developed. When I did not identify European colleagues In this rapidly evolving field it is appropriate to update frequently our state of the art knowledge of uremia therapy. who had the expertise who could expend the time and with Hence, this third edition of Replacement of Renal Function whom I could work so smoothly, I began alone. by Dialysis appears before many of its predecessors have Although I was tempted to ask all the same authors as had been destroyed by normal wear and tear over 11 and 6 years written so well previously to contribute again, I realized that the new edition must be revitalized. Accordingly a fraction of use, respectively. The first two editions of this book were designed to be of the authors changed, some new topics have been added integrated comprehensive reviews of the pertinent aspects and others have been deleted. The multinational character of dialysis and related fields with sufficient clarity for the of authorship has been maintained. Existing chapters have novice to learn, yet adequate depth for the expert to rely on been rewritten thoroughly, and new authors have provided them as encyclopedic desk references on renal replacement as requested a full discussion and bibliography in keeping therapy. Based on the favorable readers' comments and with the previous editions.

"Where are all these kidney patients coming from? A few perfection the study of the urinary sediment, clinically years ago we had never heard of kidney disease and now practical kidney function tests, and the natural history of a number of kidney diseases including glomerulonephritis. you are speaking of patients in the hundreds of thousands and indeed potentially millions. " My reply, not meant to William Goldring, Herbert Chasis, Dana Atchley, and others studied the effects of hypertension, endocarditis, be grim, was "From the cemetery, Sir. " This is a summary and circulatory diseases on the kidney and spawned suc of some Congressional testimony lance gave on behalf of extending kidney disease under Medicare. Where indeed cessive generations of alert clinical investigators, who be gan to chronicle the natural histories of a wide variety of were all the patients with kidney disease in the United States before World War II? They were certainly not kidney diseases. Quantitative studies of renal function flourished under a school headed by Homer Smith, and under the care of nephrologists! Nephrology was not listed in the questionnaires for any state or the American Medi surprisingly precise techniques were developed for study ing a whole range of explicit nephron functions. Imagine cal Association as a subspecialty or even as a special the joy with the advent of vascular catheterization to be interest.

Completely revised edition of a global resource first published in 1978 and previously revised in 1989. Sixty-three contributions are arranged in sections on the pathophysiology of the uremic syndrome--principles and biophysics of dialysis; technology of dialysis and associated methods; quantification and prescription; complications; pharmacological considerations; special clinical situations; organ system and metabolic complications; and organization and results of chronic dialysis. The aim is to give understanding of the complexities of modern dialysis apparatus so that practitioners can make the best use of the technology--and so that fledgling nephrologists can avoid the temptation to by-pass the theory and the nuances. Annotation copyright by Book News, Inc., Portland, OR

This resource covers more than 300 basic and advanced nursing procedures with equipment lists, essential steps, special considerations, patient teaching points, and documentation guidelines in a quick-scanning format. Procedures are organized alphabetically, and each is presented on a two-page spread with consistent headings, including description, contraindications, equipment list, preparation, key steps, special considerations, complications, patient teaching, and documentation.

The initial observations of dialytic support were brought from the laboratory and confined to patients with reversible acute renal failure. The thought at that time was one of short term maintenance. It was theorized that removal of waste products from the blood, albeit incomplete and inefficient, might allow these patients time to regenerate damaged tubules and regain renal function. After a dis appointing earlier experience in survival, greater sophisti cation and broader practice refined the dialysis skills and reduced mortality. It also became apparent that long periods of support were possible and successful attempts were then made in utilizing this technology in patients with chronic renal failure. These early young patients were a very select group who possessed only renal dysfunction and no other systemic involvement. Nonetheless, they demonstrated a one year survival of only 55-64%. There are presently over 80,000 patients on dialytic support in the United States and over 250,000 patients worldwide dependent on artificial replace ment. Mortality statistics vary but despite a 20-30% systemic disease involvement and a fifth decade average age in the North American experience, the one year survival has risen to apparently 90%.

