
Whole-Body Calcium Homeostasis......Page 787
Hypercalcemia......Page 788
Signs and Symptoms......Page 789
Diagnosis......Page 790
Primary Hyperparathyroidism......Page 791
Malignancy......Page 793
Nonparathyroid Endocrinopathies......Page 794
Milk-Alkali Syndrome......Page 795
Volume Repletion and Loop Diuretics......Page 796
Inhibition of Bone Resorption......Page 797
Signs and Symptoms......Page 798
Diagnosis......Page 799
Genetic Causes of Hypoparathyroidism.......Page 800
Magnesium Disorders.......Page 802
Medications.......Page 803
Hypomagnesemia and Magnesium Deficiency......Page 804
Causes......Page 805
Renal Magnesium Wasting......Page 806
Tubule Nephrotoxins.......Page 807
Cardiovascular System......Page 808
Skeletal System......Page 809
Oral Replacement......Page 810
Treatment......Page 811
Hyperphosphatemia......Page 812
Exogenous Phosphate Load......Page 813
Clinical Manifestations and Treatment......Page 814
Causes......Page 815
Autosomal Dominant Hypophosphatemic Rickets.......Page 816
Hereditary Hypophosphatemic Rickets with Hypercalciuria.......Page 817
Malabsorption.......Page 818
Treatment......Page 819
Key References......Page 820
References......Page 822
Incidence......Page 832
Prevalence......Page 835
Kidney Transplantation......Page 836
Epidemiology of Chronic Kidney Disease......Page 837
Outcome by Stages......Page 839
Epidemiology of Acute Kidney Injury......Page 841
Prevalence......Page 842
Conclusion......Page 846
Key References......Page 847
References......Page 849
Sex and Chronic Kidney Disease......Page 852
Progression of Primary Glomerular Disease......Page 854
Diabetic Nephropathy Progression......Page 855
Oral Contraceptives, Hormone Replacement Therapy, and Kidney Disease......Page 856
Incidence of Chronic Kidney Disease......Page 857
Prevalence of Chronic Kidney Disease......Page 858
Potential Mechanisms of Racial and Ethnic Disparities......Page 859
Socioeconomic Exposures......Page 860
Incidence of Chronic Kidney Disease......Page 861
Progression of Chronic Kidney Disease......Page 862
Key References......Page 863
References......Page 866
The Need to Define Risk in Chronic Kidney Disease......Page 873
Cross-Sectional Studies......Page 874
Susceptibility Factors......Page 875
Gender......Page 877
Hereditary Factors......Page 878
Acquired Nephron Deficit......Page 880
Acute Kidney Injury......Page 882
Obesity and Metabolic Syndrome......Page 883
Pregnancy and Preeclampsia......Page 884
Cardiovascular Disease......Page 885
Urinary Protein Excretion......Page 886
Dyslipidemia......Page 887
Serum Bicarbonate......Page 888
Alcohol......Page 889
Lead......Page 890
General Population Renal Risk Scores......Page 891
Risk Scores for Patients with Diagnosed Chronic Kidney Disease......Page 893
Key References......Page 895
References......Page 897
Chapter Outline......Page 904
Developmental Programming in the Kidney......Page 905
Plausibility of the Nephron Number Hypothesis......Page 906
Experimental Evidence for Programming of Nephron Endowment......Page 907
Programming of Nephron Number in Humans......Page 910
Kidney Size as a Correlate for Nephron Number.......Page 911
Altered Sodium Handling by the Kidney......Page 912
Programming of Renal Function and Disease......Page 914
Experimental Evidence......Page 916
Birth Weight, Prematurity, and Blood Pressure......Page 917
Glomerular Filtration Rate......Page 920
Proteinuria......Page 921
Acute Kidney Injury......Page 922
Chronic Kidney Disease and End-Stage Kidney Disease......Page 923
Genetic Variants Associated with Kidney Size and Nephron Number in Humans......Page 924
Maternal Nutrient Restriction......Page 926
Fetal Exposure to Hyperglycemia and the Role of Insulin-Like Growth Factors and Their Receptors......Page 928
Apoptosis......Page 929
Obstruction of the Developing Kidney......Page 930
Potential for Rescue of Nephron Number......Page 931
Catch-Up Growth......Page 932
Transgenerational Effects of Programming......Page 933
Implications of Nephron Endowment for the Recipient......Page 934
Conclusion......Page 935
Key References......Page 936
References......Page 938
Microscopic......Page 947
Angiotensin II......Page 948
Transforming Growth Factor-β......Page 949
Advanced Glycosylation End Products......Page 950
Calorie Restriction: Sirtuins, Adenosine Monophosphate–Activated Protein Kinase, Mammalian Target of Rapamycin, and Ribosomal Protein S6 Kinase 1A......Page 952
Lipid Metabolism......Page 953
Autophagy......Page 954
Renal Plasma Flow......Page 955
Glomerular Filtration Rate......Page 956
Sodium Conservation......Page 957
Sodium Excretion......Page 958
Urinary Concentration......Page 959
Acid-Base Balance......Page 960
Calcium Balance......Page 961
Acute Kidney Injury......Page 962
Hypertension......Page 964
Glomerular Disease......Page 966
Renal Replacement Therapy......Page 967
Renal Transplantation......Page 968
Urinary Tract Infection......Page 969
Key References......Page 970
References......Page 972
Hematuria......Page 983
History and Review of Systems......Page 984
Laboratory Tests......Page 985
History and Review of Systems......Page 986
Urine Studies......Page 987
Blood Studies......Page 988
Nephrotic Syndrome......Page 989
Physical Examination......Page 990
Urine Studies......Page 991
Kidney Biopsy......Page 992
Laboratory Tests......Page 993
History and Review of Systems......Page 994
Laboratory Tests......Page 995
History and Review of Systems......Page 996
Imaging......Page 997
Acute Kidney Injury (see also Chapter 31)......Page 998
Laboratory Tests......Page 1000
Kidney Biopsy......Page 1001
Chronic Kidney Disease......Page 1002
History and Review of Systems......Page 1003
Physical Examination......Page 1004
Imaging......Page 1005
Laboratory Tests......Page 1006
Key References......Page 1007
References......Page 1009
Chapter Outline......Page 1012
Filtration Markers......Page 1013
Sources of Error in Measurement of Creatinine.......Page 1014
Cystatin C......Page 1015
Equations for Estimating GFR......Page 1016
Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration Equations.......Page 1017
Radiolabeled Markers......Page 1018
Children......Page 1019
Color (Table 26.3)......Page 1020
Urine pH......Page 1021
Proteinuria (see also Chapter 53)......Page 1022
Categorization of Proteinuria......Page 1023
Sources of Error in Measurement (Tables 26.5 and 26.6)......Page 1024
Methods to Measure Urinary Albumin......Page 1025
Different Laboratory Methods to Measure Albumin in the Urine......Page 1026
Correlation between Ratios and 24-Hour Urine Protein......Page 1027
Reagent Strip Testing......Page 1028
High-Risk Populations......Page 1029
Erythrocytes......Page 1030
Leukocytes......Page 1031
Crystals......Page 1032
Key References......Page 1034
References......Page 1036
Classification......Page 1040
Distal Delivery of Filtrate......Page 1041
Urine Flow Rate......Page 1042
Tonicity Balance......Page 1043
Step 2: Examine the Renal Response to Vasopressin or dDAVP (see Flow Chart 27.2)......Page 1044
Is This a Water Diuresis?......Page 1045
Does the Drop in the Patient’s Urine Flow Rate to 6 mL/min Represent a Partial Response to dDAVP?......Page 1046
Urea Appearance Rate.......Page 1047
Questions......Page 1048
Sample Calculation.......Page 1049
Fractional Excretion of Sodium or Chloride......Page 1050
Concept 10......Page 1051
Questions......Page 1052
What Dangers Should Be Anticipated During Therapy, and How Can They Be Avoided?......Page 1053
Renal K+ Excretion.......Page 1054
Concept 13......Page 1055
The Transtubular Potassium Concentration Gradient (TTKG)......Page 1056
Subgroup with Metabolic Alkalosis.......Page 1057
Consult 7: Hypokalemia and a Low Rate of Potassium Excretion......Page 1059
What are the Options for Therapy?......Page 1060
There Is a Shift of K+ Out of Cells in the Body.......Page 1061
Does the Patient Have a Disorder that Increases Electroneutral Reabsorption of Sodium in the Cortical Collecting Duct?......Page 1063
Consult 9: Chronic Hyperkalemia in a Patient with Type 2 Diabetes Mellitus......Page 1064
What Is the Cause of Hyperkalemia in this Patient?......Page 1065
Concept 16......Page 1066
What Are the Major Threats to the Patient and How Should They Dictate Therapy?......Page 1067
Balance Data for Sodium, Potassium, and Chloride......Page 1068
Concept 17......Page 1069
Concept 18......Page 1070
Detect New Anions in Plasma......Page 1071
Detect Toxic Alcohols......Page 1073
Consult 11......Page 1074
What is the Cause of the Severe Degree of l-Lactic Acidosis in this Patient?......Page 1075
Urine pH.......Page 1076
Consult 12......Page 1077
What Dangers Should Be Anticipated During Therapy?......Page 1078
Consult 13: Determine the Cause of Hyperchloremic Metabolic Acidosis......Page 1079
Key References......Page 1080
References......Page 1082
Intravenous Urography......Page 1084
Iodinated Contrast Media......Page 1085
Ultrasonography......Page 1086
Ultrasonography: Normal Anatomy......Page 1088
Computed Tomography Technique, Including Urography......Page 1089
Computed Tomography: Normal Anatomy......Page 1090
Contrast Media–Induced Nephropathy: Background......Page 1091
