Medical Lecture Note: Ronco: Critical Care Nephrology 2nd edition (Expert Consult Series)

ritical care nephrology is a new discipline formally born in 1998 from a group of scientists and physicians who established its definition as a multidisciplinary branch of medicine dealing with issues at the crossroad of intensive care medicine and nephrology. The discipline became established thanks to a growing appreciation of the importance of this field, an expanding body of laboratory and clinical research in this area, editorials (C Ronco, R Bellomo: Critical Care Nephrology: the time has come. Nephrol Dial Transplant, 13, 264-267, 1998), International Congresses (First- Second and Third International Courses on Critical Care Nephrology, Vicenza Italy, 1998-2001-2004 and 2007), and the first dedicated textbook (Critical Care Nephrology, Kluwer Academic Publishers, 1998). This book, unique in its nature, reach, and content was well received by the scientific and clinical community. Now, 10 years after the first edition, we are pleased to present the second edition, enriched, updated, and expanded to take into account the very large body of work carried out in the last 10 years.

The unrelenting advance of medical progress opens new areas of interest and opportunity. Such areas must be explored and explained by experts with appropriate reference tools and information sources to help clinicians practice at the very best level. Thus, after much clinical and experimental research experience in the field of critical care medicine and nephrology, we have decided to undertake the effort of producing a second and revised edition of a book dealing with this subject. Common guidelines, standardized approaches, and appropriate literature dealing with a multidisciplinary approach to kidney diseases in critically ill patients are emerging and growing significantly. Internists, surgeons, critical care physicians, and nephrologists all treat critically ill patients with acute renal failure and the multiple system organ dysfunction syndromes. The approach varies from hospital to hospital and often within hospitals. It depends on the structure of the institution, the tradition of the medical school, the financial status of the facility, and the heterogeneity of training and experience of clinicians. Doctors from different fields write notes without searching for a common multidisciplinary approach to the patient. Often, they hardly meet at the bedside and various prescriptions are made in absence of a common decision-making process.

A comprehensive review of the state of the art on this matter is definitely needed both in academic and clinical medicine. Critical Care Nephrology should provide such a comprehensive review. It will inevitably become a useful reference tool both for nephrologists and intensivists. The title Critical Care Nephrology has been chosen to stress the aim of the book: to provide a comprehensive and state-of-the art description and understanding of the problems related to kidney diseases and blood purification in critically ill patients. This review includes the pathophysiological foundations of major syndromes, the basis of laboratory investigations pertinent to this field, clinical approaches to complex patient management, interactions between renal and other organ system failure, monitoring techniques, therapeutical interventions, supportive treatments, new and advanced blood purification technologies, and the principles of management for various relevant derangements. The title is also intended to draw the reader's attention to the multidisciplinary nature of this complex subject matter and to the need for maximal cooperation between experts in intensive care and nephrology.

The book has three major parts: the first deals with basic sciences—biology, chemistry, physics, molecular biology, genomics, proteomics, and immunology—as they pertain to this field. All these are dealt with in chapters with a strong attention to the clinical setting and the application of such principles to daily clinical practice. Experimental research and evidence-based concepts are also discussed. The second part describes all relevant clinical syndromes with particular attention to pathophysiology, diagnosis, and clinical care, and the third part deals with diagnostic tools and the application of technology to therapeutical strategies and future trends.

Critical Care Nephrology deals with general information, definitions of critical illness, epidemiology, monitoring and diagnostic procedures, pathophysiology of organ systems in relation to kidney function, concepts of renal physiological and pathological responses to various derangements, oxygen transport and cardiovascular adaptations, hemodynamic parameters, respiratory parameters, mechanical ventilation and cardiac support, and severity score parameters as they relate to the complex care of patients with kidney injury or the requirement of advanced blood purification technology. This book is also devoted to all forms of acute renal failure, with specific reference to intensive care patients. Prerenal, renal, and postrenal acute renal failure are discussed in terms of etiology, frequency, mechanisms, pathophysiology, tissue lesions, biopsy patterns, diagnostic procedures, and management. The nature of the multiple organ dysfunction syndrome is discussed, with special emphasis on the impact of different organs dysfunction and kidney failure. Poisoning, infections (in general and of the urinary tract), drug-induced renal failure, and sepsis are all discussed in this part, with focus on the pathophysiological foundations of these syndromes. Kidney function and acute renal failure in patients with kidney, liver, and heart transplants are also discussed in detail, as is acute illness occurring in long-term hemodialysis patients. Finally, issues related to special patients such as children, diabetics, and elderly subjects are carefully analyzed in a specific session offering an important reference to pediatric critical care nephrology specialists.

