A comparison of this edition of the Primer with the first, published in 1993, gives a snapshot of how the substance of and even its lexicon have changed in the last fifteen years. In the first two editions, the chapter on progression of chronic kidney disease (chronic renal failure then) included a figure illustrating several phases of declining function linked to a curve showing the hyperbolic relationship between serum creatinine and GFR. Terms like chronic renal insufficiency and renal failure were widely used, with meaning and import that varied with the chapter and context. Not until the fourth edition in 2005 was Chronic Kidney Disease (CKD) staging introduced. Much copy editing was required during the preparation of that edition to bring the Primer into compliance with the new and more precise terminology for reduced kidney function and CKD that is now widely accepted. Stratification and stage specific management have become routine features of the care of patients with progressive kidney damage.
In the fourth edition, a new chapter summarizing in one place the emerging of the genetic basis of structural kidney disease appeared. When selecting what to include in the current edition, superb chapter because the field had already outgrown it. Instead, the now well-established gene defects are included in the chapters on individual disorders. This decision recognizes that the genetic defects have become essential to an understanding of the pathophysiology of FSGS like many other structural disorders. The chapter on polycystic kidney disease (PKD) in the first edition was largely descriptive, although mention was made of the recently discovered PKD gene.
This edition discusses the gene products of the two PKD genes in detail and explains how their absence contributes to cyst formation. The chapter describes the potentially useful interventions being tested or soon to be tested in clinical trials. This edition introduces readers to the specific vasopressin receptor antagonists, the first truly new treatment of hyponatremia in a generation, although we don't know yet how best to employ these aquaretic agents. The role of renin-angiotensin-aldosterone system inhibition in limiting progression of CKD has been proven. CKD and are now known to be prominent and independent risk factors for cardiovascular disease, but we still need to learn how best to intervene. One could go on and on. Of course, the book is not a history. Most readers will use it as an updated reference on pathophysiology and for help with clinical problems. The essence of a primer is brevity. The and authors have kept these goals in mind throughout the preparation of the Primer.
Book Details
- Paperback: 624 pages
- Publisher: Saunders; 5th edition
- Language: English
- ISBN-10: 1416051856
- ISBN-13: 978-1416051855
- Product Dimensions: 10.9 x 8.5 x 0.9 inches