Textbook of Nephrology Anil K Mandal, Jai Prakash
INDEX
Page numbers followed by f refer to figure and t refer to table, respectively
A
Abdominal compartment syndrome 187
Absorptive hypercalciuria 99
Ace inhibitors 303
Acetylsalicylic acid 247
Acid base
control reduces risk of ventricular arrhythmias 172f
disorders 79
normal compensation in 80t
status 47
Acidemia 71
Acid-fast bacilli 369
Acquired
cystic kidney disease 233
diagnosis 234
treatment 234
cysts 233
disease 87
renal cysts 404
Acute
aluminum neurotoxicity 268
and chronic urinary tract obstruction in adults 236
diagnosis 236
management 236
pathophysiology 236
complications of hemodialysis 398, 399t
dialysis quality initiative 177
fatty liver of pregnancy 186
glomerulonephritis 178, 325
beta hemolytic streptococcal infection 115
immobilization 98
interstitial nephritis 178, 182
intrinsic renal failure 177
poststreptococcal glomerulonephritis 345
pyelonephritis 324
rejection 433, 457
renal failure 11, 177, 287, 322
in liver disease 187
in pregnancy 322
syndrome of 190
to glomerulonephritis 181t
with renin-angiotensin inhibitor drugs, syndrome of 190
symptomatic hyponatremia 33
tubular necrosis 177
ureteric colic, management of 384f
urinary obstruction 237
Adensosine triphosphate levels 457
Adequacy of dialysis dose 411
Adhesion molecules 431
Admission lab for ES 88Y white female 43t
Adrenergic agonist 68
Adrenocorticotropic 66
Adriamycin 185
Adult respiratory distress syndrome 275
Adverse effects of
diuretic therapy 119t
thiazide and loop-acting diuretics 118
Adynamic bone 258, 257f, 262
development of 259t
Aerobic Gram-negative 471
African-American
female 205
male 205
Albuterol 68
Alcohol 230
Alcoholic ketoacidosis 74
Alkali administration 78
Alkalosis 70
Allergic interstitial nephritis 13
Aluminum bone disease See Low turnover osteomalacia
Aluminum bone disease, diagnosis of 261
Aluminum toxicity 402
treatment of 268
Ambulatory peritoneal dialysis, continuous 123, 258, 288, 409, 410
Amikacin 473
Amiloride 84
Amino acids 71
Aminobiphosphonates includes pamidronate 102
Aminoglycoside dosing 292t
Aminoglycosides 281, 291
Amphotericin B 291
Amyloidosis 361
Amyloidosis treatment 361
Anasarca See Generalized edema
Anemia 212, 246, 402, 448
correction of 248
in CHF
adverse effects of 170
pathophysiology of 170
Aneurysms, history of 230
Angiotensin
converting enzyme 336
inhibitors 140, 169, 190, 215, 291, 355
receptor blockers 140, 169, 215
Animal’s self-recognition system 425
Anion gap 71
Antibacterial agents for oral treatment of urinary tract infection 472
Antibiotic dosing regimens 415t
Antibodies in allorejection, role of 432
Antidiuretic hormone 18, 86, 169
Anti-endothelial antibodies 432
Anti-GBM antibody associated 181
Antihypertensive drug therapy 336
choice of 301
principles of 302
strategies of 301
Anti-inflammatory drugs 250
Anti-neutrophilic cytoplasmic antibody 181
Antiproliferative agents 435
Antiviral strategies for CMV 444t
Aorta 297
Aortic coarctation 301
ARF
complicating nephrotic syndrome 182
from acute pyelonephritis 323
from amniotic fluid embolism 323
from obstructive uropathy 323
from super-imposed preeclampsia 323
in acute fatty liver of pregnancy 322
in specific situations 184
peculiar to pregnancy 322
to acute
glomerulonephritis 180
vasculitis 180
to glomerulonephritis, causes of 180
to hyperemesis gravidarum 322
to obstetric bleeding 323
to septic abortion 322
to vasculitis, causes of 181t
Arginine 71
vasopressin 18, 27, 86
Arterial disease 401
Arteriovenous hemofiltration, continuous 287
Aspergillus
fumigatus 463
species 446
Aspirin -ASA 75
Aspirin on uremic bleeding, effect of 247
Asymptomatic
bacteriuria 323
metabolic disturbances 309
urinary stones 10
Atheroembolization 337
Atonic megacolon 52f
Atrophic right kidney 308f
Autoimmune
AIN 180
related AIN, causes of 180t
Automated peritoneal dialysis 410
Autosomal dominant hereditary hyperparathyroidism 96
Autumn fever 271
Azathioprine 435, 454
B
Bacteria, presence of 7
Bacteriological diagnosis 370
Balloon angioplasty and stenting 336
Bartter’s syndrome 49, 56, 82
B-cell receptor and antibody 426
Belatacept 457
Benefits of adequate control of hypertension 300
Beta 2 amyloidosis 262
treatment of 268
Beta blocker therapy 57
Bilateral multiple cysts 11f
of varying size in kidneys 228f
Bilateral renal artery stenosis 190
Biphosphonates 102
BK
monitoring algorithm 445f
virus 445
Bleeding
control of 247, 248
disorders in renal failure, management of 244
time 246
treatment of source of 247, 250
Blood
access 396
counts 275
pH 256
pressure 169, 312t, 316
changes and criteria for diagnosis of hypertension 316
examination of 68
for adults, classification of 298t
lowering drugs 147
urea nitrogen 3, 191, 318
volume and cardiac output 316
Bone
biopsy 262
cysts 260
formation rate 253
marrow granuloma 180
metabolism and disease 449
pain 260
specific alkaline phosphatase 262
Brain
cells 19
natriuretic peptide levels 335
surgery 21
trauma 21
Bromide intoxication 71
Bronchoalveolar lavage 443
Bumetanide See also Furosemide
Bursting headache 230
C
Calcific uremic arteriolopathy See Calciphylaxis
Calcimimemetic agents 103
Calcimimetics See Calcium-sensing receptor agonist
Calcineurin inhibitors 434
Calciphylaxis 260, 403
Calcitonin causes 95
Calcitriol 256
analogues 266
deficiency 256
injection See also Ethanol
mediated hypercalcemia 97
treatment 259
Calcium 94, 253, 379, 380
absorption and regulation 94
and phosphorus metabolism with clinical disorders in pediatric and adult population 94
binding proteins 94
channel blockers 303, 319
control of 265
diuresis 101