Special emphasis has been placed on therapeutical interventions and treatment procedures. Different forms of extracorporeal organ support are discussed in detail, including liver, lung, and cardiac support. Artificial renal support is conceived and discussed first in terms of preventive measures to avoid renal failure and then as supportive treatment to replace renal function in different conditions. Thus, the use and pharmacokinetics of drugs in the critically ill patient is thoroughly explored. Various forms of extracorporeal therapies are discussed in detail, including hemodialysis, hemofiltration, hemoperfusion, and extracorporeal membrane oxygenation. Mechanical ventilation, mechanical cardiac support, and the total artificial heart are discussed in relation to kidney function. Recent advances in the therapy of the sepsis syndrome are presented, and new insights on future trends in terms of extracorporeal treatments are provided.

Replacement of renal function by dialysis has been carried out for many years either in acute or chronic renal failure patients. The use of continuous renal replacement techniques has permitted new achievements in the correction of the metabolic and clinical derangements observed in critically ill patients. Today, extracorporeal techniques seem to display important beneficial effects that may overcome the classic indications of urea removal and fluid regulation. For this reason, a series of new techniques are appearing on the scene, with the specific aim of designing a treatment suitable for patients with multiple organ failure. Selective removal of cytokines and pro-inflammatory mediators, plasma adsorption, and other techniques have been used in vitro, in animal models, and sometimes in patients. There is a need to summarize all the current experience in the field and to deliver a comprehensive review of most of the experimental and clinical work carried out so far. We believe this book achieves such a goal.

The multidisciplinary nature of the subject and the rapid evolution of the knowledge in the field make this second revised edition necessary. Because of its uniqueness, we believe this book will become a “classic” in the field as did its predecessor and will be an important reference tool for nephrologists and intensive care specialists. It is no coincidence that the editors of the book are themselves specialists in these particular fields and are stragegically located throughout the world.

In conclusion, the aim of this book is to provide a comprehensive and educational review of the field of critical care nephrology. Critical Care Nephrology aims to create a complete reference book for colleagues who are dealing every day with critically ill patients suffering from kidney diseases, electrolyte and metabolic imbalances, poisoning, severe sepsis, major organ dysfunction, and other pathological events that require a multidisciplinary approach, a deep knowledge of extracorporeal organ support techniques, and a deep understanding of human knowledge in this field.

The book seeks to facilitate the process of developing common definitions and approaches to patient management in nephrology and critical care medicine, so that physicians think the same way and speak the same language. As such, it aims to present a comprehensive review of the recent evolution of the indications, applications, and mechanisms of function of the most recent extracorporeal techniques both for the treatment of acute renal failure and for the management of related disorders in the critically ill patient. Given these premises, the book may also be helpful for residents, fellows, and advanced trainees in nephrology and critical care medicine, as well as for staff physicians and members of the academic and scientific community involved in practice and research in the field of critical care nephrology.

We are grateful to all contributors who made this book possible, and we especially thank the editorial team at Elsevier who managed the production of the book with great professionalism and enthusiasm. We hope our readers will find that this effort has been worth it and sincerely hope that it will contribute to improving the care of acutely ill patients worldwide.

-- Claudio Ronco, Rinaldo Bellomo, John A. Kellum

Key Features

Presents a multi-disciplinary and international approach to critical renal care for a thorough and integrated presentation of how to care for critically ill patients with renal disease or complications.
Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure.
Provides details on different forms of organ support, including liver, lung, and cardiac therapy.
Defines common guidelines in nephrology and critical care medicine for better communication among clinicians.
Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool.
Dozens of case studies are only available in the online version of this book.

Website Features

Consult the book from any computer at home, in your office, or at any practice location.
Instantly locate the answers to your clinical questions via a simple search query.
Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.

New to this edition

Features a new US editor, Dr. John Kellum, who incorporates his expertise in critical care medicine to the 2nd edition and extends the breadth of coverage with a North American perspective.
Includes access to the complete fully searchable contents online for convenient referencing.
Discusses new techniques in the field providing you with a comprehensive review of the experimental and clinical work being done.
Features a new 2-color design and shorter, more focused chapters to help you access key facts quicker.

Contents

PART I - Basic Clinical Problems

SECTION 1 - The Critically Ill Patient: Basic Principles of Care

CHAPTER 1 - The Critically Ill Patient
CHAPTER 2 - Genetic Variation and Critical Illness
CHAPTER 3 - Fundamentals of Oxygen Delivery
CHAPTER 4 - Mechanical Ventilation
CHAPTER 5 - Principles of Pharmacology in the Critically Ill
CHAPTER 6 - Hemodynamic Monitoring in the Intensive Care Unit
CHAPTER 7 - Respiratory Monitoring
CHAPTER 8 - Monitoring Kidney Function in the Intensive Care Unit
CHAPTER 9 - General Illness Severity Scores
CHAPTER 10 - Kidney-Specific Severity Scores