Contrast Administration in Patients with Elevated Creatinine Level......Page 1092
Magnetic Resonance Imaging......Page 1094
Gadolinium Chelate Contrast Media and Nephrogenic Systemic Fibrosis......Page 1095
Diagnostic Magnetic Resonance Imaging Technique......Page 1097
Functional Magnetic Resonance Imaging of the Kidney......Page 1101
Technetium 99m–Labeled Diethylenetriaminepentaacetic Acid......Page 1102
Normal Renal Function......Page 1103
Kidney Injury: Acute and Chronic......Page 1104
Renal Calcifications and Renal Stone Disease......Page 1109
Renal Infection......Page 1116
Renal Mass: Cysts to Renal Cell Carcinoma......Page 1121
Renal Cancer: Positron Emission Tomography and Positron Emission Tomography–Computed Tomography......Page 1137
Renal Vascular Disease......Page 1141
Nuclear Imaging and Renovascular Disease......Page 1145
Renal Vein Thrombosis......Page 1146
Assessment for Renal Transplantation......Page 1147
Assessment of Transplanted Kidneys......Page 1148
Key References......Page 1151
References......Page 1153
Safety and Complications of Biopsies......Page 1162
Performing the Biopsy......Page 1165
Staining for Light Microscopy......Page 1166
Terminology for Description of Glomerular Disease......Page 1167
Immunohistochemical Assay......Page 1168
Electron Microscopy......Page 1169
Size of the Biopsy Specimen......Page 1170
Key References......Page 1171
Chapter Outline......Page 1173
Phase 1: Discovery of Potential Biomarkers through Unbiased or Hypothesis-Generating Exploratory Studies......Page 1174
Biomarker Qualification Process......Page 1175
Analysis of Biomarker Performance......Page 1176
Acute Kidney Injury Markers......Page 1177
Serum Glomerular Filtration Markers......Page 1179
Blood Urea Nitrogen......Page 1180
Chronic Kidney Disease......Page 1181
β-Trace Protein......Page 1182
Nephrin......Page 1183
Acute Kidney Injury......Page 1184
Glutathione S-Transferase......Page 1185
Acute Kidney Injury......Page 1186
Chronic Kidney Disease......Page 1187
Kidney Injury Molecule-1......Page 1188
Liver-Type Fatty Acid–Binding Protein......Page 1189
Neutrophil Gelatinase– Associated Lipocalin......Page 1190
Urine NGAL......Page 1191
Plasma NGAL......Page 1192
Chronic Kidney Disease......Page 1193
Proteinuria......Page 1194
Urinary Cystatin C......Page 1195
Chronic Kidney Disease Biomarkers......Page 1196
Urinary Monocyte Chemoattractant Protein-1......Page 1197
Collagen IV......Page 1198
Combinations of Multiple Biomarkers......Page 1199
The Kidney Health Initiative......Page 1200
Key References......Page 1201
References......Page 1203
Definition of Acute Kidney Injury......Page 1213
Incidence of Acute Kidney Injury......Page 1217
Prerenal Acute Kidney Injury......Page 1218
Interstitial Disease......Page 1219
Radiocontrast Media–Induced Nephropathy.......Page 1220
Acute Phosphate Nephropathy.......Page 1221
Tubular Disease—Endogenous Nephrotoxins......Page 1222
Experimental Models......Page 1223
Epithelial Cell Injury......Page 1225
Cytoskeletal and Intracellular Structural Changes......Page 1226
Apoptosis and Necrosis......Page 1229
Parenchymal Inflammation......Page 1230
Intracellular Mechanisms—Role of Reactive Oxygen Species, Heme Oxygenase, and Heat Shock Proteins......Page 1232
Repair, Regeneration, and Role of Stem Cells......Page 1233
Permeability......Page 1234
Coagulation......Page 1235
Long-Term Effects of Endothelial Cell Injury......Page 1236
Effects of Acute Kidney Injury on Distant Organs......Page 1237
Clinical Assessment of the Patient......Page 1238
Urine Assessment......Page 1241
Novel Biomarkers of Kidney Injury......Page 1243
Radiologic Evaluation......Page 1244
Acute Kidney Injury in Pregnancy......Page 1245
Acute Kidney Injury after Solid Organ OR Bone Marrow Transplantation......Page 1247
Acute Kidney Injury Associated with Liver Disease......Page 1248
Complications of Potassium Homeostasis......Page 1249
Complications of Mineral and Uric Acid Homeostasis......Page 1250
Complications during Recovery From Acute Kidney Injury......Page 1251
Heart Failure......Page 1252
Liver Failure and Hepatorenal Syndrome......Page 1253
General Principles......Page 1254
Prevention of Other Forms of Intrinsic Acute Kidney Injury......Page 1255
Loop Diuretics......Page 1256
Postrenal Acute Kidney Injury......Page 1257
Hyperkalemia......Page 1258
Renal Replacement Therapy in Acute Kidney Injury......Page 1259
Indications for Renal Replacement Therapy......Page 1260
Intermittent Hemodialysis......Page 1261
Continuous Renal Replacement Therapy......Page 1262
Outcomes of Acute Kidney Injury......Page 1263
Key References......Page 1265
References......Page 1267
Chapter Outline......Page 1286
Isolated Proteinuria......Page 1287
Recurrent or Persistent Hematuria......Page 1288
Light Microscopy......Page 1290
Pathogenesis......Page 1293
Clinical Features and Natural History......Page 1295
Treatment......Page 1296
Steroid-Resistant Minimal Change Disease......Page 1297
Focal Segmental Glomerulosclerosis......Page 1298
Light Microscopy......Page 1299
Electron Microscopy......Page 1300
Pathogenesis......Page 1301
Clinical Features and Natural History......Page 1304
Angiotensin Inhibitors......Page 1305
Cyclophosphamide......Page 1306
Other Therapies......Page 1307
C1q Nephropathy......Page 1308
Electron Microscopy......Page 1309
Immunofluorescence Microscopy......Page 1311
Pathogenesis......Page 1312
Clinical Features and Natural History......Page 1314
Laboratory Findings......Page 1315
Cyclophosphamide or Chlorambucil......Page 1316
Calcineurin Inhibitors......Page 1317
Rituximab......Page 1318
Membranoproliferative Glomerulonephritis and C3 Glomerulopathy......Page 1319
Immunofluorescence Microscopy......Page 1320
Electron Microscopy......Page 1321
Pathogenesis......Page 1322
Treatment......Page 1323
Pathology......Page 1324
Clinical Features......Page 1326
Treatment......Page 1327
Light Microscopy......Page 1328
Electron Microscopy......Page 1329
Pathogenesis......Page 1330
Laboratory Findings......Page 1331
Treatment......Page 1332
Epidemiology......Page 1333
Immunofluorescence Microscopy......Page 1334
Light Microscopy......Page 1335
Pathogenesis......Page 1337
Clinical Features and Natural History......Page 1339
Laboratory Findings......Page 1340
Glucocorticoids......Page 1341
Other Modalities......Page 1342
Nomenclature......Page 1343
Electron Microscopy......Page 1344
Pathogenesis......Page 1345
Nomenclature and Categorization......Page 1346
Pathogenesis......Page 1349
Epidemiology......Page 1350
Light Microscopy......Page 1351
Pathogenesis......Page 1352
Clinical Features and Natural History......Page 1354
Epidemiology......Page 1355
Immunofluorescence Microscopy......Page 1356
Pathogenesis......Page 1357
Clinical Features and Natural History......Page 1359
Laboratory Findings......Page 1360
Treatment......Page 1361
Key References......Page 1363
References......Page 1365
Chapter Outline......Page 1395
Epidemiology......Page 1396
Pathogenesis of Systemic Lupus Erythematosus and Lupus Nephritis......Page 1397
Pathology of Lupus Nephritis......Page 1398
Tubulointerstitial Disease, Vascular Lesions, and Lupus Podocytopathy......Page 1401
Serologic Tests......Page 1402
Drug-Induced Lupus......Page 1403
Course and Prognosis of Lupus Nephritis......Page 1404
Treatment of Lupus Nephritis......Page 1406
Antiphospholipid Syndrome......Page 1410
Treatment......Page 1411
Mixed Connective Tissue Disease......Page 1412
Pathology......Page 1413
Pathogenesis......Page 1414
Clinical and Laboratory Features......Page 1415
Course and Treatment......Page 1416
Light Microscopy......Page 1418
Prognosis and Treatment......Page 1419
Pathology......Page 1420
Prognosis, Course, and Treatment......Page 1421
Pathogenesis......Page 1422
Prognosis and Treatment......Page 1423
Takayasu’s Arteritis......Page 1424
Laboratory Features......Page 1425
Pathology......Page 1426
Course, Prognosis, and Treatment......Page 1427
Pathogenesis......Page 1428
Pathology......Page 1429
Course, Treatment, and Prognosis......Page 1430
Sarcoidosis......Page 1431
AL and AA Amyloidosis......Page 1432
Pathology......Page 1433
Course, Prognosis, and Treatment......Page 1435
Fibrillary Glomerulonephritis and Immunotactoid Glomerulonephritis......Page 1436
Monoclonal Immunoglobulin Deposition Disease......Page 1438
Waldenström’s Macroglobulinemia......Page 1440
Mixed Cryoglobulinemia......Page 1441
Clinical Features......Page 1442
Pathology......Page 1443
Pathogenesis and Genetics......Page 1444
Clinical Features......Page 1445
Clinical Features......Page 1446
Clinical Features......Page 1447
Diagnosis......Page 1448
Pathology......Page 1449
Lipodystrophy......Page 1450
Pathology......Page 1451
Clinical Features......Page 1452
Other Bacterial Infections and Fungal Infections......Page 1453
Leishmaniasis, Trypanosomiasis, and Filariasis......Page 1454
Clinical Features......Page 1455
Pathogenesis......Page 1456
Other Glomerular Lesions in Patients with HIV Infection......Page 1457
Pathology......Page 1458
Clinical and Pathologic Features......Page 1459
Liver Cirrhosis......Page 1460
Heroin Nephropathy......Page 1461
D-Penicillamine......Page 1462
