Advances in long-term improvement and outcomes of patients with kidney disease will require the use of novel biomarkers to identify patients at high risk for kidney disease and to diagnose kidney disease early for effective treatment. A biomarker is a substance found in the blood, body fluids or tissues that provides a measure of normal biological or pathological processes or response to pharmacological compounds or drugs. There are a wide variety of biomarkers including but not limited to mRNA, proteins and peptides, and lipid molecules. In AKI, important pathophysiological processes such as inflammation, apoptotic and necrotic cell death and, tubule regeneration may be reflected in blood or urine. An array of candidate markers along with clinical information in long-term clinical studies with appropriate analytical methodologies will likely provide prognostic information. Despite well-known limitations, currently the most widely used biomarkers for the early diagnosis of CKD and AKI are proteinuria, serum creatinine and blood urea nitrogen. Most clinicians are aware that serum creatinine and blood urea nitrogen are poor biomarkers due to inherent characteristics of these molecules and handling by the kidney. Creatinine is secreted and urea nitrogen is reabsorbed by the renal tubules. Many endogenous substances interfere in the assay for creatinine. Serum creatinine and urea appear late after acute kidney injury and the serum levels in part depend on the generation (large or small body mass). Acute kidney injury is a non steady state condition thus serum creatinine and urea nitrogen will lag behind kidney injury. For these reasons new biomarkers are imperative. With knowledge of these limitations in use of current biomarkers and the lack of progress in reducing the mortality and morbidity from kidney disease, there has been a great surge of interest in identifying novel biomarkers with a particular emphasis on the early diagnosis of kidney disease. A variety of methods have been employed including transcriptomics, proteomics, gene arrays and lipidomics. Currently, candidate biomarkers have been found in different disorders and have been tested in humans and many candidate biomarkers have yet to be identified. Most studies to date are preliminary and require validation in large multicentre studies followed by commercial assay development validation and testing. This new book outlines the rapid advances made in the field of biomarker development for kidney disease in which a variety of novel molecules have been identified and studied in humans.
Kidney disease and cancer are frequent comorbidities that require specialized knowledge and expertise from both the nephrologist and the oncologist. Written by three pioneers in this growing subspecialty, Onco-Nephrology provides authoritative, definitive coverage of the mechanism and management of these two life-threatening diseases. This unique, single-volume resource covers current protocols and recommends management therapies to arrest kidney failure and allow oncologic treatments to continue and succeed. - Addresses acute and chronic kidney diseases that develop from a variety of cancers. This includes direct kidney injury from the malignancy, paraneoplastic effects of the cancer, and various cancer agents used to treat the malignancy. - Discusses key issues regarding kidney disease in patients with cancer, including conventional chemotherapeutic regimens and new novel therapies (targeted agents and immunotherapies) or the malignancies themselves that may promote kidney injury; patients with chronic kidney disease who acquire cancer unrelated to renal failure; and kidney transplantation, which has been shown to carry an increased risk of cancer. - Contains dedicated chapters for each class of the conventional chemotherapeutic agents, targeted cancer agents, and cancer immunotherapies including the basic science, pathogenic mechanisms of injury, clinical manifestations, and treatment. - Includes special chapters devoted to the individual classes of chemotherapies that relate to kidney disease for quick reference. Discusses increasingly complex problems due to more numerous and specialized anti-cancer drugs, as well as increased survival rates for both cancer and renal failure requiring long-term patient care. - Covers anti-VEGF (antivascular endothelial growth factor) agents and cancer immunotherapies – treatments that are being recognized for adverse kidney effects. - Utilizes a clear, logical format based on the ASN Core Curriculum for Onco-Nephrology, making this reference an excellent tool for board review, as well as a practical resource in daily practice. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Based on the most current evidence and best practices, Perioperative Medicine: Managing for Outcome, 2nd Edition, is an easy-to-follow, authoritative guide to achieving optimal outcomes in perioperative care. Written and edited by recognized authorities in anesthesiology and surgical critical care, this fully updated edition helps you think critically about complex, long-term issues surrounding the care of the surgical patient, providing decision trees that define strategies to enhance the medical outcome of care. - Focuses on what anesthesiologists, surgeons, and intensivists need to know in order to improve outcomes through evidence- and outcome-based approaches. - Provides practical guidance on potential risks to all major organ systems, the etiology of particular organ dysfunctions, preoperative and intraoperative risk factors, and perioperative protection strategies to minimize potential complications. - Features a consistent chapter format - with even more color-coded algorithms, summary tables, and boxes – that enables you to quickly explore and determine the best management approaches. - Includes six all-new chapters: Perioperative Fluid Management; Delirium and POCD; Role of Palliative Care/ICU; Value-Based Care: The UK Model; CFO Perspective on Value; Hospital to Home (Perioperative Transitions of Care) - Discusses timely topics such as quality improvement, pay-for-performance, preexisting disease and comorbid conditions in anesthesiology, and the team-based model of care. - Features two new editors, surgeon Clifford Ko, MD, and Perioperative Summit leader, Michael (Monty) Mythen, MD.
A concise review of the core principles and clinical entities associated with nephrology at the point of care Covers all major acute and chronic kidney diseases, from acid/base disturbances to stones to end stage renal disease. Features a concise, manageable format with recommended timeframes for mastering the content, case studies, and summary tables. Perfect for trainees and practicing non-specialists.
Advances in long-term improvement and outcomes of patients with kidney disease will require the use of novel biomarkers to identify patients at high risk for kidney disease and to diagnose kidney disease early for effective treatment. A biomarker is a substance found in the blood, body fluids or tissues that provides a measure of normal biological or pathological processes or response to pharmacological compounds or drugs. There are a wide variety of biomarkers including but not limited to mRNA, proteins and peptides, and lipid molecules. In AKI, important pathophysiological processes such as inflammation, apoptotic and necrotic cell death and, tubule regeneration may be reflected in blood or urine. An array of candidate markers along with clinical information in long-term clinical studies with appropriate analytical methodologies will likely provide prognostic information. Despite well-known limitations, currently the most widely used biomarkers for the early diagnosis of CKD and AKI are proteinuria, serum creatinine and blood urea nitrogen. Most clinicians are aware that serum creatinine and blood urea nitrogen are poor biomarkers due to inherent characteristics of these molecules and handling by the kidney. Creatinine is secreted and urea nitrogen is reabsorbed by the renal tubules. Many endogenous substances interfere in the assay for creatinine. Serum creatinine and urea appear late after acute kidney injury and the serum levels in part depend on the generation (large or small body mass). Acute kidney injury is a non steady state condition thus serum creatinine and urea nitrogen will lag behind kidney injury. For these reasons new biomarkers are imperative. With knowledge of these limitations in use of current biomarkers and the lack of progress in reducing the mortality and morbidity from kidney disease, there has been a great surge of interest in identifying novel biomarkers with a particular emphasis on the early diagnosis of kidney disease. A variety of methods have been employed including transcriptomics, proteomics, gene arrays and lipidomics. Currently, candidate biomarkers have been found in different disorders and have been tested in humans and many candidate biomarkers have yet to be identified. Most studies to date are preliminary and require validation in large multicentre studies followed by commercial assay development validation and testing. This new book outlines the rapid advances made in the field of biomarker development for kidney disease in which a variety of novel molecules have been identified and studied in humans.
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