SECTION 2 - Epidemiology of Kidney Disease in the Intensive Care Unit: Basic Principles

CHAPTER 11 - What Is Acute Kidney Injury?
CHAPTER 12 - Basic Principles of Renal Support
CHAPTER 13 - Genetic Factors Influencing Acute Kidney Injury
CHAPTER 14 - Epidemiology of Community-Acquired Acute Kidney Injury
CHAPTER 15 - Epidemiology of Nosocomial Acute Kidney Injury
CHAPTER 16 - Risk Factors for Nosocomial Renal Failure
CHAPTER 17 - Etiology of Acute Renal Failure in the Intensive Care Unit
CHAPTER 19 - Long-Term Outcomes of Acute Kidney Injury

SECTION 3 - Principles of Applied Renal Physiology

CHAPTER 20 - Glomerular Filtration Rate and Renal Functional Reserve
CHAPTER 21 - The Physiology of the Afferent and Efferent Arterioles
CHAPTER 22 - The Physiology of the Glomerular Tuft
CHAPTER 23 - Adenosine and Tubuloglomerular Feedback in the Pathophysiology of Acute Renal Failure
CHAPTER 24 - The Physiology of the Proximal Tubule
CHAPTER 25 - The Physiology of the Loop of Henle
CHAPTER 26 - Distal Tubular Physiology
CHAPTER 27 - The Physiology of the Collecting Ducts

SECTION 4 - Acute Renal Failure: Pathophysiological Principles: Pathophysiology

CHAPTER 28 - Ischemic Acute Renal Failure
CHAPTER 29 - Septic Acute Renal Failure
CHAPTER 30 - Toxic Acute Renal Failure
CHAPTER 31 - Renal Blood Flow and Perfusion Pressure
CHAPTER 32 - Vulnerability of the Kidney to Nephrotoxins
CHAPTER 33 - Humoral Mediators in Sepsis
CHAPTER 34 - Apoptosis and Necrosis
CHAPTER 35 - Oxidative Stress in Acute Kidney Injury and Sepsis
CHAPTER 36 - Pathophysiology of Vasculitis
CHAPTER 37 - Renal Repair and Recovery
CHAPTER 38 - Stem Cells and Renal Repair
CHAPTER 39 - Stem Cells and the Kidney
CHAPTER 40 - Mesenchymal Stem Cells and Their Use in Acute Renal Injury
CHAPTER 41 - Endothelial Progenitor Cells in Acute Renal Injury
CHAPTER 42 - Models of Ischemic Renal Injury
CHAPTER 43 - Models of Toxic Acute Renal Failure
CHAPTER 44 - Animal Models of Septic Acute Renal Failure
CHAPTER 45 - Critical Assessment of Animal Models of Acute Renal Failure
CHAPTER 46 - Kidney Function Tests and Urinalysis in Acute Renal Failure
CHAPTER 47 - Biomarkers in Acute Kidney Injury
CHAPTER 48 - Ultrasonography and Doppler Techniques in Acute Kidney Injury
CHAPTER 49 - Contrast-Enhanced Renal Ultrasonography
CHAPTER 50 - Computed Tomography and Magnetic Resonance Imaging in Acute Renal Failure
CHAPTER 51 - Nephrotoxicity of Contrast Media
CHAPTER 52 - New Imaging Techniques for Acute Kidney Injury
CHAPTER 53 - Indications for Renal Biopsy in Acute Renal Failure
CHAPTER 54 - Histopathological and Electron Microscopy Findings in Acute Renal Failure
CHAPTER 55 - New Imaging Techniques in Acute Kidney Injury