Key References......Page 1463
References......Page 1465
The Global Impact and Challenges......Page 1490
Quantification of the Benefits of Proteinuria Reduction......Page 1492
Immunoglobulin a Nephropathy......Page 1493
Remission in Lupus Nephritis and Vasculitis......Page 1494
Major Adverse Effects......Page 1495
Major Adverse Effects......Page 1496
Major Adverse Effects......Page 1497
Strategies for Reducing Toxicity......Page 1498
Strategies for Reducing Toxicity......Page 1499
Adrenocorticotropic Hormone......Page 1500
Treatment Algorithms and Considerations......Page 1501
Key References......Page 1502
References......Page 1504
Hemolytic-Uremic Syndrome......Page 1508
Laboratory Findings......Page 1509
Pathology......Page 1511
Mechanisms.......Page 1512
Therapy.......Page 1513
Atypical Hemolytic-Uremic Syndrome.......Page 1515
Mechanisms.......Page 1516
Therapy.......Page 1518
Mechanisms.......Page 1521
Therapy.......Page 1522
Therapy.......Page 1523
Clinical Features......Page 1524
Mechanisms......Page 1525
Acute Radiation Nephropathy......Page 1526
Therapy......Page 1527
Renal Crisis.......Page 1528
Chronic Kidney Disease.......Page 1529
Therapy......Page 1530
Hematuria and Renal Papillary Necrosis.......Page 1531
Mechanisms......Page 1532
Thrombotic Microangiopathy.......Page 1533
Thromboembolism of the Renal Artery......Page 1534
Therapy......Page 1535
Therapy......Page 1536
Diagnostic Procedures......Page 1537
Nephrotic Syndrome.......Page 1538
Prophylactic Anticoagulation of Asymptomatic Patients with Nephrotic Syndrome.......Page 1539
Key References......Page 1540
References......Page 1542
Historical View, Including Structure-Function Relationships......Page 1550
Glomerular-Related Events......Page 1551
Proteinuria-Induced Tubular Cell Activation and Damage......Page 1552
Glomerular Filtered Growth Factors and Cytokines......Page 1553
Activation of Complement Components......Page 1554
Antigens from Renal Cells and Tubule Basement Membrane......Page 1555
Cellular Infiltrates......Page 1556
Interstitial Fibrosis......Page 1557
Chronic Hypoxia in Fibrosis......Page 1558
Drugs......Page 1559
Clinical Features......Page 1560
Prognosis and Management......Page 1561
Analgesics......Page 1562
Chinese Herbs—Aristolochic Acid Nephropathy......Page 1564
Balkan Endemic Nephropathy......Page 1565
Lead......Page 1567
Hyperuricemia and Urate Nephropathy......Page 1568
Autoimmune Diseases......Page 1569
Key References......Page 1570
References......Page 1572
Definitions......Page 1579
Immune and Inflammatory Responses to Urinary Tract Infection......Page 1580
Urine Culture......Page 1581
Pharmacokinetic and Pharmacodynamic Considerations for Treatment......Page 1582
Microbiology......Page 1584
Diagnosis......Page 1585
Treatment......Page 1586
Recurrent Infection......Page 1587
Diagnosis......Page 1588
Treatment......Page 1589
Host Factors......Page 1590
Antimicrobial Treatment......Page 1591
Management of Recurrent Infection......Page 1592
Epidemiology......Page 1593
Treatment......Page 1594
Prostatitis......Page 1595
Renal Transplant Recipients......Page 1596
Persons with Urinary Stones......Page 1597
Infected Renal Cysts......Page 1598
Xanthogranulomatous Pyelonephritis......Page 1599
Genitourinary Tuberculosis......Page 1600
Fungal Urinary Tract Infection......Page 1602
Key References......Page 1603
References......Page 1605
Prevalence and Incidence......Page 1611
Congenital Causes of Obstruction......Page 1612
Intrinsic Causes......Page 1613
Extrinsic Causes......Page 1614
History and Physical Examination......Page 1616
Ultrasonography......Page 1617
Antenatal Ultrasonography......Page 1618
Computed Tomography......Page 1619
Isotopic Renography......Page 1620
Magnetic Resonance Imaging......Page 1621
Pathophysiology of Obstructive Nephropathy......Page 1622
The Late, Vasoconstrictive Phase......Page 1623
Regulation of the Glomerular Filtration Rate in Response to Obstruction......Page 1624
Effects of Obstruction on Tubular Function......Page 1625
Effects of Obstruction on Tubular Sodium Reabsorption......Page 1626
Effects of Obstruction on Urinary Concentration and Dilution......Page 1629
Effects of Relief of Obstruction on Excretion of Phosphate and Divalent Cations......Page 1630
Pathophysiology of Recovery of Tubular Epithelial Cells from Obstruction or Tubulointerstitial Fibrosis......Page 1631
Treatment of Urinary Tract Obstruction and Recovery of Renal Function......Page 1633
Recovery of Renal Function after Prolonged Obstruction......Page 1634
Key References......Page 1635
References......Page 1637
Pathology of the Kidney in Diabetes......Page 1644
Structural-Functional Relationships in Type 1 Diabetic Nephropathy......Page 1649
Microalbuminuria and Renal Structure......Page 1650
Comparisons of Nephropathy in Types 1 and 2 Diabetes......Page 1651
Other Renal Disorders in Diabetic Patients......Page 1652
Prevalence and Incidence......Page 1653
Prognosis of Microalbuminuria......Page 1655
Prognosis of Diabetic Nephropathy......Page 1656
Microalbuminuria......Page 1657
Diabetic Nephropathy......Page 1659
Treatment......Page 1661
Primary Prevention......Page 1662
Secondary Prevention......Page 1663
Primary Prevention......Page 1664
Secondary Prevention......Page 1666
Nephropathy......Page 1669
New Treatment Options......Page 1673
Epidemiology......Page 1674
Hypertension......Page 1675
Vascular Access......Page 1676
Cardiovascular Problems......Page 1677
Malnutrition—Protein-Energy Wasting During Dialysis......Page 1678
Kidney Transplantation......Page 1679
Islet Cell Transplantation......Page 1680
Key References......Page 1681
References......Page 1683
Kidney Stones in Adult Population: 1976-1994......Page 1697
Prevalence of Calcium Stones......Page 1698
Data on Stone Incidence......Page 1699
General Concepts......Page 1700
Activity Product Ratio......Page 1702
Assessment of Nucleation......Page 1703
Magnesium......Page 1704
Bikunin......Page 1705
1,25-Dihydroxyvitamin D Dependence.......Page 1706
1,25-Dihydroxyvitamin D–Independent Absorptive Hypercalciuria.......Page 1707
Genetic Hypercalciuric Rat Model of Hypercalciuria......Page 1708
Renal Leak Hypercalciuria......Page 1709
Pathophysiologic Mechanism of Hyperuricosuria......Page 1710
Role of Acid-Base Status......Page 1711
Increased Hepatic Production......Page 1712
Role of Oxalobacter formigenes......Page 1714
Alterations of Urinary pH......Page 1715
Physicochemistry of Uric Acid......Page 1716
Hyperuricosuria......Page 1717
Increased Acid Load to Kidneys.......Page 1718
Role of Renal Lipotoxicity......Page 1719
Molecular Biology and Genetics......Page 1720
Pathophysiology......Page 1721
Acquired Causes......Page 1722
Genomewide Association Studies......Page 1723
Polygenic Animal Model......Page 1724
Association between Metabolic Syndrome and Nephrolithiasis......Page 1725
Urolithiasis and Hypertension......Page 1726
Pathophysiologic Mechanisms Linking Osteoporosis and Kidney Stones......Page 1727
Genetic Factors......Page 1729
Family History......Page 1730
Extensive Metabolic Evaluation......Page 1731
Urinary Supersaturation Estimation......Page 1732
Magnetic Resonance Imaging......Page 1734
Medical Expulsive Therapy......Page 1735
Dietary Intervention in Cystinuria.......Page 1736
Alkali Treatment......Page 1737
Xanthine Oxidase Inhibitors......Page 1739
Urinary Acidification.......Page 1740
Key References......Page 1741
References......Page 1743
Angiomyolipoma......Page 1761
Multilocular Cystic Nephroma and Mixed Epithelial Stromal Tumor......Page 1762
Epidemiology......Page 1763
Pathology and Cytogenetics......Page 1764
Molecular Biology and Hereditary Disorders......Page 1765
Clinical and Laboratory Features......Page 1767
Radiologic Diagnosis......Page 1768
Staging and Prognosis......Page 1770
Nephron-Sparing Surgery......Page 1772
Lymph Node Dissection......Page 1773
Adjuvant Therapy......Page 1774
Sorafenib.......Page 1775
Axitinib.......Page 1776
Vaccines......Page 1777
Renal Pelvic Tumors......Page 1778
Wilms’ Tumor......Page 1779
Key References......Page 1780
References......Page 1782
Chapter Outline......Page 1789
Pathogenesis......Page 1790
Light-Chain Deposition Disease......Page 1791
Extracorporeal Removal of Free Light Chains......Page 1792
Hematopoietic Stem Cell Transplantation......Page 1793
Sinusoidal Occlusion Syndrome......Page 1794
Tumor Lysis Syndrome......Page 1795
Treatment......Page 1796
Cyclophosphamide......Page 1797
Calcineurin Inhibitors......Page 1798
Hypercalcemia of Malignancy......Page 1799
Total-Body Irradiation and Transplantation......Page 1800
Leukemia and Lymphoma......Page 1801
Clinical Features......Page 1802
Paraneoplastic Glomerular Diseases......Page 1803
Polyomavirus (BK-Type) Infection......Page 1804
Thrombotic Microangiopathy......Page 1805
Key References......Page 1806
References......Page 1808
Chapter Outline......Page 1815
Degrees of Genetic Disease Causality and Predictive Power of Genetic Analysis......Page 1816
Indication-Driven Diagnostic Mutation Analysis Panels......Page 1817
Monogenic Causation of Steroid-Resistant Nephrotic Syndrome......Page 1818
Genotype-Phenotype Correlations......Page 1819
