Handbook of. Nephrology. Irfan K. Moinuddin, MD. David J. Leehey, MD

Transcription

1 Handbook of Nephrology First Edition Irfan K. Moinuddin, MD Assistant Professor of Medicine Southern Illinois University Springfield, Illinois David J. Leehey, MD Professor of Medicine Loyola University of Chicago Medical Center Maywood, Illinois

2 Acquisitions Editor: Julie Goolsby Product Manager: Tom Gibbons Vendor Manager: Bridgett Dougherty Senior Manufacturing Manager: Benjamin Rivera Marketing Manager: Kimberly Schonberger Design Coordinator: Teresa Mallon Production Service: S4Carlisle 2013 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business Two Commerce Square 2001 Market Street Philadelphia, PA USA LWW.com All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in China Library of Congress Cataloging-in-Publication Data [ ] [ ] Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) or fax orders to (301) International customers should call (301) Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST

3 PREFACE Because of its inherent logic, focus on pathophysiology, and clinical relevance to a broad group of patients, nephrology has always appealed to some of the sharpest minds and most profound thinkers in medicine. The teaching of this discipline has also always been challenging, and many learners find nephrology to be a difficult subspecialty of medicine. The idea of writing the Handbook of Nephrology was not ours. Over many years, our students have told us that our teaching provided them with learning strategies and learning content not always found in current books. This Handbook of Nephrology is a concise introduction to the field which is primarily directed at medical students, interns, and residents. We believe primary care physicians, internists, surgeons, nurse practitioners, pharmacists, and physician assistants will also find the book useful. The book is not primarily aimed at nephrology fellows and board-certified nephrologists; however, we believe it may also be helpful as a teaching aid to nephrology fellows and faculty. Many people assisted us in bringing this book to fruition. We would like to especially acknowledge two of them, Dr. John Daugirdas, clinical professor of medicine at University of Illinois Medical Center, Chicago, Illinois, and Dr. Todd Ing, professor emeritus of nephrology at Loyola University Medical Center, Maywood, Illinois. Dr. Daugirdas assisted in developing the concept for this book, and Dr. Ing reviewed and commented on all of the content. This book is meant to be a pocketbook. It is not a comprehensive textbook. Certain more specialized topics, such as transplantation and renal genomics, are not covered. Rather than provide encyclopedic knowledge, we hope that this book will facilitate the understanding of concepts which will stimulate the acquisition of knowledge and the application of knowledge. vii

4 Chapter 4 / Chapter Title ix CONTENTS Preface vii 1. Urinalysis 1 2. Measurement of Renal Function Proteinuria Hematuria Disorders of Plasma Sodium Concentration Disorders of Potassium Homeostasis Metabolic Acidosis and Alkalosis Disorders of Calcium/Phosphorus/Magnesium Homeostasis Acute Renal Failure Glomerulonephritis Nephrotic Syndrome Chronic Kidney Disease Diabetic Kidney Disease Hypertension and Kidney Disease Macrovascular Diseases of the Kidney 169 ix

5 x Contents 16. Microvascular Diseases of the Kidney Nephrolithiasis Cystic Renal Diseases Hemodialysis and Peritoneal Dialysis The Kidney During Pregnancy 208 Index 209