SECTION 5 - Acute Renal Failure: Clinical Aspects: Clinical Syndromes

CHAPTER 56 - Multiple Organ Dysfunction Syndrome
CHAPTER 57 - Burns and Acute Renal Failure
CHAPTER 58 - Drug-Induced Acute Renal Failure
CHAPTER 59 - Acute Renal Failure in Pregnancy
CHAPTER 60 - Diagnosis and Management of the HELLP Syndrome
CHAPTER 61 - Oliguria
CHAPTER 62 - Abdominal Compartment Syndrome
CHAPTER 63 - Acute Tubular Necrosis
CHAPTER 64 - Acute Interstitial Nephritis
CHAPTER 65 - Acute Obstructive Nephropathy
CHAPTER 66 - Glomerulonephritis
CHAPTER 67 - Acute Lupus Nephritis
CHAPTER 68 - Hemolytic Uremic Syndrome
CHAPTER 69 - Acute Renal Failure in Oncological Disorders and Tumor Lysis Syndrome
CHAPTER 70 - Bleeding and Hemostasis in Acute Renal Failure
CHAPTER 71 - Gastrointestinal Problems in Acute Renal Failure
CHAPTER 72 - Cardiovascular Problems in Acute Renal Failure
CHAPTER 73 - Water and Electrolyte Disturbances in Acute Renal Failure
CHAPTER 74 - Neurological Problems in Acute Renal Failure
CHAPTER 75 - Immunological and Infectious Complications of Acute Kidney Injury
CHAPTER 76 - Nonpharmacological Management of Acute Renal Failure
CHAPTER 77 - Vasoactive Drugs and Acute Renal Failure
CHAPTER 78 - Use of Diuretics in Acute Renal Failure
CHAPTER 79 - Dopamine Receptor Agonists
CHAPTER 80 - Atrial Natriuretic Peptide in Acute Renal Failure
CHAPTER 81 - Adenosine Antagonists
CHAPTER 82 - Antioxidants
CHAPTER 83 - Antiapoptotic Agents
CHAPTER 84 - Growth Factors
CHAPTER 85 - Other Experimental Interventions for the Management of Acute Renal Failure
CHAPTER 86 - Adenosine 2A Receptor Agonists in Acute Kidney Injury
CHAPTER 87 - Biochemical and Clinical Indications to Initiate Renal Replacement Therapy
CHAPTER 88 - Proteomics and Acute Renal Failure
CASE STUDY 1 - Case Studies: Renal Failure

SECTION 6 - Fluid and Electrolyte Problems: Basic Physiology

CHAPTER 89 - Regulatory Mechanisms of Water and Sodium Balance
CHAPTER 90 - Potassium and Magnesium Physiology
CHAPTER 91 - Calcium and Phosphate Physiology
CHAPTER 92 - Colloid Osmotic Pressure
CHAPTER 93 - Blood Biochemistry: Measuring Major Plasma Electrolytes
CHAPTER 94 - Assessment of Fluid and Electrolyte Problems: Urine Biochemistry
CHAPTER 95 - Assessment of Volume Status
CHAPTER 96 - Nephrotic Syndrome
CHAPTER 97 - Intravascular Volume Depletion
CHAPTER 98 - Disorders of Sodium and Water Balance
CHAPTER 99 - Disorders of Potassium Balance
CHAPTER 100 - Alterations in Calcium and Phosphorus Metabolism in Critically Ill Patients
CHAPTER 101 - Disorders of Magnesium Balance
CHAPTER 102 - Disorders of Trace Elements and Vitamins
CHAPTER 103 - Loop Diuretics
CHAPTER 104 - Osmotic Diuretics
CHAPTER 105 - Thiazide Diuretics
CHAPTER 106 - Aldosterone Antagonists, Amiloride, and Triamterene
CHAPTER 107 - Carbonic Anhydrase Inhibitors
CHAPTER 108 - Principles of Fluid Therapy
CHAPTER 109 - Crystalloids and Colloids
CHAPTER 110 - Blood and Blood Products
CASE STUDY 2 - Case Studies: Fluids and Electrolytes

SECTION 7 - Acid-Base Problems: Basic Physiology

CHAPTER 111 - Clinical Acid-Base Chemistry
CHAPTER 112 - Renal Acid-Base Physiology
CHAPTER 113 - Respiratory Acid-Base Physiology
CHAPTER 114 - Pathophysiology of Hyperlactatemia
CHAPTER 115 - Impact of Acid-Base Disorders on Different Organ Systems
CHAPTER 116 - Arterial and Venous Blood Gases
CHAPTER 117 - Anion Gap and Strong Ion Gap
CHAPTER 118 - Metabolic Acidosis
CHAPTER 119 - Diagnosis and Therapy of Metabolic Alkalosis
CHAPTER 120 - Respiratory Acid-Base Disorders
CHAPTER 121 - Complex (Mixed) Acid-Base Disorders
CHAPTER 122 - Lactic Acidosis—Clinical Syndrome
CHAPTER 123 - Diabetic Ketoacidosis
CHAPTER 124 - Unmeasured Anions in Metabolic Acidosis
CHAPTER 125 - Iatrogenic Hyperchloremic Metabolic Acidosis
CHAPTER 126 - Renal Tubular Acidosis
CHAPTER 127 - Acid-Base Disorders Secondary to Renal Failure
CHAPTER 128 - Acute Metabolic Alkalosis
CHAPTER 129 - Disorders of Chronic Metabolic Alkalosis
CHAPTER 130 - Acid-Base Disorders Secondary to Poisoning
CHAPTER 131 - Acid-Base Disorders in Chronic Lung Diseases
CHAPTER 132 - Alkalinizing Therapy in the Management of Acid-Base Disorders
CHAPTER 133 - The Role of Renal Replacement Therapy in the Management of Acid-Base Disorders
CASE STUDY 3 - Case Studies: Acid-Base Problems