Monogenic Causation......Page 1820
Nephronophthisis-Related Ciliopathies......Page 1821
Inherited Renal Tubulopathies (See Chapter 45)......Page 1822
Future Directions in Single-Gene Disorders......Page 1823
Key References......Page 1824
References......Page 1826
Alport’s Syndrome (Hereditary Nephritis)......Page 1829
Genetics and Pathogenesis......Page 1830
Pathologic Findings and Diagnosis......Page 1831
Genetics......Page 1832
Hereditary Angiopathy, Nephropathy, Aneurysms, and Muscle Cramps......Page 1833
Nephrin and Pathogenesis of CNF......Page 1834
Posttransplantation Recurrence of Proteinuria......Page 1835
Clinical Manifestations......Page 1836
PLCE1 Disease: Familial Diffuse Mesangial Sclerosis......Page 1837
MYO1E Disease......Page 1838
Denys-Drash and Frasier’s Syndromes......Page 1839
Key References......Page 1840
References......Page 1842
Chapter Outline......Page 1846
Pathogenesis......Page 1847
Aminoaciduria......Page 1848
Clinical Presentation......Page 1849
Pathogenesis......Page 1850
Clinical Presentation......Page 1851
Treatment......Page 1853
Clinical Presentation......Page 1854
Treatment......Page 1855
Clinical Presentation......Page 1856
Cystinuria......Page 1857
Pathognesis......Page 1858
Surgical Management......Page 1860
Clinical Presentation......Page 1861
Renal Phosphate Transporters......Page 1862
Pathognesis......Page 1863
Autosomal Recessive Hypophosphatemic Rickets......Page 1864
Inherited Disorders of Renal Glucose Transport......Page 1865
Inherited Disorders of Acid-Base Transporters......Page 1866
Carbonic Anhydrase II Deficiency......Page 1867
Pathognesis......Page 1869
Clinical Presentation......Page 1870
Inherited Disorders with Hypertension and Hypokalemia......Page 1871
17α-Hydroxylase Deficiency......Page 1873
Clinical Presentation......Page 1874
Pathognesis......Page 1875
Pathognesis......Page 1876
Inherited Disorders of Renal Magnesium Processing......Page 1877
Isolated Recessive Hypomagnesemia with Normocalciuria......Page 1878
Pathogenesis......Page 1879
The AVP-AVPR2-AQP Shuttle Pathway......Page 1880
Clinical Presentation and History of X-Linked Nephrogenic Diabetes Insipidus......Page 1882
Loss-of-Function Mutations of AQP2 (OMIM #107777)......Page 1884
Key References......Page 1885
References......Page 1887
Development of Renal Epithelial Cysts......Page 1895
Genetics and Genetic Mechanisms......Page 1899
Pathogenesis......Page 1900
Pathology......Page 1903
Diagnosis......Page 1905
Hypertension......Page 1907
Renal Failure......Page 1909
Vascular Manifestations......Page 1911
Hypertension......Page 1912
End-Stage Kidney Disease......Page 1913
Intracranial Aneurysm......Page 1914
Somatostatin Analogs.......Page 1915
Epidemiology......Page 1916
Pathology......Page 1917
Diagnosis......Page 1918
Treatment......Page 1919
Manifestations......Page 1920
Treatment......Page 1921
Diagnosis......Page 1922
Hepatocyte Nuclear Factor-1β– Associated Nephropathy......Page 1923
Medullary Cystic Kidney Disease (Autosomal Dominant Tubulointerstitial Kidney Disease)......Page 1924
Autosomal Recessive Ciliopathies with Interstitial Nephritis and Renal Cystic Disease......Page 1925
Joubert Syndrome......Page 1928
Nephronophthisis Variants Associated with Skeletal Defects (Skeletal Ciliopathies)......Page 1929
Multicystic Dysplastic Kidney......Page 1930
Diagnosis......Page 1931
Localized or Unilateral Renal Cystic Disease......Page 1932
Manifestations......Page 1933
Epidemiology......Page 1934
Diagnosis......Page 1935
Cystic Renal Cell Carcinoma......Page 1936
Subcapsular and Perirenal Urinomas (Uriniferous Pseudocysts)......Page 1937
Key References......Page 1938
References......Page 1940
Chapter Outline......Page 1952
Epidemiology......Page 1954
Gender and Hypertension......Page 1955
Race/Ethnicity and Hypertension......Page 1956
Blood Pressure Control Rates......Page 1957
Pressure Natriuresis and Salt Sensitivity......Page 1958
Genetics of Hypertension......Page 1959
Renin Angiotensin Aldosterone System......Page 1960
Sympathetic Nervous System......Page 1962
Obesity......Page 1963
The Endothelium......Page 1964
Role of the Immune System in Hypertension......Page 1965
History and Physical Examination......Page 1966
Orthostatic Blood Pressure Measurement......Page 1968
Office Versus Out-of-Office Blood Pressure......Page 1969
Clinical Use of Ambulatory and Home Blood Pressure Monitoring......Page 1971
Renin Profiling......Page 1972
Secondary Hypertension......Page 1973
Intrinsic Kidney Disease......Page 1974
Primary Hyperaldosteronism......Page 1975
Pheochromocytoma......Page 1977
Hyperparathyroidism, Calcium Intake, Vitamin D, and Hypertension......Page 1979
Hypertensive Urgency and Emergency......Page 1980
Blood Pressure Control and Chronic Kidney Disease Progression......Page 1982
Diabetes......Page 1983
Irbesartan Diabetic Nephropathy Trial......Page 1985
Albuminuria, Blood Pressure, and Diabetic Nephropathy......Page 1986
Clinical Trials in Older Adults......Page 1987
Nonpharmacologic Intervention......Page 1989
Pharmacologic Intervention......Page 1990
Blood Pressure Management in Patients Undergoing Dialysis......Page 1991
Management of Primary Hypertension in Chronic Kidney Disease......Page 1992
Angiotensin Receptor Blockers......Page 1993
β-Adrenergic Blockers......Page 1994
Key References......Page 1995
References......Page 1997
Chapter Outline......Page 2004
Historical Perspective......Page 2005
Renal Artery Stenosis Versus Renovascular Hypertension......Page 2007
Role of the Renin Angiotensin System in One-Kidney and Two-Kidney Renovascular Hypertension......Page 2008
Mechanisms Sustaining Renovascular Hypertension......Page 2009
Mechanisms of Ischemic Nephropathy......Page 2011
Adaptive Mechanisms to Reduced Renal Perfusion......Page 2012
Mechanisms of Tissue Injury in Azotemic Renovascular Disease......Page 2014
Renal Reperfusion Injury......Page 2016
Epidemiology of Renal Artery Stenosis and Renovascular Hypertension......Page 2017
Fibromuscular Disease Versus Atherosclerosis......Page 2018
Clinical Features of Renal Artery Stenosis......Page 2019
Progressive Vascular Occlusion......Page 2022
Role of Concurrent Diseases......Page 2024
Physiologic and Functional Studies of the Renin Angiotensin System......Page 2025
Studies of Individual Renal Function......Page 2026
Doppler Ultrasonography of the Renal Arteries......Page 2027
Computed Tomography Angiography......Page 2029
Captopril Renography......Page 2030
Overview......Page 2031
Management of Unilateral Renal Artery Stenosis......Page 2032
Progressive Renal Artery Stenosis in Medically Treated Patients......Page 2035
Angioplasty for Fibromuscular Disease......Page 2036
Angioplasty and Stenting for Atherosclerotic Renal Artery Stenosis......Page 2037
Renovascular Hypertension......Page 2039
Stents for Progression of Renal Insufficiency and Cardiovascular Outcomes......Page 2040
Surgical Treatment of Renovascular Hypertension and Ischemic Nephropathy......Page 2041
Summary......Page 2044
Key References......Page 2045
References......Page 2047
Hemodynamic and Vascular Changes of Normal Pregnancy......Page 2051
Renal Adaptation to Pregnancy......Page 2052
Mechanism of Vasodilation in Pregnancy......Page 2053
Epidemiology and Risk Factors......Page 2054
Hypertension......Page 2056
Hellp Syndrome......Page 2057
Long-Term Cardiovascular and Renal Outcomes......Page 2058
Placental Vascular Remodeling......Page 2059
Cerebral Changes......Page 2060
Immunologic Intolerance......Page 2061
Angiogenic Imbalance......Page 2062
Angiotensin II Type 1 Receptor Autoantibodies......Page 2064
Screening for Preeclampsia......Page 2065
Antiplatelet Agents......Page 2066
Magnesium and Seizure Prophylaxis......Page 2067
Chronic Hypertension and Gestational Hypertension......Page 2068
Goals of Therapy......Page 2069
Choice of Agents......Page 2070
Intravenous Agents for Urgent Blood Pressure Control......Page 2071
Acute Tubular Necrosis and Bilateral Cortical Necrosis......Page 2072
Obstructive Uropathy and Nephrolithiasis......Page 2073
Chronic Kidney Disease and Pregnancy......Page 2074
Lupus Nephritis and Pregnancy......Page 2075
Pregnancy during Long-Term Dialysis......Page 2076
Effect of Pregnancy on Renal Allograft Function......Page 2077
Management of Immunosuppressive Therapy in Pregnancy......Page 2078
Key References......Page 2079
References......Page 2081
Class Mechanisms of Action......Page 2090
Carboxyl Angiotensin-Converting Enzyme Inhibitors......Page 2091
Class Renal Effects......Page 2094
Class Efficacy and Safety......Page 2096
Biphenyl Tetrazole and Oxadiazole Derivatives......Page 2101
Class Renal Effects......Page 2103
Class Efficacy and Safety......Page 2104
Class Mechanisms of Action......Page 2106
Nonselective β-Adrenergic Antagonists......Page 2107
Nonselective β-Adrenergic Antagonists with α-Adrenergic Antagonism or other Mechanisms of Antihypertensive Action......Page 2108
Class Renal Effects......Page 2109
Class Efficacy and Safety......Page 2110
Class Members......Page 2112
Benzothiazepines......Page 2113
Dihydropyridines......Page 2114
Class Renal Effects......Page 2116
Class Efficacy and Safety......Page 2118
