Childhood Renal Disorders Ecab

Childhood Renal Disorders - ECAB - E-Book

Childhood Renal Disorders - ECAB

Nephrotic Syndrome in Children - ECAB - E-Book

Urinary tract disorders, be they anomalies or infections, are an important cause of acute and long-term morbidity in children. These conditions need prompt diagnosis and management, not only to relieve the acute morbidity, but also to prevent the long-term renal damage. This makes diagnostic and therapeutic issues concerning these conditions very important. The most common urinary problem encountered in children is urinary tract infection (UTI), which is usually bacterial in origin. Urinalysis and culture play an important role in the diagnosis of this condition. The treatment consists of prompt and specific antibiotic therapy followed by genitourinary imaging in high risk patients to detect underlying urinary tract anomalies. Vesicoureteric reflux (VUR) is characterized by retrograde flow of urine from the bladder to the kidneys, thereby predisposing it to UTI, and the two conditions together are believed to be associated with renal nephropathy. Patients with VUR have an increased risk of developing hypertension, toxemia of pregnancy, and significant renal damage, including end-stage renal disease subsequently in life. Based on the current literature, the author has enumerated various treatment options available for the different grades of VUR. The urinary bladder is meant to function as a storage organ for urine that empties completely in an appropriate time and place. Any disorder that results involuntary passage of urine or inability to void to completion constitutes bladder dysfunction. Bladder dysfunction is increasingly recognized as a risk factor for UTI and VUR, and a cause for enuresis with daytime symptoms. Its diagnosis requires detailed clinical history and examination, non-invasive urodynamic tests, frequency volume charts, and abdominal ultrasonography to predict the type of bladder dysfunction. The author has emphasized on the importance of multidisciplinary approach in its management, comprising of medications, treatment of any underlying cause, scheduled voiding regimen, clean intermittent catheterization, positive reinforcement and where necessary, biofeedback strategies. The book also contains a chapter on the management and long-term outcome of common kidney and urinary tract anomalies detected on antenatal screening such as unilateral or bilateral hydronephrosis, multicystic dysplastic kidneys, and posterior urethral valves.

Hypertension is fast becoming a pandemic of enormous proportions, and its sequelae of cardiovascular and cerebrovascular adverse events is making it a leading cause of morbidity and mortality worldwide. The interrelationship of hypertension and kidney changes though established for quite some time, the exact mechanisms and causality are still being discovered. The role of kidney as evidenced by subtle changes in the initiation of ‘primary hypertension’ is increasingly being scrutinized. The effects of established renal causes that induce hypertension such as renal artery stenosis are well established. Pediatric population is also no longer immune to this potentially debilitating condition. This book will help the readers to: Understand the intricacies of the genesis of hypertension and its effects on the kidney Explore the various established guidelines and newer promising aspects in diagnosis and management of hypertension and the kidney changes Know the newer emerging concepts in the treatment of hypertension in the pediatric population Enlighten them about the benefits of timely management of the condition to prevent its progression to end-stage kidney disease, which requires expensive and invasive interventions not suitable to majority of population in a developing country like ours. This book aims to guide the practitioner to diagnose and manage hypertension in the setting of suspected, diagnosed, or established kidney disease with special reference to practical experience in India.

With the increase in lifestyle-related diseases like diabetes and hypertension the prevalence of Chronic Kidney Disease (CKD) is increasing exponentially and with it is increasing the burden of its ominous consequence, End Stage Renal Disease (ESRD). While ESRD is no longer a death sentence with the advent of efficient renal replacement therapies and the success of renal transplantation, factors such as high cost of these procedures, limited availability of donated kidneys and not enough number of centers equipped with these facilities puts the effective management of ESRD beyond the reach of an average person many-a-times. Additionally the presence of co-existing diseases that contribute to and sometimes complicate the renal impairment as well as delayed referral of the patients to nephrologists also makes matters worse. ESRD is not just a medical but also a social and economic condition that devastates the person and his/her entire family. Hence, early detection and effective prevention of progression of CKD in early stages to advanced CKD and ESRD is the call of the day. In fact, understanding the pathophysiology of the condition and adopting methods of primordial prevention in populations at risk may be desirable to ensure reduction in the incidence of CKD. In those with established CKD, a proactive approach to manage the disease manifestations and limit the ravages of other comorbidities is desirable. For those in advanced stages of CKD, the institution of an appropriate renal replacement therapy individually suited to the patient keeping in view the medical status, lifestyle requirements, economic viability and social acceptability should be advised. This book will help the reader understand the intricacies of the aspects mentioned above and guide the practitioner to diagnose and manage End Stage Renal Disease with special reference to practical experience of the same in India. The authors have put together the most relevant facts about the disease for an easy comprehension and understanding of the same by practitioners and students across the specialty.

Hyperuricemia: A Renal Perspective - ECAB - E-Book

The prevalence of Diabetes Mellitus is increasing rapidly all over the world and more so in the developing countries. The global burden of diabetes is expected to double between 2000 and 2030, with the greatest increases in prevalence occurring in the Middle East, sub-Saharan Africa and India. Moreover, the development of type 2 diabetes during the childbearing years is also likely to increase, primarily in the developing countries. It has already been established that Diabetes is the most common primary cause leading to end stage renal disease (ESRD) and Diabetic Nephropathy is the leading cause of chronic kidney disease (CKD) in India. The cornerstones of management of Diabetic Kidney Diseases include early diagnosis of diabetic nephropathy, prevention of its progression and treatment of the co-morbid conditions. Substantial under-diagnosis of both diabetes and chronic kidney disease leads to lost opportunities for prevention. An inadequate or inappropriate care of patients with diabetic kidney disease contributes to disease progression eventually up to a stage that requires renal replacement therapy, which is not a feasible option for many on a long-term basis, especially in a developing country like ours. This book covers various aspects of diabetic kidney disease in detail and attempts to familiarize the reader with the existing aspects of the conditions as well as touch upon the new advances in the field. The first chapter outlines the extent to which the condition affects the population globally as well as in our country. The second chapter explores the underlying mechanism by which the disease starts and progresses and the pathological markers of the same. The third chapter delineates the clinical and diagnostic markers of the condition. The fourth and fifth chapters speak of the non-diabetic glomerular and non-glomerular diseases in diabetics. The sixth chapter addresses the most important and desirable goal of preventing the progression and ideally the onset of the disease. The seventh chapter puts together the various treatment modalities available and the subsequent chapter explores the management options for cases requiring renal replacement. In addition to the emphasis to Indian literature at the end of each chapter, the ninth chapter is specially included to highlight the salient aspects of this condition from the Indian perspective. This book will be beneficial not only for the nephrologists, but also for the epidemiologists, medical students, diabetologists and every doctor who deals with diabetes mellitus.