SECTION 8 - Aspects of Metabolisms, Endocrinology, and Hematology in Critical Illness and Acute Renal Injury: Basic Physiology

CHAPTER 134 - Energy Requirement and Consumption in the Critically Ill Patient
CHAPTER 135 - Carbohydrates and Lipids
CHAPTER 136 - Amino Acid and Protein Turnover and Metabolism in Acute Renal Failure
CHAPTER 137 - Endocrinology of the Stress Response during Critical Illness
CHAPTER 138 - Nitrogen Balance and Nutritional Assessment
CHAPTER 139 - Diagnosis and Management of Critical Illness—Related Corticosteroid Insufficiency
CHAPTER 140 - Nutritional Support in the Critically Ill with Acute Renal Failure
CHAPTER 141 - Hematological Malignancies and Critical Illness
CHAPTER 142 - Anemia of Critical Illness
CHAPTER 143 - Adrenal Dysfunction in the Critically Ill: Doubts and Controversies
CHAPTER 144 - Enteral Nutrition
CHAPTER 145 - Parenteral Nutrition
CHAPTER 146 - Blood Glucose Control in Critical Care
CASE STUDY 4 - Case Studies: Nutrition and Endocrinology

SECTION 9 - Infectious Diseases: Basic Physiology

CHAPTER 147 - Microbiological Considerations in the Intensive Care Patient
CHAPTER 148 - Endotoxin Recognition
CHAPTER 149 - Innate Mechanisms of Host Defense
CHAPTER 150 - The Neutrophil and Inflammation
CHAPTER 151 - The Macrophage in Innate and Adaptive Immunity
CHAPTER 152 - Alarm Phase Cytokines
CHAPTER 153 - The Role of Complement in Sepsis
CHAPTER 154 - Oxidative Stress in Acute Kidney Injury
CHAPTER 155 - High Mobility Group Box 1 Protein
CHAPTER 156 - Epithelial Barrier Dysfunction as a Mechanism Underlying the Pathogenesis of Multiple-Organ Dysfunction
CHAPTER 157 - The Coagulation System in Inflammation
CHAPTER 158 - Laboratory Testing in Infectious Diseases
CHAPTER 159 - The Sepsis Syndrome
CHAPTER 160 - Septic Shock
CHAPTER 161 - The Kidney in Sepsis
CHAPTER 162 - Human Immunodeficiency Virus Infection and Acute Renal Failure
CHAPTER 163 - Urinary Tract Infections in the Intensive Care Unit
CHAPTER 164 - Acute Kidney Injury in Malaria
CHAPTER 165 - Poststreptococcal Glomerulonephritis
CHAPTER 166 - Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome
CHAPTER 167 - Tropical Infections Causing Acute Kidney Injury
CHAPTER 168 - Principles of Antibiotic Prescription in Intensive Care Unit Patients and Patients with Acute Renal Failure
CHAPTER 169 - Renal Replacement Therapy in Acute Renal Failure Secondary to Sepsis
CHAPTER 170 - Blood Purification for Sepsis
CASE STUDY 5 - Case Studies: Infectious Diseases

SECTION 10 - Acute Intoxication and Poisoning: Basic Physiology

CHAPTER 171 - Characteristics, Pathophysiology, and Effects of Common Toxic Substances
CHAPTER 172 - Laboratory Testing in Toxicology
CHAPTER 173 - Drugs and Antidotes in Acute Intoxication
CHAPTER 174 - Hemodialysis, Hemofiltration, and Hemoperfusion in Acute Intoxication and Poisoning
CHAPTER 175 - Plasmapheresis in Acute Intoxication and Poisoning
CHAPTER 176 - Poisoning: Kinetics to Therapeutics
CASE STUDY 6 - Case Studies: Acute Intoxication and Poisoning

PART II - Organ Interaction

SECTION 11 - The Heart and the Kidney

CHAPTER 177 - Hypertensive Emergencies
CHAPTER 178 - Cardiac Surgery and the Kidney
CHAPTER 179 - Renal Function in Congestive Heart Failure
CHAPTER 180 - Acute Renal Failure after Cardiac Surgery
CHAPTER 181 - Renal Function and Acute Renal Failure in the Setting of Heart and Heart-Lung Transplantation
CHAPTER 182 - The Kidney in Acute Heart Failure Syndromes and Cardiogenic Shock
CHAPTER 183 - Renal Function during Cardiac Mechanical Support and the Artificial Heart
CHAPTER 184 - The Role of Extracorporeal Blood Purification Therapies in the Prevention of Radiocontrast Agent—Induced Nephropathy