Class Members......Page 2121
Class Efficacy and Safety......Page 2122
Class Members......Page 2123
Class Efficacy and Safety......Page 2124
Class Members......Page 2125
Class Members......Page 2126
Class Renal Effects......Page 2127
Class Mechanism and Class Member......Page 2128
Class Member......Page 2129
Determination of Blood Pressure Goal......Page 2130
Single-Pill Combination Therapy......Page 2131
Treatment of Older Patients......Page 2132
Treatment Based on Gender......Page 2135
Treatment of Obese Patients......Page 2136
Cardiovascular Disease......Page 2138
Strategies for Selecting the Optimal Combination Antihypertensive Therapy......Page 2139
Renin Angiotensin Aldosterone System Inhibitors and Calcium Channel Blockers......Page 2140
Dual Renin Angiotensin Aldosterone System Blockade......Page 2141
Bedtime Antihypertensive Dosing Versus Morning Dosing......Page 2142
Resistant Hypertension......Page 2143
Drug Treatment of Hypertensive Urgencies and Emergencies......Page 2145
Parenteral Drugs and Direct-Acting Vasodilators......Page 2146
Calcium Channel Blockers......Page 2148
Clinical Considerations in the Rapid Reduction of Blood Pressure......Page 2149
Key References......Page 2150
References......Page 2152
Sites and Mechanisms of Action......Page 2169
Pharmacokinetics and Dosage......Page 2171
Sites and Mechanisms of Action......Page 2172
Pharmacokinetics and Differences between Drugs......Page 2174
Sites and Mechanisms of Action......Page 2177
Pharmacokinetics......Page 2179
Vasopressin Receptor Antagonists......Page 2180
Diuretic Braking Phenomenon......Page 2181
Eicosanoids......Page 2183
Diuretic Resistance......Page 2184
Acute Decompensated Heart Failure......Page 2186
Acute Decompensated Heart Failure in Acute Coronary Syndrome......Page 2188
Cirrhosis of the Liver......Page 2189
Nephrotic Syndrome......Page 2191
Acute Kidney Injury......Page 2192
Osteoporosis......Page 2193
Hyponatremia......Page 2194
Hypokalemia......Page 2195
Hyperglycemia......Page 2197
Impotence......Page 2198
Key References......Page 2199
References......Page 2201
Chapter Outline......Page 2212
Alterations in Glomerular Physiology......Page 2213
Renin Angiotensin Aldosterone System......Page 2214
Natriuretic Peptides......Page 2215
Adjustments in Renal Autoregulatory Mechanisms......Page 2216
Whole-Kidney Hypertrophic Responses......Page 2217
Glomerular Enlargement......Page 2218
Renotropic Factors......Page 2219
Mesangial Cell Responses: a Unifying Hypothesis......Page 2220
Adaptation in Proximal Tubule Solute Handling......Page 2221
Glomerulotubular Balance......Page 2222
Sodium Excretion and Extracellular Fluid Volume Regulation......Page 2223
Potassium Excretion......Page 2224
Calcium and Phosphate......Page 2225
Hemodynamic Factors......Page 2226
Endothelial Cells......Page 2228
Podocytes......Page 2229
Cellular Infiltration in Remnant Kidneys......Page 2230
Transforming Growth Factor-β......Page 2231
Angiotensin II......Page 2232
Bone Morphogenetic Protein-7......Page 2233
Acidosis......Page 2234
Hypertrophy......Page 2235
Proteinuria......Page 2236
A Unified Hypothesis of Chronic Kidney Disease Progression......Page 2239
Pharmacologic Inhibition of the Renin Angiotensin Aldosterone System......Page 2240
Arterial Hypertension......Page 2241
Dietary Protein Intake......Page 2243
Gender......Page 2244
Ethnicity......Page 2245
Obesity and Metabolic Syndrome......Page 2246
Sympathetic Nervous System......Page 2247
Dyslipidemia......Page 2248
Hyperphosphatemia......Page 2250
Fibroblast Growth Factor 23......Page 2251
Tobacco Smoking......Page 2252
Acute Kidney Injury......Page 2253
Key References......Page 2254
References......Page 2256
Structure and Function of the Glomerular Capillary Wall......Page 2274
Endothelial Cell Layer......Page 2275
Epithelial Filtration Slits......Page 2276
Multilayer Membrane Models......Page 2277
Theoretical Models of Tubular Reabsorption......Page 2278
Proteinuria of Glomerular Origin......Page 2279
Glomerular Damage......Page 2280
Podocytes: Changes in Function and Cell Number......Page 2281
Mesangial Cells: Proliferation and Deposition of Extracellular Matrix......Page 2282
Parietal Epithelial Cells: Activation......Page 2283
Tubular Damage......Page 2284
Tubular Cells: Activation......Page 2285
Resident Monocyte/Dendritic Cells......Page 2286
Fibroblasts: Activation and Deposition of Extracellular Matrix......Page 2287
Protective Macrophages......Page 2288
Kidney-Derived Progenitor Cells......Page 2289
Pathogenesis of Hypoalbuminemia......Page 2290
Consequences of Hypoalbuminemia......Page 2291
Alterations in Blood Volume......Page 2292
Intrarenal Mechanisms......Page 2293
Pathogenesis of Nephrotic Hyperlipidemia......Page 2295
Clinical Consequences of Hyperlipidemia......Page 2296
Pathogenesis of Hypercoagulability......Page 2297
Clinical Consequence of Hypercoagulability......Page 2298
Key References......Page 2299
References......Page 2301
Chapter Outline......Page 2309
Urea......Page 2310
d–Amino Acids......Page 2311
Guanidines......Page 2312
Phenols and Other Aromatic Compounds......Page 2313
Aliphatic Amines......Page 2314
Original Middle Molecule Hypothesis......Page 2315
Effects of Diet and Gastrointestinal Function......Page 2316
On Resting Energy Expenditure......Page 2317
On Lipid Metabolism......Page 2318
Overall Nutrition......Page 2319
Neurologic Function......Page 2320
Why Is the Glomerular Filtration Rate So Large?......Page 2321
Key References......Page 2322
References......Page 2324
Phosphorus Balance and Homeostasis......Page 2330
Calcium Balance and Homeostasis......Page 2332
Calcium-Sensing Receptor......Page 2333
Parathyroid Hormone......Page 2334
Vitamin D......Page 2336
FGF-23 and Klotho......Page 2338
Bone Biology......Page 2339
Pathophysiology of Vascular Calcification......Page 2341
Cellular Transformation......Page 2343
Matrix Vesicles and Apoptosis......Page 2344
Fetuin-A......Page 2345
PTH–FGF-23–1,25(OH)2D Loop......Page 2346
Parathyroid Hormone......Page 2347
Soluble Klotho......Page 2349
Histomorphometry in Patients with CKD......Page 2350
The Spectrum of Bone Histomorphometry in CKD......Page 2351
TMV Classification......Page 2353
Micro–Computed Tomography and Micro–Magnetic Resonance Imaging......Page 2354
Parathyroid Hormone......Page 2355
Nutritional Vitamin D Deficiency......Page 2356
Fracture......Page 2357
CKD-MBD in Kidney Transplant Recipients......Page 2358
Bone Changes After Transplantation......Page 2359
Key References......Page 2360
References......Page 2362
Chapter Outline......Page 2370
Arterial Wall Thickening......Page 2371
Arterial Calcification......Page 2372
Altered Cardiac Geometry......Page 2373
Myocardial Fibrosis......Page 2374
Clinical Manifestations of Cardiovascular Disease in Chronic Kidney Disease......Page 2375
Association between Albuminuria and Cardiovascular Disease......Page 2376
Blood Pressure......Page 2377
Anemia......Page 2379
Vitamin D......Page 2380
Obesity......Page 2381
Use of Imaging and Other Assessments of Cardiovascular Function in Risk Prediction......Page 2382
Blood Pressure Reduction......Page 2383
Reduction of Low-Density Lipoprotein Cholesterol Level......Page 2384
Correction of Anemia......Page 2387
Vitamin D......Page 2388
Conclusions......Page 2389
Key References......Page 2390
References......Page 2391
Definition and Prevalence of Anemia in Chronic Kidney Disease......Page 2398
Erythropoietin......Page 2401
The Role of Iron, Folate, and Vitamin B12 in Erythropoiesis......Page 2406
Shortened Red Blood Cell Survival......Page 2407
Iron Metabolism, Hepcidin, and Anemia of Chronic Disease......Page 2408
Drugs......Page 2410
Posttransplantation Erythrocytosis......Page 2411
Erythropoiesis-Stimulating Agents......Page 2412
Darbepoetin Alfa......Page 2413
Iron Management......Page 2415
Serum Transferrin Receptor.......Page 2416
Percentage of Hypochromic Red Blood Cells.......Page 2417
Liver Magnetic Resonance Imaging.......Page 2418
Intravenous Iron Therapy......Page 2419
Iron Therapy in Patients with CKD.......Page 2421
Efficacy and Safety of Anemia Management with ESAs and Iron......Page 2423
Large Randomized Controlled Trials.......Page 2424
Red Blood Cell Transfusion......Page 2425
Pathophysiology......Page 2427
Hypercoagulability and Chronic Kidney Disease......Page 2429
Pharmacologic Interventions......Page 2430
Leukocyte Functional Impairment......Page 2432
Key References......Page 2433
References......Page 2435
Pancreatic Hormonal Disorders: Insulin Resistance......Page 2453
Causes of Uremic Insulin Resistance......Page 2454
Treatment of Insulin Resistance in CKD......Page 2455
Causes of Thyroid Hormone Disturbances in CKD......Page 2456
Growth Hormone......Page 2457
The GH/IGF-I System and Kidney Function......Page 2459
Aldosterone and Cortisol......Page 2460
Treatment......Page 2461
Clinical Manifestations......Page 2462
Treatment......Page 2463
Vitamin D and Parathyroid Hormone: Metabolism and Actions in CKD......Page 2464
Key References......Page 2465
References......Page 2467
Stroke......Page 2473
Epidemiology of Stroke in Chronic Kidney Disease, Dialysis, and the Transplant Population......Page 2474
