Renal Pathophysiology: The Essentials (Renal Patholophysiology: The Essentials) Third Edition

Renal Pathophysiology: The Essentials (Renal Patholophysiology: The Essentials) Third EditionThis text offers medical students a case-based approach to learning mechanisms of renal disease. Each chapter covers a disease and begins with a patient case, followed by discussion of the pathophysiology of the disease.

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Issues of differential diagnosis and therapy are linked to pathophysiologic mechanisms. Short questions interspersed in the text require students to apply their knowledge, and detailed answers to the questions are given. This edition includes a full-color insert and an appendix of normal lab values.

Renal Pathophysiology: The Essentials (Renal Patholophysiology: The Essentials) Third Edition
by Rennke MD, Helmut G. (Author), Denker MD, Bradley M. (Author)
ISBN-13: 978-0781799959
ISBN-10: 0781799953

Renal Pathophysiology: The Essentials (Renal Patholophysiology: The Essentials) Third Edition – Content

Preface iv
1 Review of Renal Physiology 1
2 Regulation of Salt and Water Balance 32
3 Disorders of Water Balance: Hyponatremia,
Hypernatremia, and Polyuria 69
4 Edematous States and the Use of Diuretics 99
5 Acid–Base Physiology and Metabolic
Alkalosis 126
6 Metabolic Acidosis 156
7 Disorders of Potassium Balance 175
8 Urinalysis and Approach to the Patient
With Renal Disease 199
9 Pathogenesis of Major Glomerular and
Vascular Diseases 219
10 Tubulointerstitial Diseases 269
LWBK342-FM LWBK342-Rennke May 15, 2009 17:49
vi Contents
11 Acute Renal Failure 296
12 Progression of Chronic Renal Failure 317
13 Signs and Symptoms of Chronic
Renal Failure 342
Figure Credits 367
Index 369

Renal Pathophysiology: The Essentials (Renal Patholophysiology: The Essentials) Third Edition – Review of  Renal Pathophysiology


By the end of this chapter, you should have an understanding
of each of the following issues:
■ The general mechanisms by which solute reabsorption and secretion
occur in the different nephron segments.
■ The factors regulating the glomerular filtration rate.
■ The mechanisms by which the glomerular filtration rate is measured in

Although readers of this book should have already completed a course on
normal renal physiology, a brief review of the basic principles involved is
helpful in understanding the mechanisms by which disease might occur.
Tubular functions will be discussed with a major emphasis on sodium and
LWBK342-01 LWBK342-Rennke April 30, 2009 15:35
2 Renal Pathophysiology: The Essentials water reabsorption. The glomerular filtration rate including its regulation and how it is estimated in the clinical setting will also be reviewed.
The kidney performs two major functions: ■ It participates in the maintenance of a relatively constant extracellular environment that is necessary for the cells (and organism) to function
normally. This is achieved by excretion of some waste products of metabolism (such as urea, creatinine, and uric acid) and of water and electrolytes that are derived primarily from dietary intake.

Balance or steady state is a key principle in understanding renal functions.
Balance is maintained by keeping the rate of excretion equal to the sum of net intake plus endogenous production: Excretion = Intake + Endogenous production

■ As will be seen, the kidney is able to individually regulate the excretion of water and solutes (such as sodium, potassium, and hydrogen) largely by changes in tubular reabsorption or secretion. If, for example, sodium intake is increased, the excess sodium can be excreted without requiring alterations in the excretion of water or other electrolytes.

■ It secretes hormones that participate in the regulation of systemic and renal hemodynamics (renin, angiotensin II, and prostaglandins), red cell production (erythropoietin), and mineral metabolism [calcitriol, (1,25-OH dihydroxyvitamin D), the major active metabolite of vitamin D].

The kidney also performs a number of miscellaneous functions such as the catabolism of peptide hormones and the synthesis of glucose (gluconeogenesis) under fasting conditions…………..

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