SECTION 12 - The Lung and the Kidney

CHAPTER 185 - Lung Function in Uremia
CHAPTER 186 - The Kidney during Mechanical Ventilation
CHAPTER 187 - Extracorporeal Support and Renal Function
CHAPTER 188 - Acute Respiratory Distress Syndrome and the Kidney: Lung and Kidney Crosstalk
CHAPTER 189 - Early High-Volume Hemofiltration to Prevent Invasive Ventilation in Critically Ill Patients
CHAPTER 190 - Pulmonary Renal Syndromes

SECTION 13 - The Liver and the Kidney

CHAPTER 191 - Liver-Kidney Interaction
CHAPTER 192 - Pathophysiology of the Hepatorenal Syndrome
CHAPTER 193 - The Liver in Kidney Disease
CHAPTER 194 - Kidney Dysfunction after Liver Transplantation
CHAPTER 195 - Pharmacological Treatment for Hepatorenal Syndrome
CHAPTER 196 - Extracorporeal Liver Support and the Kidney

SECTION 14 - The Brain and the Kidney

CHAPTER 197 - Treatment of Combined Acute Renal Failure and Cerebral Edema
CHAPTER 198 - Renal Protection in the Organ Donor
CHAPTER 199 - Dialysis Dysequilibrium Syndrome
CHAPTER 200 - Effect of Renal Replacement Therapy on the Brain

SECTION 15 - Uremic Toxins

CHAPTER 201 - Metabolic Waste Products in Acute Uremia
CHAPTER 202 - Granulocyte-Inhibitory Proteins and Other Proteinaceous Molecules in Acute Kidney Injury
CHAPTER 203 - Uric Acid as a Toxin
CHAPTER 204 - Myoglobin as a Toxin
CHAPTER 205 - Nanoparticles: Potential Toxins for the Organism and the Kidney?

PART III - Renal Replacement Therapy

SECTION 16 - General Principles of Acute Renal Replacement Therapy

CHAPTER 206 - History and Development of Acute Dialysis Therapy
CHAPTER 207 - Renal Replacement Therapy in the Intensive Care Unit
CHAPTER 208 - Indications for Renal Replacement Therapy in the Critically Ill
CHAPTER 209 - The Bases of Mass Separation Processes
CHAPTER 210 - Renal Replacement Techniques: Descriptions, Mechanisms, Choices, and Controversies
CHAPTER 211 - Principles of Extracorporeal Circulation
CHAPTER 212 - Membranes and Filters for Use in Acute Renal Failure
CHAPTER 213 - Evolution of Machines for Acute Renal Replacement Therapy
CHAPTER 214 - Principles of Anticoagulation in Extracorporeal Circuits
CHAPTER 215 - Principles of Fluid Manufacturing and Sterilization for Renal Replacement Therapy in the Intensive Care Unit
CHAPTER 216 - Starting and Stopping Renal Replacement Therapy in the Critically Ill
CHAPTER 217 - The Concept of Renal Replacement Therapy Dose and Efficiency
CHAPTER 218 - Quantification of Acute Renal Replacement Therapy
CHAPTER 219 - Principles of Pharmacodynamics and Pharmacokinetics of Drugs Used in Extracorporeal Therapies
CHAPTER 220 - Ethical Considerations in Acute Renal Replacement Therapy

SECTION 17 - Intermittent Hemodialysis and Sustained Low-Efficiency Daily Dialysis in the Intensive Care Unit: Basic Principles

CHAPTER 221 - Intermittent Techniques for Acute Dialysis
CHAPTER 222 - Vascular Access for Intermittent Renal Replacement Therapy
CHAPTER 223 - Solute and Water Transport across Artificial Membranes in Conventional Hemodialysis
CHAPTER 224 - Flow Distribution and Cross-Filtration in Hollow-Fiber Hemodialyzers
CHAPTER 225 - Biocompatibility of the Dialysis System
CHAPTER 226 - Composition of Hemodialysis Fluid
CHAPTER 227 - Indications for and Contraindications to Intermittent Hemodialysis in Critically Ill Patients
CHAPTER 228 - Technical and Clinical Complications of Intermittent Hemodialysis in the Intensive Care Unit
CHAPTER 229 - Correction of Water, Electrolyte, and Acid-Base Derangements by Hemodialysis and Derived Techniques
CHAPTER 230 - Urea Kinetics, Efficiency, and Adequacy of Hemodialysis and Other Intermittent Treatments
CHAPTER 231 - Assessment of Fluid Status and Body Composition and Control of Fluid Balance with Intermittent Hemodialysis in the Critically Ill Patient
CHAPTER 232 - Outcome of Intermittent Dialysis in Critically Ill Patients with Acute Renal Failure
CHAPTER 233 - Intermittent Hemofiltration for Management of Fluid Overload and Administration of Contrast Media
CHAPTER 234 - Hybrid Dialysis Techniques in the Intensive Care Unit
CHAPTER 235 - Practical Aspects of Hybrid Dialysis Techniques
CHAPTER 236 - Acute Dialysis with the GENIUS System
CHAPTER 237 - Daily Dialysis in the Intensive Care Unit: Nursing Perspectives
CHAPTER 238 - Information Technology in Renal Replacement Therapy
CHAPTER 239 - Current Nomenclature

