The Editor, Anil K Mandal, is a distinguished and energetic nephrologist and nephro-pathologist who has managed to persuade a number of very talented academics to participate in this new venture. This textbook written for a specific purpose for Asian-Pacific Physicians promises to be both a popular and useful text.

In nephrology conferences there are “big talks” about bench to bedside research, but the scope of such research is limited. Ingenuity of research is unfocused unless there is potential of commercial interest. It is important to note that the majority of nephrology practice in the developed countries is related to dialysis, emergency room visits and hospital admissions; with office and hospital consultation comprising of only about a third of the practice. On contrary, in the developing countries where the scope of dialysis is limited, consultation practice in private office and hospital predominates. In hospital setting, fluid and electrolyte disorders are very common. Drug-induced acute renal failure has emerged as the most common type of nephrology consultation in hospital setting. Acute or chronic renal failure associated with diabetes, congestive heart failure and hypertension are the leading sources of office based practice in nephrology.

Second edition is developed to facilitate nephrology practice in Southeast Asia. This revised volume is focused to adequately identify and treat fluid and electrolyte disorders, acute and chronic renal failure, hypertension and diabetes. Since diabetes and hypertension are two leading causes of renal failure, tight control of these disorders to prevent renal failure is emphasized. The keyword for a renal physician is prevention. Second edition should reflect that to the readers.

It should be understood that this revised volume does not describe every ailment in nephrology practice, but has included almost all of the common disorders encountered in clinical practice. Most importantly, the volume is carefully designed to make it affordable to most or all physicians in the practice of nephrology in Southeast Asia.

Dr Agarwal and I wish to convey our heartfelt appreciation to all of our colleagues who took time and interest to contribute to this book. Our sincerest thanks go to Tina Fischer, a most dedicated secretary in my office; she has played a commendable role in the completion of this book. Last and not the least, I would like to express my gratitude to Dr SS Marathe, President of Medical Specialists for providing me the facility in pursuing my academic and research endeavors, as exemplified by second edition of Textbook of Nephrology for the Asian-Pacific Physicians.

These purposes are: (1) There is a wide margin of difference in the currency exchange between the Western world and the Asian-Pacific countries. This currency difference makes books published in the Western world less or non-affordable to most practising physicians including nephrologists in the Asian-Pacific countries. (2) Except in Japan and Australia, there are very few trained nephrologist in the Asian-Pacific countries. For example, there are hardly 240 trained nephrologists for an 800 million population in India, giving a ratio of 0.3 nephrologist per million or barely 1 nephrologists for every 3 million. The international directory of nephrology indicates that a similar or a lower ratio of the nephrologists per million population exists in many of the Asian-Pacific countries. (3) The system of continuous medical education in nephrology is also rather tenuous in the Asian-Pacific countries. Therefore, the practising physicians in these countries have few or no avenues to obtain information or seek assistance while dealing with their patients who have major renal problems. In addition, I have consistently observed that the non-nephrologist physicians become more apprehensive by the findings of acidosis, rising serum potassium and blood urea nitrogen than other laboratory abnormalities in their patients. These purposes were embedded in the mind of the editor for sometime, and thus this book was conceived.

I have a hope that this Textbook of Nephrology would become affordable to most of the physicians in the Asian-Pacific countries.

This book is not complete due to the lack of inclusion of some other topics in nephrology; nonetheless, this text has covered major areas of nephrology to facilitate nephrology care in the Asian-Pacific countries. In addition, rather than not having a volume at all, this initial edition, at best, may serve as a forum to address the issues and the needs so that the next edition can be developed in a more comprehensive fashion.

The encouragement, support and contributions made by my distinguished colleagues from the USA and the Asian-Pacific countries for the completion of this volume are immeasurable. My special gratitude goes to Dr H Verdain Barnes, Professor and Chair, Department of Medicine, Wright State University, for providing me with the facilities that are conducive for this type of tedious work. My special thanks go to Mrs. Chris Wert, Senior Secretary, Department of Medicine, Wright State University, whose dedicated work has turned this volume into reality. I am also very thankful to all the secretaries of the word processing satellite of the Wright State University, Medical Sciences Division, Dayton, Ohio, for consistently working with me to complete this volume. I am thankful to my elder daughter, Aditi Mandal for her time and effort in the editorial work. Finally, I am very appreciative of Mr. Jitendar P. Vij of Jaypee Brothers Medical Publishers, New Delhi, for his keen interest in publishing this nephrology volume.