gluconate 67
phosphorus homeostasis 211
sensing receptor agonist 267
stones 380
urolithiasis, risk factors for 381t
Candida 446
albicans infection 290
species 446
Canicola fever 271
Carbon 423
dioxide 71
Carbonic anhydrase inhibitors 120
Cardiac
arrhythmias 301
conduction, abnormalities of 274
manifestations 51
Cardiovascular
diseases 297
drugs 250
Caroli’s disease 231
Carpal tunnel syndrome 403
Catecholamines 47
Cationic amino acids 71
Cause, treatment of 103
Caveats in antihypertensive therapy 308
Ceftazidime 473
Ceftazidime See Cephalosporins
Ceftriaxone 473
Cell membranes 18
of erythrocytes 19
Cell-adhesion molecules 436
Cellular elements in urine 7f
Cellulose
acetate 394
diacetate 394
triacetate 394
Cellulosynthetic 394
Central diabetes insipidus 20
Central diabetes insipidus 21
causes of 21t
Central inhibitors 304
Central nervous system 282
Centrally acting alpha-2 receptor agonists 319
Cephalosporins 290
Cerebral salt wasting 27
Cerebrospinal fluid 273
Chemokines 430, 436
Chlamydia 180
Chloride 16
pumps 23
resistant 78
responsive 78
Chronic
allograft
dysfunction 458
nephropathy 456
complications of
dialysis 401
hemodialysis 401t
peritoneal dialysis 401t
diuretic 118
glomerulonephritis 325
hypertension
of whatever cause 316
with super-imposed preeclampsia 317
hyponatremia 34
kidney disease 3, 116, 205, 254
adults 201f
stages of 4t
laxative use 50
or recurrent hyperkalemia, prevention of 68
rejection 433
renal failure 199
cause of 369
clinical perspective 199
nondialysis treatment 199
prevention 199
tubulointerstitial nephritis 326
urinary obstruction 237
Churg-Strauss syndrome 181
Ciprofloxacin See Fluoroquinolone
Cirrhosis and progressive renal failure, course of with 188f
Cirrhosis of liver 115
Cisplatin 293
Clonal
anergy 434
expansion 433
Collecting tubulur responsiveness to AVP 87
Colonic pseudo-obstruction See Ogilvie syndrome
Combined alpha-beta receptor blockers 319
Common
drugs causing AIN 179t
infections post-transplant 442
presentation of 442t
Complete central diabetes insipidus 91
Congenital
chloridorrhea 78
nephrotic syndrome 352
management of 353
Congestive heart failure 64, 112, 115, 207t, 298
Conjugated estrogen therapy 249
Connecting tubing system 395
Contractile cells 18
Contraction alkalosis 78
Control vs. infusion electrocardiographic findings, comparison of 55t
Conventional
abdominal aortogram 337f
catheter angiography 333
Coronary artery disease 301
Corticosteroids 357, 436
Creatinine
clearance 4, 219f
value
decrease in 5
elevation of 5
Cryoprecipitate 248
Cryptococcus neoformans 463
Crystalline structures 154f
evidence of 155f
CSF studies 276
CSW and SIADH, differential diagnosis of 27t
Cushing syndrome 82, 301
Cycling peritoneal dialysis, continuous 410
Cyclosporine 281, 293, 454
A 355
Cysteine 71
Cystic
diseases 234
of kidney 225, 225t, 226t
renal dysplasia 234
Cystine 379, 380
stones 388
Cytokine receptors 429
Cytokines 429
and role 429
Cytology of urine 11
Cytomegalovirus 444, 463
Cytotoxic T lymphocytes 450
D
Decisive indication of insulin 136
Decompression of megacolon 53f
Decoy cells 464
Deep venous thrombosis 439
Degree of metabolic acidosis 276
Dent’s disease 381
Depression and marital status 149
Desmopressin therapy 248
Develops renal disease 362
Dexamethasone 185
Diabetes 44, 127, 152, 259, 448
and sexual dysfunction 145
etiology 145
pathology 145
treatment 145
dialysis business enterprise 204
insipidus 87
causes 87
physiology of 15
treatment of 92t
mellitus 91, 158, 297, 301, 461
history of 220t
therapy for 131
newer development in 142
with goal to prevention of complications, management of 127
with proteinuria and chronic kidney disease 217
Diabetic
ketoacidosis 74
kidney disease
early detection of 362
management of 362
slowing progression of 362
nephropathy 325, 361
stages of 362t
renal complications, prevention of 362
Dialysis 103, 284, 326
amyloidosis 403
apparatus 394
dementia 403
membranes 394
types of 394
practice, modifications of 398
prescription 412
related amyloid bone disease 259
therapy 67
in CHF 173
type of 259
Diarrhea 9, 75
Diazoxide 319
Diet
alone 139
in renal disease, modification of 5
Dietary modification 385
Diffusion 284
and ultrafiltration, processes of 393f
Dihydropyridine calcium channel blockers 113
Dilute urine 87
Diphosphonates See also Biphosphonates
Discharge medications 57
Distal HCO3 absorption, factors influencing 83t
Distended abdomen 52f
Diuresis renography 241
Diuretics 172, 320
infusion 121
radionuclide urography See also Diuresis renography
therapy 117
D-lactic acidosis 75
DN vs NDRD 161
Doppler ultrasound 332
Dosage changes in CAVH/CVVH 289t
Doxercalciferol 267
Drugs 23, 280
bioavailability 280
causing tubular
crystallization 293t
nephrolithiasis 293t
dosage adjustment in renal failure 284, 285
dosing in
CAPD 289t
renal disease 279
impair platelet function 250
in continuous ambulatory peritoneal dialysis, movement of 288f
induced AIN 179
clinical features of 179
induced crystal formation and nephrolithiasis 293
induced hyperkalemia, analysis of 64
induced nephrotoxicity 291
modification of immune response 434
resistant disease 373
with hyponatremia 26t
with prolonged bleeding time 250t
Dual energy X-ray absorptiometry 462
Duplex ultrasonography 331
Dyslipidemia 447
E
Early morning glycemic surge 136
Eclampsia, pathophysiology of 317
Eculizumab 459
ED, management of 148
Edema 349
anatomy of 112
assessment of 116
causes of 113, 115
etiologies of 113
management of 351
physiology of 112
Effective arterial volume 113
Effective circulating blood volume 113f, 169
Effective renal plasma flow 12