SECTION 18 - Continuous Renal Replacement Therapies: Basic Principles

CHAPTER 240 - History and Development of Continuous Renal Replacement Therapy
CHAPTER 241 - Indications for Renal Replacement Therapy in the Critically Ill Patient
CHAPTER 242 - Beginning and Ending Continuous Therapies in the Intensive Care Unit
CHAPTER 243 - Vascular Access for Continuous Renal Replacement Therapy
CHAPTER 244 - Anticoagulation Strategies for Continuous Renal Replacement Therapies
CHAPTER 245 - Strategies to Prevent Coagulation of the Extracorporeal Circuit
CHAPTER 246 - Continuous Renal Replacement Therapy: Hemofiltration, Hemodiafiltration, or Hemodialysis?
CHAPTER 247 - Slow Continuous Ultrafiltration
CHAPTER 248 - Continuous Venovenous Hemofiltration
CHAPTER 249 - Predilution and Postdilution Reinfusion Techniques
CHAPTER 250 - Continuous Venovenous Hemodialysis and Continuous High-Flux Hemodialysis
CHAPTER 251 - Solute and Water Kinetics in Continuous Therapies
- Clinical and Technical Aspects
CHAPTER 252 - Hemodynamic and Biological Response to Continuous Renal Replacement Therapies
CHAPTER 253 - High-Volume Hemofiltration in the Intensive Care Unit
CHAPTER 254 - Pulse High-Volume Hemofiltration in Management of Critically Ill Patients with Severe Sepsis or Septic Shock
CHAPTER 255 - Removal of Mediators of Inflammation by Continuous Renal Replacement Therapy: An Open Debate of Pros and Cons
CHAPTER 256 - Nonrenal Applications of Extracorporeal Treatments: Heart Failure and Liver Failure
CHAPTER 257 - Continuous Renal Replacement Therapy in Trauma
CHAPTER 258 - Clinical Effects of Continuous Renal Replacement Therapies
CHAPTER 259 - Immunomodulation and Biological Effects of Continuous Renal Replacement Therapy
CHAPTER 260 - Continuous Ultrafiltration and Dialysis with a Wearable Artificial Kidney
CHAPTER 261 - The Bioartificial Kidney
CHAPTER 262 - Information Technology and Therapy Delivery in Continuous Renal Replacement Therapies
CHAPTER 263 - Adjustment of Antimicrobial Regimen in Septic Patients Undergoing Continuous Renal Replacement Therapy in the Intensive Care Unit

SECTION 19 - Peritoneal Dialysis in the Intensive Care Unit

CHAPTER 264 - The Peritoneal Dialysis System
CHAPTER 265 - Indications, Contraindications, and Complications of Peritoneal Dialysis in Acute Renal Failure
CHAPTER 266 - Peritoneal Access for Acute Peritoneal Dialysis
CHAPTER 267 - Solute and Water Transport across the Peritoneal Membrane
CHAPTER 268 - Choice of Peritoneal Dialysis Technique: Intermittent or Continuous
CHAPTER 269 - Technology of Peritoneal Dialysis in the Intensive Care Unit
CHAPTER 270 - Correction of Fluid, Electrolyte, and Acid-Base Derangements by Peritoneal Dialysis in Acute Renal Failure
CHAPTER 271 - Efficiency and Adequacy of Peritoneal Dialysis in Acute Renal Failure
CHAPTER 272 - Clinical Results and Complications of Peritoneal Dialysis in Acute Renal Failure
CHAPTER 273 - Treatment of Peritonitis and Other Clinical Complications of Peritoneal Dialysis in the Critically Ill Patient
CHAPTER 274 - Comparison of Peritoneal Dialysis with Other Treatments for Acute Renal Failure
CHAPTER 275 - Continuous-Flow Peritoneal Dialysis as Acute Therapy
CHAPTER 276 - Nursing Issues and Procedures in Acute Peritoneal Dialysis

SECTION 20 - Extracorporeal Blood Purification Techniques beyond Dialysis

CHAPTER 277 - Plasmapheresis in Critical Illness
CHAPTER 278 - Sorbents: From Basic Structure to Clinical Application
CHAPTER 279 - Hemoperfusion
CHAPTER 280 - Albumin Dialysis with Molecular Adsorbent Recirculating System in the Treatment of Liver Failure
CHAPTER 281 - Clinical Outcomes with the Molecular Adsorbent Recirculating System
CHAPTER 282 - Extracorporeal Blood Purification Techniques beyond Dialysis: Coupled Plasmafiltration-Adsorption
CHAPTER 283 - The Prometheus System
CHAPTER 284 - Toraymyxin and Other Endotoxin Adsorption Systems
CHAPTER 285 - The Plasmafiltration-Adsorption-Dialysis System
CHAPTER 286 - Slow Plasma Exchange plus CHDF for Liver Failure and CHDF Alone for Severe Acute Pancreatitis
CHAPTER 287 - Multiple-Organ Support Therapy for the Critically Ill Patient