Discovery and Relative Importance of Continuous Arteriovenous HemofIltration Lee W. Henderson Continuous arteriovenous hemofiltration (CAVH) has seen a brisk upswing in popularity in Europe since its introduction by Dr. Kramer and colleagues from Gottingen, West Germany in 1977 [1]. In the United States, the technique re ceived approval as a clinical tool from the Food and Drug Administration in April 1982. This approval flowed, in no small measure, from the extensive expe rience reported from Europe and in particular West Germany [e. g., 2, 3]. Reports of its clinical utility now have begun to appear in the United States [4]. Removal of excess total body water using synthetic membranes in an extracor poreal circuit dates back to the work of Alwall and the artificial kidney that he designed which permitted utilization of a hydrostatic pressure gradient to moti vate water flow across the membrane [5]. Kolffs original rotating drum with its unencased membrane required an osmotic driving force [6]. Hemofiltration, the use of the filtration process to remove uremic solutes with the artificial kidney, in analogy with the glomerulus, was reported in 1967 [7]. This was made possible by the availability of synthetic membranes with far higher hydraulic permeability (approximately 10 times higher) than conventionally used cellulosic hemodialysis membrane. Specific applications of these "high flux" membranes to the removal primarily of excess total body water followed shortly thereafter [8].

We are pleased to present our readers the Proceedings of the International Symposium "New Perspectives in Hemodialysis, Peritoneal Dialysis, Arteriovenous Hemofiltration, and Plasma pheresis" which was held in Freiburg i. Br. (FRG) during Oct tober 6-8, 1988. The meeting was held on the occasion of opening the new dialysis unit of the University Hospital of Freiburg i. Br .. The topics discussed included membrane biocompatibility, catabolic factors associated with dialysis therapy, phar macological therapy in dialyzed patients, erythropoietin and renal anemia, new developments in CAVH, CAPD and plasmapheresis, renal replacement therapy in acute renal failure, and plasmapheresis therapy in systemic diseases. It was unfortunately impossible in this volume, to include the extended, lively and stimulating discussions which were enjoyed by the participants during the conference. The meeting has provided an unique framework for close interaction between scientists from various disciplines, including nephrology, pharmacology, hematology, cardiology, anesthesiology, surgery, intensive care medicine, and patho logy. We would like to express our gratitude and appreciation for all those who have stimulated, encouraged and supported us to hold the symposium in Freiburg. This endeaver could not have been possible without the generous financial support of Asid-Bonz (BOblingen), Bayer AG (Leverkusen), Bayropharm GmbH (Koln), Baxter (Munchen), Ciba-Geigy (Wehr/Baden), Cilag GmbH (Sulzbach), Fresenius AG (Oberursel), Gambro (Martinsried), Gry Pharma GmbH (Kirchzarten), Hoechst AG (Frankfurt), Hospal (Nurnberg), Knoll AG (Ludwigshafen), Lederle-Cyanamid (Wolfratshausen), E. Merck (Darmstadt), MSD Sharp and Dohme GmbH (Munchen), Pfizer GmbH (Karlsruhe), and pfrimmer and Co (Erlangen) ."

A workshop was organised in order to achieve multi-discipli- nary review of the pathogenesis and management of acute failure, particularly as it occurs and is managed in intensive therapy units. The book deals with the realities and practicalities of this important area of acute medicine. Each chapter is followed by a discussion, so that a concen- sus view is obtained from an international body of experts.

Since the inaugural publication of Pediatric Dialysis in 2004, a wide range of advances have taken place in dialysis-related care, leading to a wealth of new knowledge in the field. Pediatric Dialysis, Second Edition brings this knowledge together to provide the most comprehensive source of state-of-the-art information on the dialysis of infants, children and adolescents. With new chapters, updated chapters and references, and contemporary, unique perspectives from authors who are leaders in the global pediatric nephrology community, Pediatric Dialysis, Second Edition is, once again, an authoritative reference that will facilitate best practices in both acute and chronic dialysis. Experienced clinicians and trainees alike will find Pediatric Dialysis, Second Edition not only another valuable contribution to the literature but an indispensable guide to managing their pediatric patients on dialysis.