Effects of
cumulative doses of conjugated estrogen on bleeding time 249t
extracellular fluid 82
Electrolyte imbalance in severe CHF 169
Empiric peritonitis treatment 414t
End-stage renal disease 140, 199, 205, 215, 227, 369
cases by diagnosis 201f
cause of 305
Endocrine
and metabolic abnormalities 352
manifestations 52
Endocrinopathies 404
Endogenous acid 70
Endothelial cells 19, 245, 431
by insulin treatment 155f
End-stage renal disease 158, 438, 453
causes of 159
Engagement of MHC and TCR, mechanism of 426
Enterobacter 442
Eosinophilia 179
Epinephrine See also Albuterol
Epinephrine causes 64
Epistaxis 274
Epistaxis See Nasal
Epstein-Barr virus 465
infections 180
Erectile dysfunction 145
assessment of 136
in men 145
Erythrocytosis 449
Escherichia coli 442
ESRD on volume of distribution, effect of 281t
Estimated glomerular filtration 205
Ethanol 268
glycol intoxication 75
treatment of 75
Etidronate 102
Evaluating water deprivation test results 90
Everolimus 456
Excessive solute load 86
Excretory function 3
Exit-site infections of peritoneal catheter 414
Expected benefit of dialysis therapy 172f
Extracellular
fluid 38
compartment 112
hyperkalemia 64
to intracellular space 109
Extracorporeal shock wave lithotripsy 230
Extrarenal manifestations of ADPKD 228t
F
Falciparum malaria 31
Familial hypocalciuric hypercalcemia 95
Fever 179
Fibrinolysis clot lysis 245
Fibroblast growth factor-23 106
Fibromuscular dysplasia 340
Field fever 271
Fingerstick blood glucose levels 133t
Flash pulmonary edema 329
Fluid overload, pathophysiology of 169
Fluoroquinolone 179
Focal
and segmental glomerulosclerosis 356
neurological deficits 230
Focus 305
Fort Bragg fever 271
Fosinopril on proteinuria and renal function, effect of 218t
Fracturing osteodystrophy 260
Free-standing dialysis units 204t
Frequently relapsing nephrotic syndrome 354
FSGS, treatment of 357
Fungal infections 445
Fungus streptomyces tsukubaensis 455
Furosemide See Diuretic
Furosemide developed acute renal failure 193t
G
Gallium nitrate 102
Ganciclovir resistance 444
Gastric pH 280
Gastrointestinal
bleeding 244
complications 441
HCO3 loss 76
hemorrhage 187
smooth muscle dysfunction, manifestations of 52
suction, common causes of 48
Generalized edema 112
Genetic disease See also Acquired disease
Genitourinary tract tuberculosis, types of 373
Gentamicin 473
Gestational diabetes insipidus 89
signs of 89
symptoms of 89
GFR, assessment of 4
Gitelman’s syndrome 49, 56
Glomerular filtration rate 3, 86, 170, 177, 199, 252, 279, 315
estimation of 279
Glomerulonephritis, treatment of 182
Glucocorticoid 102, 454
deficiency 27
Glucose 67, 135
and renal function test 40t
Glycemic control
in diabetes 136t
monitoring of 135
Glycerol 19
Goldner-stained of bone histology 257f
Graft adaptation 433
Granuloma 98
Granulomatous
disorders 98
interstitial nephritis 179
H
Heart failure 75, 300
HELLP syndrome 186
Hematologic disorders 448
Hematoxylin and eosin-stained section 359f
Hematuria 11, 182, 441
Hemodialysis
complications of 393, 398
lines and pressure monitors 396f
machine 394
practice 397
principles of 393
technique of 393
therapy, dreadful statistics of 204
Hemoglobin 205
Hemolytic uremic syndrome 186, 187
Hemophan See Cellulosynthetic
Hemorrhage 438
Hemorrhagic
pericarditis 245
pulmonitis 275
Hemostatic defects 247
and bleeding sites in uremia 247
Hepatic
fibrosis and portal hypertension 231
syndrome 271
Hepatorenal syndrome 187
High anion gap metabolic acidosis 72
High blood
glucose levels 153
pressure
classification of 297
management of 310
High bone turnover, disorders of 256
High glucose to body function 152
High magnification See Osteitis fibrosa
High urinary sodium 33
Hiked up pelvis 371
Hilar cysts 234
Hindrance to control of hyperglycemia 127
Histiocytic cells 368
HIV/AIDS 373
Hollow-fiber and plate dialyzers 395f
Hormones 18
Hospital course after initiation of resurgent therapy 122t
Hospital-acquired hypernatremia 39, 41t
Human immunodeficiency virus 453
Hungry bones syndrome 109
Hydralazine See Vasodilators
Hydration 101
Hydrochlorothiazide, dose of 300
Hydrogen 423
Hydroxyethyl starch 274
Hyperacute rejection 432
Hypercalcemia 78
causes of 95, 100t
development of 264
symptoms of 99
treatment of 101
Hypercalciuria 387
Hyperchloremic metabolic acidosis 76
causes of 76t
Hyperglycemia 153
control of 129
definition of 127
Hyperkalemia 62
and metabolic acidosis 209
causes of 64
diagnosis 62, 65
etiology of 65
management of 66
pathophysiology 62
prevention 62
risk of 171
treatment 62
Hyperkalemic periodic paralysis 64
Hyperlipidemia 74, 297, 301, 351
Hypernatremia 37
adjuvant therapy 42
and aging 38
diagnosis 37
etiology 37
intravenous therapy 42
management 37, 42
oral correction 42
pathophysiology 3739f
risk factors for 38
Hyperoxaluria 387
Hyperparathyroidism, treatments for 264t
Hyperphosphatemia 105, 255
management of 107
Hyperproteinemia 74
Hypertension 211, 297, 402, 447, 460
after kidney transplantation 447t
and diabetes mellitus 297
in pregnancy 312
management of 305
with hypokalemia 311
with oral contraceptives 312
Hypertensive
emergencies 310
patients undergoing surgery 310
Hyperthyroidism 98
Hyperuricosuria 387
Hypoalbuminemia causing 115
Hypoaldosteronism 68
Hypocalcemia 104
management of 104
treatment of 104
Hypocitraturia 387
Hypoglycemia 139
Hypoglycemic symptoms, relief of 139
Hypokalemia 46
alcoholism, common causes of 48
causes of 47, 64
common causes of 48
diagnosis of 53
diarrhea vs. RTA vs. familial periodic paralysis 57f
diuretic therapy, common causes of 48
etiology of 53
induced antibiotic, uncommon causes of 49