PART IV - Special Topics In Critical Care Nephrology

SECTION 21 - Critical Care Nephrology in Pediatrics

CHAPTER 288 - Pathophysiology of Pediatric Acute Kidney Injury
CHAPTER 289 - Epidemiology of Pediatric Acute Kidney Injury
CHAPTER 290 - Treatment of Acute Kidney Injury in Children: Conservative Management to Renal Replacement Therapy
CHAPTER 291 - Technical Aspects of Pediatric Continuous Renal Replacement Therapy
CHAPTER 292 - Multiple Organ Dysfunction in the Pediatric Intensive Care Unit
CHAPTER 293 - Drug Dosing in Pediatric Acute Kidney Insufficiency and Renal Replacement Therapy
CHAPTER 294 - Nutrition of Critically Ill Children with Acute Renal Failure
CHAPTER 295 - Continuous Renal Replacement Therapies in Combination with Other Extracorporeal Therapies
CHAPTER 296 - Outcome of Pediatric Acute Kidney Injury
CHAPTER 297 - Renal Replacement Therapy for the Critically Ill Infant
CHAPTER 298 - Inborn Errors of Metabolism and Continuous Renal Replacement Therapy
CHAPTER 299 - Modified Ultrafiltration in Pediatric Heart Surgery

SECTION 22 - Kidney Transplantation and Critical Care

CHAPTER 300 - Patient Selection and Pretransplantation Care for Kidney Transplant Recipients
CHAPTER 301 - Kidney Support and Perioperative Care in Kidney Transplantation
CHAPTER 302 - Short- and Long-Term Management after Kidney Transplantation
CHAPTER 303 - Acute Renal Failure in Kidney Transplant Recipients
CHAPTER 304 - Infectious Complications of Renal Transplantation

SECTION 23 - Special Kidney Problems in the Intensive Care Unit

CHAPTER 305 - Management of Patients with Diabetes in the Intensive Care Unit
CHAPTER 306 - Acute Renal Failure in the Elderly Critically Ill Patient
CHAPTER 307 - Anticancer Drugs and the Kidney
CHAPTER 308 - Anti-inflammatory Drugs and the Kidney
CHAPTER 309 - Antibiotics and Antiviral Drugs in the Intensive Care Unit
CHAPTER 310 - Calcineurin Inhibitors and Other Immunosuppressive Drugs and the Kidney
CHAPTER 311 - Alternative Medicine and Chinese Herbs and the Kidney
CHAPTER 312 - Environment, Smoking, Obesity, and the Kidney
CHAPTER 313 - Lead and Heavy Metals and the Kidney
CHAPTER 314 - Statins and the Kidney
CHAPTER 315 - Erythropoietin Therapy in Critically Ill Patients
CHAPTER 316 - Activated Protein C Therapy and Sepsis-Associated Acute Kidney Injury
CHAPTER 317 - Vasoactive Drugs and Renal Function
CHAPTER 318 - Drug Dosing in Patients with Acute Kidney Injury and in Patients Undergoing Renal Replacement Therapy
CHAPTER 319 - Dialysis for Acute Renal Failure in Developing Countries
CHAPTER 320 - Medical Informatics in Disaster Response

About the Authors

Claudio Ronco, MD, Director, Department of Nephrology, Dialysis, and Transplantation, St. Bortolo Hospital Vicenza, Italy.
Rinaldo Bellomo, MD, MB BS(Hons), FRACP, FCCP, Professor, University of Melbourne, Director of Intensive Care Research, Austin Hospital, Melbourne, Victoria, Australia.
John A. Kellum, MD, FCCM, FACP, Professor and Vice Chair, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Book review

"Critical Care Nephrology still continues to provide an impressive up-to-date comprehensive coverage.This book undoubtedly is of great value for all physicians who deal with critically ill patients and renal failure and is therefore highly recommended."

-- Netherlands Journal of Critical Care, December 2009

Product Details

Hardcover: 1848 pages
Publisher: Saunders; 2nd edition (December 18, 2008)
Language: English
ISBN-10: 1416042520
ISBN-13: 978-1416042525
Product Dimensions: 11.1 x 9 x 2.3 inches

List Price: $340.00

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Ronco: Critical Care Nephrology 2nd edition (Expert Consult Series)

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