Hypertension......Page 2475
Atrial Fibrillation......Page 2476
Hypertension......Page 2477
Antiplatelet Agents......Page 2478
Erythropoietin......Page 2479
Supportive Care......Page 2480
Pathophysiology......Page 2481
Dialysis Dementia......Page 2482
Evaluation......Page 2483
Management......Page 2485
Pathophysiology......Page 2486
Key References......Page 2487
References......Page 2489
Pruritus......Page 2494
Acquired Ichthyosis......Page 2495
Calciphylaxis (Calcific Uremic Arteriolopathy)......Page 2496
Metastatic Calcification......Page 2497
Eruptive Xanthomas......Page 2498
Nephrogenic Systemic Fibrosis......Page 2499
Dialysis-Associated Steal Syndrome......Page 2500
Lindsay’s (Half-and-Half) Nail......Page 2501
Leukocytoclastic Vasculitis......Page 2502
Genodermatoses (Table 60.5)......Page 2503
Key References......Page 2505
References......Page 2507
Justification of Dietary Support During Chronic Kidney Disease......Page 2509
Dietary Protein, Renal Inflammation, and Oxidant Stress......Page 2511
Urea......Page 2512
Urea Production and Degradation......Page 2513
Uric Acid......Page 2514
Total Nonurea Nitrogen Excretion......Page 2515
Metabolic Acidosis......Page 2516
Ubiquitin-Proteasome System......Page 2517
Signals Triggering Muscle Atrophy......Page 2518
Catabolic Conditions Activate Myostatin in Muscles......Page 2520
Nitrogen Balance......Page 2521
Serum Albumin and Malnutrition......Page 2522
Serum Transferrin, Prealbumin, Complement, and Insulin-Like Growth Factor-1......Page 2523
Free Plasma Amino Acid and Ketoacid Levels......Page 2524
Energy Requirements of Patients with Chronic Kidney Disease......Page 2526
Salt......Page 2527
Protein Intake......Page 2528
Patients with Nephrotic Syndrome......Page 2529
Proteins, Phosphates, and Fibroblast Growth Factor-23......Page 2530
Nondiabetic Chronic Kidney Disease......Page 2532
Meta-Analyses of Low-Protein Diets and Progression of Chronic Kidney Disease......Page 2534
Nutritional Impact and Safety of Modified Diets in Chronic Kidney Disease......Page 2535
Vitamins and Trace Elements in Uremia......Page 2536
Conclusion......Page 2537
Key References......Page 2538
References......Page 2540
Chapter Outline......Page 2548
Estimated Glomerular Filtration Rate and Staging of Chronic Kidney Disease: Caveats and Implications for Stepped Care......Page 2550
Lifestyle Interventions......Page 2551
Smoking Cessation......Page 2552
Weight Loss......Page 2553
Sodium Restriction......Page 2554
Dietary Protein Restriction......Page 2555
Antihypertensive Drugs......Page 2556
Intensive Versus Usual Blood Pressure–Lowering Trials......Page 2557
Diabetic Nephropathy......Page 2559
Nondiabetic Chronic Kidney Disease......Page 2560
Angiotensin Receptor Blockers......Page 2561
Combination Treatment with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers......Page 2563
Direct Renin Inhibitors......Page 2564
Proteinuria as a Therapeutic Target......Page 2565
Renal Dysfunction and Hyperkalemia Induced by Inhibitors of the Renin Angiotensin Aldosterone System......Page 2566
Strategy for Maximal Renoprotection: Aiming for Remission of Chronic Kidney Disease......Page 2567
Association Between Chronic Kidney Disease and Cardiovascular Disease......Page 2569
Antihypertensive Agents and Cardiovascular Protection......Page 2570
Treatment of Dyslipidemia......Page 2572
Antiplatelet Therapy......Page 2573
Mineral and Bone Disorder......Page 2574
Stages 1 and 2......Page 2575
Stage 4......Page 2576
Stage 5......Page 2577
Key References......Page 2578
References......Page 2580
Multisystem Abnormalities Underlying the Pathogenesis of Disordered Mineral Metabolism......Page 2588
Guiding Therapeutic Principles......Page 2589
Gastrointestinal Phosphate-Binding Agents......Page 2590
Phosphate-Binding Resins......Page 2591
Treatment with Vitamin D Analogs......Page 2592
Calcium-Sensing Receptor Allosteric Modulators (Calcimimetic Agents)......Page 2595
Therapeutic Goals......Page 2597
General Considerations......Page 2598
Vitamin D Sterols......Page 2600
Key References......Page 2601
References......Page 2603
Chapter Outline......Page 2608
Absorption......Page 2609
Distribution......Page 2610
Metabolism......Page 2611
Alterations of Cytochrome P450 Enzyme Activity......Page 2612
Pharmacogenomics......Page 2613
Pharmacodynamics......Page 2614
Assessment of Kidney Function......Page 2615
Acute Kidney Injury......Page 2617
Individualization of the Drug Dosage Regimen......Page 2618
Patients Undergoing Hemodialysis......Page 2620
Assessment of the Impact of Hemodialysis......Page 2621
Patients Receiving Continuous Renal Replacement Therapy......Page 2622
Clinical Bottom Line......Page 2623
Key References......Page 2629
References......Page 2630
Chapter Outline......Page 2635
Incidence and Prevalence......Page 2636
Mortality......Page 2637
Transition From Chronic Kidney Disease Stage 5......Page 2640
Arteriovenous Fistulas......Page 2641
Arteriovenous Grafts......Page 2642
Monitoring and Surveillance......Page 2643
Hemodialysis Catheters......Page 2644
General Principles of Hemodialysis: Physiology and Biomechanics......Page 2645
Clearance......Page 2646
Factors That Affect Clearance in a Flowing System......Page 2647
Dialysance......Page 2648
Dialyzer Clearance Versus Whole Body Clearance......Page 2649
Components of the Extracorporeal Circuit......Page 2651
Hemodialyzers......Page 2652
Membrane Permeability and Surface Area......Page 2653
High-Efficiency and High-Flux Dialyzers......Page 2654
Dialysate Circuit......Page 2655
Computer Controls......Page 2656
Hazards Associated with Dialysis Water......Page 2657
Microbiology of Hemodialysis Systems......Page 2658
Historical Perspectives......Page 2659
Measuring Hemodialysis Adequacy......Page 2660
Solute Generation......Page 2661
Urea Reduction Ratio......Page 2662
Comparison of Hemodialysis and Peritoneal Dialysis Doses......Page 2664
Short Daily Hemodialysis......Page 2665
Goals of Hemodialysis......Page 2666
Dialyzer Choice......Page 2667
Anticoagulation......Page 2668
Sodium......Page 2669
Potassium......Page 2670
Bicarbonate......Page 2671
Ultrafiltration Rate and Dry Weight......Page 2672
Reuse......Page 2673
Principles of Erythropoietin Use......Page 2674
Nutrition......Page 2675
Vitamins and Trace Elements......Page 2676
Nontraditional Cardiovascular Risk Factors......Page 2677
Diagnosis and Treatment......Page 2678
Vascular Calcification......Page 2679
Hypertension......Page 2680
Infections and Response to Vaccination......Page 2681
Dialysate Factors......Page 2682
Dialysis Disequilibrium Syndrome......Page 2683
Pericardial Disease......Page 2684
The Future of Renal Replacement Therapy......Page 2685
Key References......Page 2686
References......Page 2688
Peritoneal Membrane Anatomy and Structure......Page 2705
Peritoneal Transport Physiology......Page 2706
Evaluation of Peritoneal Transfer Rate......Page 2707
The Peritoneal Catheter and Access......Page 2708
Catheter-Related Complications......Page 2710
Peritoneal Dialysis Solutions......Page 2711
Glucose-Based Solutions Low in Glucose Degradation Products......Page 2712
Peritoneal Dialysis Modalities......Page 2713
Indicators to Evaluate Dialysis Adequacy......Page 2714
Peritoneal Transport Type......Page 2715
Clearance Targets and Clinical Outcomes......Page 2716
Nutritional Counseling and Nutrient Supplements......Page 2718
Inflammation and Peritoneal Dialysis......Page 2719
Measures to Preserve Residual Kidney Function......Page 2720
Management of Cardiovascular Disease in Peritoneal Dialysis......Page 2721
Definition, Diagnosis, and Clinical Course......Page 2722
Route and Schedule of Administration......Page 2723
Gram-Negative Bacteria......Page 2724
Mechanical Complications......Page 2725
Metabolic Complications......Page 2726
Patient Outcomes with Peritoneal Dialysis......Page 2727
Economics and Cost-Effectiveness of Peritoneal Dialysis......Page 2728
Key References......Page 2729
References......Page 2731
Sepsis......Page 2741
AKI in the Context of Pulmonary Dysfunction......Page 2742
Goals of Care......Page 2743
Intermittent Hemodialysis......Page 2744
Continuous RENAL Replacement Therapy......Page 2745
Intensity of RENAL Replacement Therapy......Page 2746
Fluid Balance, Ultrafiltration, and Maintenance of Hemodynamic Stability......Page 2748
Drug Dosing Considerations......Page 2749
Key References......Page 2750
References......Page 2752
General Principles......Page 2755
Anti–Glomerular Basement Membrane Disease......Page 2756
Antineutrophil Cytoplasmic Antibody–Associated Vasculitis......Page 2757
Lupus Nephritis......Page 2758
Kidney Failure Associated with Multiple Myeloma and Other Hematologic Disorders......Page 2759
Hemolytic Uremic Syndrome and Thrombotic Thrombocytopenic Purpura......Page 2761
Recurrent Focal Segmental Glomerulosclerosis......Page 2762
ABO-Incompatible Kidney Transplantation......Page 2763
Plasmapheresis and Nonrenal Disease......Page 2764
Catastrophic Antiphospholipid Antibody Syndrome......Page 2765
Technical Aspects......Page 2766
Other Separation Modalities......Page 2767
Venous Access......Page 2768
Complications......Page 2769