leukemia, uncommon causes of 49
magnesium depletion, uncommon causes of 49
management of 49
manifestations of 50
prevention of 46, 61
primary, common causes of 48
renal tubular acidosis, common causes of 48
severe
diarrhea, common causes of 48
vomiting, common causes of 48
tips in treating 61
treatment of 46, 54
uncommon causes of 49
with CHF 57
with ectopic adrenocorticotrophic hormone production, uncommon causes of 49
Hypokalemic familial periodic paralysis 50
Hyponatremia 90
diagnosis of 32
etiology 26
in cerebral malaria 31
in critically-ill neurological patients 27
in severe exercise 27
management 26
pathophysiology of 26, 31
prevention 35
signs of 28
symptoms of 28
treatment 32
Hyponatremic encephalopathy 30
Hypophosphatasia 96
Hypophosphatemia 108
I
Idiopathic
AIN 180
edema 114
infantile hypercalcemia 96
INF-G production and regulation 431
Immune-complex mediated diseases 181
Immunofluorescence microscopy 299
Immunoglobulin basic structure light and heavy chain 424f
Immunoglobulins 424
Immunophilins 435
Immunoreceptor tyrosine-based activation motif 427
Immunosuppressive agents 453
Inappropriate antidiuretic hormone, syndrome of 26
Increase in potassium load 63
Incretin mimetics 143
Individual antihypertensive therapy 305
Infection and hernia 230
Infection-related AIN 180
causes of 180t
Infection-related stones 388
Infectious complications 463
Infertility in men 148
Influenza 277
Inhibit osteoclastic bone reabsorption 101
Inorganic acid intake 76
Insulin 47, 67
edema 114
therapy 132
initiation of 135
principles of 132
types, duration of 134t
versus oral antidiabetic agents 137
Intra-abdominal pressure 409
related complications 416
Intracellular
fluid compartment 112
shifts of hydrogen ions 78
Intravenous
pyelography 474
urography 371
Intrinsic
acute renal failure 178
renal failure 177
IR-AIN See Infection-related AIN
K
K+ excretion, decrease in 62
Kassirer-Bleich equation 70
Kawasaki’s syndrome 277
Kerr Kink sign 371
Ketoacidosis 71, 74
Ketoacids 71
Kidneys 18, 46, 63, 232
biopsy 3, 161
disease 3
function 132, 338
stone disease 10
transplantation 441
transplants, surgical complications after 439t
ureter
and bladder See Positive KUB
bladder film right renal stone 10f
Klebsiella 442
KUB film See Kidney, ureter, bladder film right renal stone
L
L. icterohaemorrhagiae 272
L. interrogans 271, 272
Lactate 71
Lactic acidosis 71
ketoacidosis 72
Large renal calculi 237
Leflunomide 435
Left ventricular hypertrophy 297
Legs of penguins touching cold soil 17
Leptospira
icterohaemorrhagiae 271
interrogans 271
Leptospiral lipopolysaccharide 274
Leptospirosis 271
epidemiology 272
pathogenesis 273
pathology 273
Levamisole 355
Liddle’s syndrome 50, 56, 79, 82
Lipedema 115
Lipid abnormalities in nephrotic syndrome 352t
Listeria monocytogenes 463
Lithium carbonate 98
Lithium-induced diabetes insipidus 88
Liver 18
cysts 230, 231
disease, treatment of patients with 373
enzymes 277
function tests 275
L-lactic acidosis 73
Loading dose, calculation of 284
Long QT syndrome and Torsade de pointes 51
Loop-acting diuretics 117
Loss of immunoglobulins 352
Loss of vitamin D 352
Low intake of potassium 50
Low magnification See Adynamic bone
Low magnification See Osteitis fibrosa
Low magnification See Osteomalacia
Low turnover osteomalacia 258
Lower urinary tract 237
Lung cells 19
Luteinizing hormone 147
LV failure 297
Lymphedema 115
Lymphocele 441
M
M avium intracellulare 368
M tuberculosis 365, 366, 370, 372
Macroplastique 475
Macrovascular complications (atherosclerosis) 164
Magnesium
preparation 58
supplementation 58
Magnocellular neurons in posterior pituitary 87
Maintain therapeutic blood levels 443
Major histocompatibility complex 425
Malignancies 449
after renal transplantation 450f
Malignant hypertension 297
Mammalian target of rapamycin 435
Maneuvers to improve erectile function 148
M-ARF See Myeloma-related acute renal failure
Measurement of dialysis dose 411
Medical management of stones 385
Medications interfering with cyclosporine metabolism 455f
Medullary
cystic disease 232
treatment 233
interstitial osmolality 86
sponge kidney 233
treatment 233
Membranoproliferative glomerulonephritis 360
Membranous nephropathy 357
Menorrhagia See Uterine
Mesangiocapillary glomerulonephritis 360
Mesangium 18
Metabolic acidosis 9, 171, 210, 256
and metabolic alkalosis 70
common causes of 73f
production of 70
types of 80t
Metabolic alkalemia See Metabolic alkalosis
Metabolic alkalosis 74, 78, 81
causes of 78
development of 81, 81t
factors influencing maintenance of 83t
generation of 81t
management 81
pathophysiology 81
treatment of 79
with volume overload low urinary chloride 84
Metabolic
bone disease 108
complications 416, 447
Metabolism 282
Metabolites in renal failure, effect of 283t
Methanol intoxication 75
Methicillin-resistant staphylococcus 290
Methionine 71
Methyldopa 319
MHC proteins 425
Mica and kidney transplant 425
Microalbuminuria 9
Microbiology and taxonomy 271
Microscopic polyangitis 181
Microvascular complications 164
Midstream clean catch urine 470
Mild hyperphosphatemia 212
Milk alkali syndrome 78, 99
Minimal change nephrotic syndrome 349, 353
Minocycline See also Alcohol
Miscellaneous drug dosing in CAPD 290t
Mithramycin See Plicamycin
Mixed bone disease 258
Mixed osteitis fibrosa with osteomalacia 256
Molecular mimicry 346
MRA, CTA and DSA, comparison of 335
Mud fever 271
Multiple
endocrine neoplasia 97
myeloma 23, 184
Mycobacterial growth indication tube 370
Mycobacterium tuberculosis 443
infection, cases of 443
Mycophenolate mofetil 455
Mycophenolic acid, prodrugs of 435
