By Robert W. Schrier MD
- Topics lined contain: electrolyte and acid-base problems, UTI’s, kidney stones, glomerulonephritis and vasculitis, acute or persistent renal failure, high blood pressure, and renal ailment in being pregnant and diabetes
- NEW content material on kidney disorder in diabetes.
- Time-saving define structure for simple quick-reference
- Practical guidance on drug dosing in sufferers with impaired kidney functionality, with particular tips on greater than 500 drugs
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An entire clinically centred advisor to dealing with the total spectrum of kidney illnesses and hypertensionAccessible, concise, and up to date, present analysis & therapy Nephrology & high blood pressure features:- distinct medical review of all significant ailments and problems, from end-stage renal disorder to fundamental and secondary high blood pressure- a realistic, learn-as-you-go method of diagnosing and treating renal issues and high blood pressure that mixes affliction administration suggestions with the most recent clinically confirmed treatments- up to date insurance of transplantation drugs and need-to-know interventional systems- an immense evaluation of subspecialty issues: renal disorder within the aged, diabetic nephropathy, severe care nephrology, and dialysis- specialist authorship from trendy clinicians within the components of kidney affliction, dialysis, and high blood pressure
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Additional info for Manual Of Nephrology
The peak incidence occurs between the ages of 20 and 30 years. Kidney stones are a major cause of morbidity due to associated renal colic, urinary tract obstruction, urinary tract infection (UTI), and renal parenchymal damage. In the United States, calcium-containing stones make up approximately 90% of all stones; they contain primarily calcium oxalate, either alone or in combination with calcium phosphate. The remaining 10% are composed of uric acid, struvite-carbonate, and cystine. A kidney stone can form only when urine is supersaturated with respect to a stone-forming salt.
Bisphosphonates have become the agents of choice for the management of hypercalcemia due to bone reabsorption. They are analogues of inorganic pyrophosphate that are selectively concentrated in bone, where they interfere with osteoclast attachment and function. Bisphosphonates have a slow onset (2 to 3 days) and a long duration of action (several weeks). Etidronate was the first bisphosphonate approved for the treatment of hypercalcemia. The serum calcium concentration begins to fall on day 2 with etidronate and reaches a nadir on day 7.
Chronic renal disease impairs the hydroxylation of calcidiol to calcitriol. Vitamin D–dependent rickets is a result of either the impaired hydroxylation of calcidiol to calcitriol (type I) or end-organ resistance to calcitriol (type II). Type I patients respond to physiologic doses of calcitriol. Patients with type II disease have dramatically increased concentrations of calcitriol, respond poorly to calcitriol therapy, and have mutations in the vitamin D receptor. 3. Other rare causes of hypocalcemia include the tumor lysis syndrome, osteoblastic metastases, acute pancreatitis, toxic shock syndrome, and sepsis.
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