Key References......Page 2771
References......Page 2773
Chapter Outline......Page 2777
Forced Diuresis......Page 2778
Fecal Elimination Enhancement......Page 2779
Extracorporeal Treatment–Related Factors......Page 2780
Hemofiltration......Page 2781
Extracorporeal Liver Assist Devices (Albumin Dialysis)......Page 2782
General Indications for Extracorporeal Removal of Poisons......Page 2783
The Toxic Alcohols: Ethylene Glycol, Methanol, Isopropanol......Page 2784
Toxicocology and Toxicokinetics......Page 2785
Clinical Presentation......Page 2786
Diagnostic Testing......Page 2787
Treatment......Page 2788
Toxicology and Toxicokinetics......Page 2789
Treatment......Page 2790
Clinical Presentation and Diagnostic Testing......Page 2791
Clinical Presentation and Diagnostic Testing......Page 2792
Treatment......Page 2793
Phenytoin......Page 2794
Clinical Presentation and Diagnostic Testing......Page 2795
Clinical Presentation and Diagnostic Testing......Page 2796
Clinical Presentation and Diagnostic Testing......Page 2797
Clinical Presentation and Diagnostic Testing......Page 2798
Treatment......Page 2799
Key References......Page 2800
References......Page 2802
Overview of Vascular Access and Epidemiology for Dialysis......Page 2810
Rationale for Interventional Nephrology......Page 2811
Surveillance for Graft Stenosis......Page 2813
Angioplasty of Arteriovenous Graft Stenosis......Page 2817
Thrombectomy of Grafts......Page 2818
Technical Procedure: Percutaneous Arteriovenous Graft Thrombectomy......Page 2819
Deployment of Stents for Arteriovenous Graft Stenosis and Thrombosis......Page 2821
Preoperative Vascular Mapping......Page 2822
Technical Procedure: Sonographic Preoperative Vascular Mapping......Page 2824
Salvage of Immature Arteriovenous Fistulas......Page 2825
Ligation of Accessory Veins......Page 2827
Percutaneous Transluminal Angioplasty of Arteriovenous Fistulas......Page 2828
Percutaneous Mechanical Thrombectomy and Thrombolysis of Arteriovenous Fistulas......Page 2829
Technical Procedure: Percutaneous Thrombectomy of Arteriovenous Fistulas......Page 2830
Central Vein Stenosis......Page 2831
Nontunneled Temporary Hemodialysis Catheters......Page 2833
Technical Procedure: Insertion of Temporary Dialysis Catheters......Page 2834
Technical Procedure: Insertion of Tunneled Hemodialysis Catheters......Page 2835
Less Common Locations for Tunneled Hemodialysis Catheters......Page 2837
Exchange of Tunneled Hemodialysis Catheters......Page 2838
Peritoneal Dialysis Catheter Procedures......Page 2839
Technical Procedure: Insertion of Peritoneal Catheters by Peritoneoscopic Technique......Page 2840
Percutaneous Kidney Biopsy (see also Chapter 29)......Page 2841
Technical Procedure: Percutaneous Kidney Biopsy Under Real-Time Ultrasound Guidance......Page 2842
Key References......Page 2843
References......Page 2845
Characteristics of the Allogeneic Immune Response......Page 2851
Immune Tolerance......Page 2852
Transplantation Antigens......Page 2853
HLA Molecules: Class I......Page 2854
Inheritance of HLA......Page 2856
HLA Typing......Page 2857
Relative Strengths of HLA Loci......Page 2858
ABO Blood Group Antigens......Page 2859
T Cell Receptor Complex......Page 2860
Adhesion Molecules......Page 2862
Costimulatory Molecules......Page 2863
Helper T Cells and Their Role in the Alloimmune Response......Page 2864
Effector Mechanisms of Allograft Rejection......Page 2865
Chronic Rejection......Page 2867
Mycophenolic Acid......Page 2868
Cyclosporine......Page 2869
Polyclonal Immune Globulins......Page 2870
Monoclonal Antibodies......Page 2871
Tolerogenic Protocols in Transplantation......Page 2872
Key References......Page 2873
References......Page 2874
Transplantation Surgery Procedure......Page 2875
Handling and Preservation of Donor Kidney......Page 2876
Overview......Page 2877
Monoclonal Antibodies......Page 2879
Cyclosporine......Page 2880
Mycophenolate Acid......Page 2881
Costimulatory Signal Blockers......Page 2882
Medical Status......Page 2883
Donor Immune Status and Cross-Match......Page 2884
Immediate Posttransplantation Period (First Week)......Page 2885
Delayed Graft Function......Page 2886
Ischemic Acute Tubular Necrosis.......Page 2887
Outcome and Significance of Delayed Graft Function......Page 2888
Hypovolemia and Drugs......Page 2889
Acute Rejection......Page 2890
Acute Cellular Rejection.......Page 2891
Distinguishing Acute Calcineurin Inhibitor Nephrotoxicity and Acute Rejection.......Page 2892
Acute Pyelonephritis......Page 2893
Urine Leaks......Page 2894
Late Acute Rejection......Page 2895
Human Polyomavirus Infection......Page 2896
Late Allograft Dysfunction and Late Allograft Loss......Page 2897
Calcineurin Inhibitor Toxicity......Page 2898
Diabetic Nephropathy......Page 2899
Factors Affecting Kidney Allograft Survival......Page 2900
Human Leukocyte Antigen Matching......Page 2901
Cold Ischemia Time......Page 2902
Recipient Gender......Page 2903
Improving Kidney Allograft Outcomes: Matching Kidney and Recipient Risk......Page 2904
Bone Disorders after Kidney Transplantation......Page 2905
Osteoporosis......Page 2906
Hypertension......Page 2907
Cancer After Kidney Transplantation......Page 2908
Posttransplantation Lymphoproliferative Disorder......Page 2909
Infections More Than 6 Months After Transplantation......Page 2910
Cytomegalovirus......Page 2911
Patients With Diabetes......Page 2912
Pregnant Kidney Transplant Recipients......Page 2913
Conclusion......Page 2914
Key References......Page 2915
References......Page 2917
Clincal Classification of Kidney Malformation......Page 2926
Mechanisms of Inheritance......Page 2928
Ureteric Budding, ROBO2, and Bmp4......Page 2929
Control of GDNF Expression in the Metanephric Mesenchyme: SALL1, EYA1, and SIX1......Page 2930
TCF2, Maturity-Onset Diabetes Type 5, and Sporadic Forms of CAKUT......Page 2931
The Environment in Utero and Cakut......Page 2932
Functional Consequences of Cakut......Page 2933
Renal Agenesis......Page 2934
Renal Fusion......Page 2935
Overall Approach to Management of Cakut in Utero and in the Immediate Postnatal Period......Page 2936
Long-Term Outcomes of Renal Malformation......Page 2937
Key References......Page 2938
References......Page 2940
Spectrum of Kidney and Urinary Tract Disorders in Children......Page 2944
Assessment of Glomerular Filtration Rate......Page 2945
Assessment of Proteinuria......Page 2946
Renal Agenesis and Hypoplasia......Page 2947
Multicystic Dysplastic Kidney......Page 2948
Prognosis......Page 2949
Ureteropelvic Junction Obstruction......Page 2950
Pathogenesis......Page 2951
Renal Cyst and Diabetes Syndrome......Page 2952
Renal Coloboma Syndrome......Page 2953
Prune-Belly Syndrome......Page 2954
Diagnosis......Page 2955
Treatment......Page 2956
Nephronophthisis......Page 2957
Glomerular Disorders......Page 2958
Hereditary Nephrotic Syndrome......Page 2959
Early Onset......Page 2961
Infantile and Childhood Onset......Page 2962
Pathogenesis......Page 2963
Classification, Kidney Biopsy Indications, and Histology Patterns......Page 2964
Second-Line Therapies in Steroid-Sensitive Nephrotic Syndrome.......Page 2965
Calcineurin Inhibitors.......Page 2966
Epidemiology......Page 2967
Differential Diagnosis......Page 2968
Bartter-Like Syndromes......Page 2969
Classical Bartter’s Syndrome (Type III)......Page 2970
Renal Tubular Acidosis......Page 2971
Treatment......Page 2974
Prognosis......Page 2975
Hypocitraturia......Page 2976
Clinical Features......Page 2978
Treatment......Page 2979
Dent’s Disease......Page 2980
Cystinuria......Page 2981
Primary Hyperoxaluria......Page 2982
Primary Hyperoxaluria Type 2.......Page 2983
Histopathologic Features.......Page 2984
Treatment......Page 2986
Treatment......Page 2987
Epidemiology......Page 2988
Treatment......Page 2989
Prognosis......Page 2990
Hemolytic Uremic Syndrome Due to Complement Disorders......Page 2991
Treatment and Prognosis......Page 2992
Causes of Growth Failure and Developmental Delay in Chronic Kidney Disease......Page 2993
Prevention and Treatment of Growth Failure in Chronic Kidney Disease......Page 2994
Cardiovascular Comorbidity in Pediatric Chronic Kidney Disease......Page 2995
Intermediate Cardiovascular End Points in Children with Chronic Kidney Disease......Page 2996
Risk Factors for Progressive Renal Failure and Pharmacologic Nephroprotection......Page 2997
Key References......Page 2998
References......Page 3001
Normal Metabolism of Water and Sodium of Specific Interest to the Pediatric Age......Page 3014
Hypernatremic Dehydration......Page 3016
Nephrogenic Diabetes Insipidus......Page 3017
Hypo-Osmolality and Hyponatremia: Pathogenesis and Classification......Page 3019
Nephrogenic Syndrome of Inappropriate Antidiuresis......Page 3021
Basis of Fluid Therapy for Dehydration in Children......Page 3022
Aspects of Normal Metabolism of Potassium of Specific Interest to the Pediatric Age......Page 3023
Hypokalemia......Page 3024
Bartter’s Syndrome......Page 3025
Gitelman’s Syndrome......Page 3027
Liddle’s Syndrome......Page 3028
Pseudohypoaldosteronism......Page 3029
Acid-Base Equilibrium in Children......Page 3031
Primary Proximal Type 2 Renal Tubular Acidosis......Page 3032