Mycoplasma 180
Myeloma-related acute renal failure 184
Myopathies 403
N
N-acetylprocainamide 282
Nasal 244
Nausea 75
NDRD in type 2
diabetic, management of 162
Neonatal primary hyperparathyroidism 95
Nephrogenic
diabetes insipidus 22, 88, 90, 91
causes of 22t
systemic fibrosis 331
Nephrological manifestation of renal tuberculosis 370t
Nephron function in diseased kidneys, preservation of 205
Nephropathy, type of 161
Nephrosclerosis 291
Nephrostomy drainage analysis 239t
Nephrotic syndrome 162, 325, 349, 352
definition 349
etiology of 350t
with interstitial nephritis 163
Nephrotoxic drug 187
Net acid excretion 71
Neurohypophyseal 87
acquired causes of 87
central 87
diabetes 88
insipidus 91
Neurohypophysis 87
causes 88
Neurologic manifestations 260
Neuropathies 403
Neutral protamine hagedorn 134
New-onset diabetes after transplantation 448t
New-onset diabetes mellitus after transplant 461
Nightly intermittent peritoneal dialysis 411
Nitric oxide 247
Nitrogen 423
Nocardia asteroides 463
Nocturnal intermittent peritoneal dialysis 411
Non anion gap metabolic acidosis 76
Nondiabetic
nephropathy 158
proteinuria renal disease 216
renal disease 158, 159, 217
in diabetes mellitus 158
Nondialysis treatment of CRF 207
Nonfunctional gastrointestinal syndromes 109
Non-Hodgkin’s lymphoma 99, 349
Non-infection complications 416
Nonsteroidal anti-inflammatory
agents 292
drugs 179
Normal-protein diet 363
Normocalcemic hypercalciuria 99
NSAIDs See Nonsteroidal anti-inflammatory drugs
Nuclear imaging with kidney disease 12
O
Obesity 297
Obstetric complications 186
Obstructive uropathy 13
Office visits, course of 307t
Ogilvie syndrome 441
Omeprazole 179
Oral hypoglycemic agents 137, 138t
Osmolal gap, calculation of 7
Osmolality
in renal medulla 17
of tubular fluid 15
Osmotic diuresis 23
Osteitis fibrosa 253, 256, 257f, 262
Osteodystrophy 402
Osteomalacia 257f, 262
Overfilled hypothesis 351
Oxalate 379, 380
Oxidative stress, concept of 361
Oxygen 423
Oxytocin 18
P
P jirovecii See Pneumocystis carinii
Pamidronate 102
Parathormone blood levels 402
Parathyroid
hormone 94, 261
secretion 252
related protein 99
Parathyroidectomy 267
Parenteral drugs for treatment of hypertensive emergencies 311t
Partial diabetes 88
Pauci-immune 181
glomerulonephritis 181
Percutaneous nephrolithotomy 230
Perfusion of both kidneys, difference in 14f
Perinephric pseudocysts 234
Periodic acid Schiff stain 206f
Peritoneal
dialysis 406
access 408
complications 406, 413
management 406
modalities of 409
principles of 406
solutions 409
equilibration test 407, 408f
membrane
characteristics, assessment of 407
failure 417
physiology of 406
solute and water transport 407
Peritonitis 413
Persistent headache 301
Pheochromocytoma 98, 301
Phosphate 71, 103, 105
decreased excretion of 107
Phosphatidyl inositol bisphosphate 429
Phosphorus 255, 379, 380
control of 264
Piperacillin 290
Pipestem ureter 371
Pituitary diabetes insipidus See also Central diabetes insipidus
Plasma
AVP measurement 90
potassium concentration results 55t
vasopressin level 87
von Willebrand factor 245
Platele 245t
defects 246
dysfunction 246
transfusion 250
Plicamycin 102
Plus urinary potassium 33
Pneumocystis carinii 441, 463
Pneumonia 443
Polycystic kidney 301, 325
disease 11f, 227
autosomal
dominant 227
recessive 231
diagnostic of 228f
Polydimethylsiloxane, injections of 475
Polymerase chain reaction 371, 463
Polyomavirus 464
Polypeptide 423
Polyuria See Dilute urine
Polyuria
and diabetes insipidus 86
causes of 86, 87t, 91
of hypercalcemia 89
treatment 91
Ponticelli regimen 360
Poor man’s adventure helping patients stay off dialysis 205t
Positive KUB 328
Posthypercapnic alkalosis 78
Postmeal glucose surges 135f
Postobstructive diuresis 242
Postoperative hyponatremia, types of 30t
Postrenal transplantation late complications including rejection 453
Poststreptococcal glomerulonephritis 345
treatment 347
Postsurgery hyponatremia 30
Post-transplant
bone loss 462
diabetes mellitus 461
hypertension, prevalence of 447
lymphoproliferative disorder 465
treatment of 451
medical and surgical complications, management of 438
membranous glomerulopathy 358
tuberculosis, treatment of 443
Potassium 205
channels, number of 19
homeostasis in critically ill adults 57
large intake of 63
level, management daily medicines administered 58f
secretion 63
sparing diuretics 120
supplementation 54
Pramlintide acetate 143
Predialysis patient 263
Preeclampsia 186, 316
pathophysiology of 317
Preemptive therapy 444
Pregnancy 103, 326
associated acute renal failure 185
hypertensive
diseases in 316
disorders of 316t
in pre-existing renal disease 324
induced hypertension, diagnosis of 316
related
acute renal failure, causes of 186t
renal disease and hypertension 304, 315
renal transplantation 326
specific disorder 186
Pre-renal azotemia 187
Prescribed acidic and basic drugs, list of 282t
Presumably glucose 154f
evidence of 155f
Primary
hemostasis 245
hyperaldosteronism 57, 301
hyperparathyroidism 97
polydipsia 89, 91
Profile in drug selection 301
Progressive renal failure 169
Prolonged bleeding time 246
Prophylactic therapy 444
Prophylaxis 473
Protein
and related substances 423
binding 281
related substances
primary structure 423
quaternary structure 423
secondary structure 423
tertiary structure 423
subunits 423
Proteinuria 9, 158, 219f
and creatinine clearance, correlation between 221f
consequences of 352
loss of heparan sulfate 221
on renal function in
diabetic renal disease, effect of 215
nondiabetic renal disease, effect of 215
treatment of 215
Proteus
enterococcus 442
mirabilis 388
Proximal
HCO3 absorption, factors influencing 83t
muscle weakness 260
Pruritus 260
Pseudohyperkalemia 64
Pseudomonas 290, 442
PTH response to hypocalcemia 255f
Pulmonary
capillary 275
edema 75
Pulse therapy 458
Pyelocalyceal cysts 234
Pyelonephritis 10
R
Rabbit’s serum 272
Radiologic
evaluation in renal disease 9
testing for stone disease 383t
Radionuclide tracer, quantity of 4
Rapamycin 456
Rapidly progressive glomerulonephritis 181
Rash 179
Reactive oxygen species 361
Recapitulation of drug-induced hyperkalemia 64
Recombinant factor 249
Recurrent
hyponatremia 34
stone formers 385
Red blood cell 7f
cast 8f
Redistribution of potassium 64
Reflux nephropathy 326
Refractory edema
and anasarca, management strategies of 120
therapies for 120
Regulators of calcium metabolism 95
Remediable factors aggravating renal failure 206t
Renal
arteriogram beaded of bilateral renal areries 12f
artery 337
revascularization 336
stenosis
potential causes of 440t
revascularization 338
thrombosis 438, 439
stenosis 11, 13, 329, 331t, 440
biopsy 13
blood flow 169
bone disease, types of 256
cortical necrosis 183, 183t
cysts 225
disease 20, 292t
edema 114
immunologic markers in 9
percentage of end stage 216f
epithelial cells 274
failure 72, 301
common in 284
on conduction system of heart 170
pathophysiology of 169
treatment of patients with 373
fractional flow reserve 335
function 64
and electrolyte trends 39f
and serum electrolytes 41t
parameters 194t
preservation of 229, 305
tests 275
handling of calcium 94
hypoperfusion 187
leak hypercalciuria 99
limited vasculitis 181
lymphangiomatosis 234
manifestations 51, 227
masses 10
microvasculature 180
osteodystrophy 252
classification of 256
clinical features of 259
diagnosis of 261
treatment of 263
phosphorus excretion, factors affecting 106t
plasma flow 315
evaluation of 12
replacement therapy 169, 177
continuous 287
in severe CHF 172
response to metabolic acidosis 71
retinal
dysplasia 232
relationship in proteinuric 161
syndrome 271
transplant recipients 98
transplantation 230
immunologic concepts of 423
tubular
acidosis 9, 47, 72, 76
epithelium 7
tubules 63
ultrasound 473
vasculitis 178
vein thrombosis 438, 439
Renin-angiotensin
aldosterone-system, activation of 362
inhibitor drugs in diabetes, use of 140
Renovascular
disease 329
management of 335
hypertension 301, 311
causes of 329t
Resorptive hypercalciuria 99
Respiratory
compensation for metabolic acidosis 71
problems 404
Response to therapeutic intervention, definitions of 354t
Restriction of protein intake 363
Rifle classification of ARF 177t
Rituximab 459
Roller pump 395
RTA classification 76t
S
Salicylate intoxication 75
Salt and fluid intake, variable restriction of 117
Sarcoidosis 23
Satisfactory glucose control 132
Secondary
hemostasis 245
hyperaldosteronism See also Hypokalemia primary, common causes of
hyperparathyroidism 96, 97, 253
pathogenesis of 253t
Sepsis-associated ARF 186
Septicemia 443
Serial serum potassium levels 311t
Serologic diagnosis 370
Serological methods 276
Serum
calcium concentration on predialysis PTH values in hemodialysis, effect of 265f
chemistries 261
chemistry values 312t
creatinine 3, 191, 202, 205, 208
factors influencing level of 5t
electrolytes 40t
glucose levels
and EGFR, correlation between 220f
for ES 88Y white female 43t
markers for bone formation 262
phosphorus, control of 263
potassium levels 60f
in 80-year-old white female 175t
sodium 37
uric acid 315
levels for ES 88Y white female 43t
Seven-day fever 271
Severe
atherosclerotic vascular disease 248
congestive heart failure 169
pathophysiology 169
prevention 169
treatment 169
damaged cells 154f
diuretic-induced hyponatremia in elderly 27
heart failure 300
hyperkalemia 67
hyperparathyroidism, effect of 265f
hypokalemia 81
renal failure 246
Sexual
activity in females, anatomy of 149
life in diabetic women 149
Shohl’s solution 67
Short-bowel syndrome 75
SIADH 28
Simple cyst from malignancy, differentiation of 226t
Simple cysts 225
treatment of 227
Sirolimus 456
Skeletal
deformity 260
muscle dysfunction, manifestations of 50
resistance to calcemic action of PTH 256
SLE and antiphospholipid syndrome 187
Smoking 297
cessation 363
Smooth muscle 18
cells 299
Sodium 16, 211
bicarbonate infusion 67
citrate 67
and citric acid, mixture of 67
excretion of 7
polystyrene sulfonate 66, 67
Solitary kidney 237
Solute overload 91
Specific
bleeding 247
immune responses of T cells and B cells 430
renal diseases, evaluation of 10
treatment 209
hypertension 209
Spironolactone 84
Spontaneous
retroperitoneal hemorrhage 245
subcapsular hematoma 244
Staphylococcus 442
aureus 289, 290, 400
epidermidis 289
State of metabolic acidosis 71
Stenotrophomonas 290
Steroid-resistant nephrotic syndrome in children, management of 355
Stone formation, pathophysiology of 379
Stones, types of 380
Streptococcus pneumoniae 443
Streptomyces hygroscopicus 435
Stroke 300
Structure of major histocompatibility complex molecules 425f
Subdural hematoma 244
Subsequent hypocalcemia 254
Sulfate 71
Sulfosalicylic acid 7
Sulfuric acid 71
Suppressor T cells 431
Swineherd’s disease 271
Syndrome of
abdominal compartment 187
acute renal failure with renin-angiotensin inhibitor drugs 190
Bartter’s 49, 56, 82
Cushing 82
Gitelman’s 56
Hell 186
HELLP 186
inappropriate antidiuretic hormone 26
inappropriate antidiuretic hormone See SIADH
Ogilvie 441
von Hippel Lindau 232
Williams 96
withdrawal 310
Systematic approach to patient with hypertension 300
Systemic effects of metabolic acidosis 72
Systemic lupus erythematosis 180, 325
Systolic 299
T
T cells, role of 349