Primary Distal Type 1 Renal Tubular Acidosis......Page 3033
Metabolism of Magnesium......Page 3035
Familial Hypomagnesemia with Hypercalciuria and Nephrocalcinosis......Page 3036
Autosomal Dominant Hypomagnesemia......Page 3037
Calcium and Phosphate Balances......Page 3038
Vitamin D, Parathyroid Hormone, Calcitonin, and Fibroblast Growth Factor 23......Page 3039
Infusions of Lipid or Citrate Blood Products......Page 3040
Treatment of Hypocalcemia......Page 3041
Hypercalcemia......Page 3042
Williams-Beuren Syndrome......Page 3043
Neonatal Severe Hyperparathyroidism......Page 3044
Hypophosphatemia......Page 3045
Diagnostic Workup for Hypophosphatemia......Page 3046
Hyperphosphatemia......Page 3047
Treatment of Hyperphosphatemia......Page 3048
Key References......Page 3049
References......Page 3051
Chapter Outline......Page 3057
Epidemiology of End-Stage Kidney Disease......Page 3058
Nutrition and Weight......Page 3059
Anemia......Page 3060
Hypertension......Page 3061
Vascular Calcification......Page 3062
Neurodevelopment......Page 3063
Medications......Page 3064
Exhaustion of Access Sites......Page 3065
Hemodialysis......Page 3066
Vascular Access......Page 3067
Blood Flow......Page 3068
Hypothermia......Page 3069
Peritoneal Dialysis Solutions......Page 3070
Encapsulating Peritoneal Sclerosis......Page 3071
Continuous Renal Replacement Therapy......Page 3072
Kidney Transplantation......Page 3073
Incidence, Prevalence, and Allocation......Page 3074
Infection......Page 3075
Cardiovascular Issues......Page 3076
HLA Matching and Sensitization......Page 3077
Induction Immunosuppression......Page 3078
Cyclosporine......Page 3079
Mycophenolate......Page 3080
Immunosuppression Combinations......Page 3081
Delayed Graft Function......Page 3082
Infections......Page 3083
Epstein-Barr Virus Infection......Page 3084
Pneumocystis jiroveci Pneumonia......Page 3085
Patient Survival......Page 3086
Cardiovascular Disease......Page 3087
Cancer......Page 3088
Bone Health and Growth......Page 3089
Puberty and Reproduction......Page 3090
Key References......Page 3091
References......Page 3093
Dengue Fever......Page 3102
Yellow Fever......Page 3103
Malaria......Page 3104
Leptospirosis......Page 3105
Spiders......Page 3106
Lonomia Caterpillars......Page 3107
Renal Involvement in Crotalus Bites......Page 3108
Chronic Kidney Disease in Latin America......Page 3109
Mesoamerican Nephropathy......Page 3110
End-Stage Kidney Disease in Latin America......Page 3111
Trends and the Future......Page 3113
Key References......Page 3114
References......Page 3116
Chapter Outline......Page 3118
Fluid and Electrolyte Abnormalities......Page 3119
Acute Kidney Injury in Human Immunodeficiency Virus Infection......Page 3121
Acute Kidney Injury in the Intensive Care Unit......Page 3122
Hypertension......Page 3123
Hepatitis B Virus Nephropathy......Page 3125
Human Immunodeficiency Virus–Associated Renal Disease......Page 3126
Renal Replacement Therapy......Page 3127
Conclusion......Page 3129
Key References......Page 3130
References......Page 3132
Chapter Outline......Page 3135
Acute Kidney Injury......Page 3136
Epidemiology......Page 3139
Genetic Disorders......Page 3143
Genetic Glomerular Diseases......Page 3144
Genetic Metabolic Diseases and Inherited Tubular Disorders......Page 3145
Familial Mediterranean Fever......Page 3146
Clinical Spectrum and Renal Disease......Page 3151
Treatment of Familial Mediterranean Fever......Page 3152
Management of End-Stage Kidney Disease in the Middle East......Page 3153
Hemodialysis......Page 3154
Management of End-Stage Kidney Disease with Viral Hepatitis......Page 3155
Kidney Transplantation......Page 3156
Pharmacologic Treatment of Kidney Transplant Recipients......Page 3158
Summary......Page 3159
Key References......Page 3160
References......Page 3161
Chapter Outline......Page 3169
Acute Kidney Injury......Page 3170
Clinical Features......Page 3171
Clinical Features......Page 3172
Dengue Fever......Page 3173
Pathogenesis......Page 3174
Ethylene Glycol Poisoning......Page 3175
Acute Cortical Necrosis......Page 3176
Demographics of End-Stage Kidney Disease......Page 3177
Hemodialysis......Page 3178
Kidney Transplantation......Page 3179
Renovascular Hypertension......Page 3181
Herbal Medicine Toxicity......Page 3182
Key References......Page 3183
References......Page 3185
Acute Kidney Injury......Page 3189
Leptospirosis......Page 3190
Scrub Typhus (Tsutsugamushi Disease)......Page 3192
Hantavirus......Page 3194
Severe Fever with Thrombocytopenia Syndrome Virus......Page 3195
Malaria......Page 3196
Dengue Viral Infection......Page 3199
Severe Acute Respiratory Syndrome......Page 3200
Opisthorchiasis......Page 3201
Snakebite......Page 3202
Toxic Mushrooms......Page 3204
Chronic Kidney Disease......Page 3205
Chronic Kidney Disease after Infection......Page 3206
Primary Glomerulonephritis......Page 3208
Lupus Nephritis......Page 3210
Hepatitis B/Hepatitis C Virus–Associated Nephritis......Page 3211
Herbal Medicines......Page 3212
Japan......Page 3213
Malaysia......Page 3214
Key References......Page 3215
References......Page 3217
Chapter Outline......Page 3222
Access to Health Care in Australia......Page 3223
Renal Replacement Therapy in Australia......Page 3224
Home Hemodialysis......Page 3226
Cancer in Renal Transplant Recipients......Page 3227
Analgesic Nephropathy in Australia......Page 3228
Renal Disease in Indigenous Australians......Page 3230
Health Status of the Indigenous Population......Page 3233
Chronic Kidney Disease and Diabetes......Page 3234
Renal Replacement Therapy......Page 3235
Outcome of Renal Replacement Therapy......Page 3236
Pacific Islands......Page 3237
Key References......Page 3238
References......Page 3240
Nephrology’s Contribution to the Birth of Bioethics......Page 3244
Patient Selection Criteria and the Overt Rationing of Dialysis......Page 3245
Cessation of and Withdrawal From Dialysis......Page 3246
Advance Directives and Patients Undergoing Dialysis......Page 3247
Clinical Practice Guideline on Withholding and Withdrawing Dialysis......Page 3248
The “Difficult” Patient Undergoing Dialysis......Page 3253
Dialysis of the Older Patient......Page 3254
Palliative Care and Referral to Hospice......Page 3255
Access to Renal Transplantation......Page 3256
Key References......Page 3258
References......Page 3260
Disparity......Page 3262
Prenatal Environment and Disparities in Kidney Disease Risk......Page 3263
Postnatal Environment and Disparities in Kidney Disease Risk......Page 3264
Race, Social Conditions, and Disparities in Incident Kidney Disease......Page 3265
Unequal Health System Access and Surveillance......Page 3266
Importance of Health System Structure......Page 3267
Dialysis: Process and Outcome......Page 3268
Kidney Transplantation: Process......Page 3269
Moving Toward More Equitable Care......Page 3270
Initiatives to Reduce Disparities......Page 3271
Key References......Page 3272
References......Page 3274
Prevalence of Chronic Kidney Disease and Age-Related Changes in Estimated Glomerular Filtration Rate......Page 3278
Screening for Chronic Kidney Disease......Page 3279
Mortality......Page 3280
End-Stage Kidney Disease......Page 3281
Hypertension......Page 3282
Diabetes......Page 3284
Anemia......Page 3285
Tools to Aid Medication Use......Page 3286
Referral to Nephrologists and Strategies for Optimizing Care......Page 3287
Outcomes......Page 3288
Kidney Replacement Therapy: Dialysis Modality Selection......Page 3289
Kidney Transplantation......Page 3290
Advanced Care Planning in Patients with Kidney Disease......Page 3291
Key References......Page 3292
References......Page 3294
Chapter Outline......Page 3299
Embryonic Stem Cells......Page 3300
Therapeutic Cloning (Somatic Cell Nuclear Transfer)......Page 3301
Reprogramming (Induced Pluripotent Stem Cells)......Page 3303
Adult Stem Cells......Page 3304
Intrarenal Progenitor Cells......Page 3305
Design and Selection of Biomaterials......Page 3306
Cell-Based Therapies for Treatment of Kidney Disease......Page 3307
Differentiation of Mesenchymal Stem Cells into Renal Tissue......Page 3308
Recruitment of Mesenchymal Stem Cells to Renal Tissue Following Acute Injury......Page 3309
Immunogenicity of Renal Anlagen......Page 3310
Functional Transplantation of Metanephroi......Page 3311
Xenotransplantation of Renal Anlagen......Page 3312
In Situ Development of Renal Units......Page 3313
Summary......Page 3314
Key References......Page 3315
References......Page 3317
Quality Improvement and Quality Improvement Tools......Page 3321
Assessing Quality in Chronic Diseases and Kidney Disease......Page 3322
Quality Improvement Tools......Page 3323
Lean......Page 3324
Emerging Quality Improvements in Kidney Disease......Page 3326
Role of Erythropoiesis-Stimulating Agents in Catalyzing Quality Improvement......Page 3327
Bundled Prospective Payment System and Quality Incentive Program......Page 3329
Vascular Access Practice, Fistula First Breakthrough Initiative, and Quality Improvement......Page 3330
A View to the Future......Page 3332
Quality Initiatives in Chronic Kidney Disease......Page 3333
Key References......Page 3336
References......Page 3338