Tachycardia 301
Tacrolimus 455
Tamm-Horsfall mucoprotein 9
Target injury 432
T-cell receptor 426
basic structure of 426f
T-cell triggering 427
TCR triggering, nature of 427
Therapeutic
strategies 247
vasopressin test 90
Thiazide diuretics 117, 302
Thrombotic thrombocytopenic purpura 186, 187
Thyroid-stimulating hormone 147, 404
Tidal peritoneal dialysis 411, 411f
Tissue-damaging response 366
Titratable acid 71
Tolvaptan 35
Toxin-induced acidosis 74
Transient
hypertension 317
neurologic symptoms 230
proteinuria 9
Transmission electron microscopy 299
Transplant renal artery stenosis 440
Transplanted kidney 237
Transurethral resection of prostate 242
Treating hypernatremia, algorithm for 44f
Treating hypertension in elderly 305t
Triamterene 84, 120
Trichrome stain 206f
Trimethoprim-sulfamethoxazole 442
Tuberculosis of kidney 365
management 372
microscopy 368
pathogenesis 366
Tuberculous autonephrectomy 371
Tuberous sclerosis 231
Tubular
fluid osmolalities in loop of henle 16f
function, assessment of 5
unresponsiveness to aldosterone 63
Tunnel infections 416
Tyrosine kinases, role of 428
U
Underfill hypothesis 351
Undetected and uncontrolled hypertension 297
Upper urinary tract obstruction 237, 240
Urea 16, 18
Uremia 256, 300
Uremic See Severe renal failure
Ureteric colic 237
Ureteric colic, management of 384
Uric acid 202, 379, 380
stones 388
Urinalysis 5, 275, 301
and microscopy of AFB 370
findings and significance 6t
Urinary
ammonia 9
analysis of 208
anion gap, calculation of 7
bladder 236
chloride concentration 83t
concentration 17
abnormalities of 20
and dilution
description of 17
physiology of 15
physiology of 15
creatinine 208
culture 370
dilution, physiology of 15
electrolytes 7, 301
treated with ACE and diuretic 195t
flow rate 86
sediment findings 8t
sediment, microscopic evaluation of 7
stones 379
diagnosis 382
management 384
presentation of 382
types of 380t
system, evaluation of 13t
tract consists of kidneys 236
tract infection 7, 10, 442
classification of 469
clinical features of 471
definition 469
in different age groups 471t
in paediatrics, management of 469
in pregnancy 323
management of 472
pathogenesis 470
tract
anatomy of 236
clinical presentation of 236
obstruction 237, 240, 440
TB 369
chemotherapy of 372
surgical management of 374
Urine
and serum
creatinine 219f
osmolality 20
chloride 78
collection 30
method of 469
electrolytes
and osmolality 29t
measurement of 7
leaks 440
osmolality 29
physical characteristics of 6
storage of 470
Urolithiasis 326
Urologic
complications 440
procedure 242
Uterine 244
Uterus 236
V
Vagina 236
Valproic acid 281
Vancomycin dosing 292t
Vasa recta 18
Vascular
calcifications 260
catastrophe 212
complications 438
disorders 326
endothelial growth factor 456
smooth muscle cells 303
Vasculitis-associated ARF, treatment of 182
Vasodilators 319
Vasopressin
antagonists 35
mode of action 18
receptors 18
release 18
resistant diabetes insipidus 89
Venous thromboembolism 439
Veno-venous hemodialysis, continuous 74
Vesicoureteric reflux 475
VHL syndrome See von Hippel Lindau syndrome 232
Vincristine 185
Viruses related to malignancies after transplantation 450f
Vitamin
A intoxication 98
D 98, 255, 402
deficiency 108
intoxication 106
receptor activators 266
treatment with 265
Voiding cystourethrography 474
Volume homeostasis 211
Vomiting 74, 75
von Hippel Lindau syndrome 232
von Willebrand factor 246
W
Washdown 112
Water
channels 19
deprivation test 21t, 89
procedure 89
intoxication, development of 90
loading test 29
treatment 395
Weil’s disease 271
signs of 277
symptoms of 277
Wermer syndrome 97
White blood cell 7f
casts 8f
White
female 205
male 205
Willebrand’s disease 249
Williams syndrome 96
Withdrawal syndromes 310
X
Xanthomonas See Stenotrophomonas
Y
Yersinia and Salmonella 268
×
Chapter Notes

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1Textbook of NEPHROLOGY2
3Textbook of NEPHROLOGY
Third Edition
Editor Anil K Mandal MBBS FACP FASN FICP (Honorary) Fulbright Scholar Consultant Nephrologist Northeast Florida Area Hospitals Courtesy Clinical Professor of Medicine University of Florida in Gainesville, Florida, USA E-mail: amandal@med-spec.com Associate Editor Jai Prakash MD FASN Professor of Nephrology Banaras Hindu University Institute of Medical Sciences Department of Nephrology Varanasi, Uttar Pradesh, India Email: jpojha555@hotmail.com jprakash53@gmail.com Foreword KK Malhotra
4
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Mobile: +08801912003485
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Phone: +00977-9841528578
© Anil K Mandal, Jai Prakash
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Textbook of Nephrology
First Edition: 1993
Second Edition: 2004
Third Edition: 2014
9789350905326
Printed at
5Dedicated to
Those who are inspirational in my daily work;
Atashi Mandal
Huntington Beach, California, USA
Karen Kidwell
Saint Augustine, Florida, USA
Shriram Marathe
Saint Augustine, Florida, USA
The entire office staff of Medical Specialists of Northeast Florida
Moustafa Eldick
Palatka, Florida, USA
JP Tiwari
Goa, India
Linda Hiebert
Saskatoon, Canada
Rajendra Bhimma
Caronisha Bhimma
Durban, South Africa
6
7List of Contributors 9Foreword to the Third Edition
Nephrology has made great strides during the last decade and demand for renal services has grown considerably throughout the world. A book highlighting practical and clinical aspects of nephrology fills an important gap on the subject. The last edition of the book was very well received and there was an urgent demand for revision of the book. All the chapters have been extensively revised and some new chapters have been added. Four new chapters dealing with Diabetes and Kidney have been included. Professor Mandal has large practical experience in this area of nephrology and has highlighted his observations in these chapters. The book has been supplemented with figures, tables and graphs. This makes it more readable. Professor Anil K Mandal and his co-authors deserve appreciation for the hard work they have done in preparing this book. I am sure this will serve the specific purpose for which it has been written.
KK Malhotra mbbs md isn fams fapi ficn
Director, Clinical Research, and Senior Consultant, Nephrology
Pushpawati Singhania Research Institute
For Liver, Renal & Digestive Diseases
New Delhi, India
10
11Foreword to the First Edition
This textbook, written very largely by people from the Asian-Pacific area, many of whom are now working in other parts of the world, is likely to fill a particular need for Asian-Pacific physicians. The chapters contain practical information giving formulas to assist the physician in making judgements on things like electrolyte disturbances and other practical problems which arise in nephrological practice. The chapter on dialysis is a useful one written for physicians rather than nephrologists and explaining the techniques in simple and practical terms.
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.
Priscilla Kincaid-Smith
Department of Pathology
University of Melbourne
Parkville, Victoria
Australia
12
13Preface to the Third Edition
Third edition is an update of the second edition with addition of several new chapters on diabetes: what does high glucose higher than normal levels (70–99 mg/dL or 3.8 to 5.5 mmol/L) do to body function?, diabetes and sexual dysfunction and a logical approach to management of diabetes with a goal to prevention of complications. Diabetes-associated renal disease may not be due to diabetes as written by Professor Jai Prakash from Varanasi, India. The reason being Type 2 diabetes is not a well-defined entity, due to lack of assessment by 2-hour postprandial glucose level or glucose tolerance test. Therefore, some of these patients with so-called Type 2 diabetes may not have diabetes.
Nevertheless, diabetes has constituted a big part of nephrology practice with the intention to reduce proteinuria hence reducing the risk of end-stage renal disease (ESRD) and dialysis therapy. This intention was not accomplished as more and more diabetes patients are entering into dialysis programs. In the editor's practice, diabetes patients do not enter into dialysis, because editor pays total attention to glycemic control and does not prescribe reninangiotensin inhibitor drugs or discontinues these drugs for patients who were receiving them at the time of first office visit. Diabetes is a self-care disease. Well-motivated patients understand that diabetes is a serious disease and do their best to keep sugar under control so that they do not develop the horrible complications such as foot ulcer, gangrene and kidney failure. Professionals should do everything to prevent renal failure and resulting dialysis treatment. It is with those goals in mind that the new chapters were added. Diabetes is the most common cause of sexual dysfunction in men and women and a major cause of family turmoil. This is an uncultivated and uninformed area. Thus, with the addition of this chapter, the editor feels that professionals may be alerted to the importance of the discussion of sexual function with their diabetes patients.
The focus of the third edition is a conservative nephrology practice clear of dialysis and transplantation. However, the chapters on dialysis and transplantation are retained to help trainees and those practitioners who are more interested in those two areas than others. The chapters are written based on observations and application of methods of diagnosis and management plans which work well for the patients. Thus, this book is a practical one to appropriately tackle problems pertaining to renal disease, hypertension, and diabetes. This book is not evidencebased resulting from clinical trials which are not helpful when it comes to direct patient care. Style of the book is succinct and lucid and is free of commercial interest. Finally, the editors are pleased to express a deep appreciation to all of the authors for their contribution to the enrichment of this third edition.
Anil K Mandal
14
15Preface to the First Edition
The purpose of developing a volume in nephrology entitled Textbook of Nephrology for the Asian-Pacific Physicians is neither a gesture to crowd the publishing market with another nephrology book nor an intention to compete with any of the existing volumes in the medical books market. The purposes of developing a volume of nephrology for the Asian-Pacific physicians are discrete and do not overlap with those of any of the existing nephrology textbooks.
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 practicing physicians including nephrologists in the Asian-Pacific countries. (2) Except in Japan and Australia, there are very few trained nephrologists 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 nephrologist 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 practicing 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 editors 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 Shri Jitendar P Vij of Jaypee Brothers Medical Publishers, New Delhi, for his keen interest in publishing this nephrology volume.
AK Mandal
Anil K Agarwal