1 URINARY TRACT STRUCTURE AND INFECTION Introduction Normal anatomy of the urinary tract Structure of the kidney Innervation of the urinary tract Embryology of the kidney and urinary tract Infection of the urinary tract Aetiology and pathogenesis of urinary tract infection Investigation of urinary tract infection Imaging of the urinary tract Vesicoureteric reflux Overview: treatment of urinary tract infections 2 BODY FLUIDS, NEPHRON FUNCTION AND DIURETICS Introduction Body fluid and electrolyte distribution Functional anatomy of the nephron Sodium transport Regulation of sodium transport Potassium transport Pharmacology of diuretic agents Principles of fluid and electrolyte replacement therapy 3 WATER BALANCE AND REGULATION OF OSMOLALITY Introduction Causes and assessment of polyuria Renal mechanisms for urine concentration Feedback control of plasma osmolality Failure to concentrate the urine Failure to dilute the urine 4 ACID-BASE BALANCE AND REGULATION OF pH Introduction Role of the kidney in H+ balance Disturbances of acid-base balance: acidosis Disturbances of acid-base balance: alkalosis Summary of findings in principal acid-base disturbances 5 GLOMERULAR FILTRATION AND ACUTE KIDNEY INJURY Introduction Renal blood flow Glomerular filtration Autoregulation of renal blood flow and glomerular filtration rate Renal excretion and the clearance formula Measuring the glomerular filtration rate Urea Pathophysiology of oliguria Causes of acute kidney injury Acute tubular necrosis Overview: assessment and management of a patient with acute kidney injury Biochemical changes in acute kidney injury Complications of acute kidney injury Management of acute kidney injury 6 PROTEINURIA AND THE NEPHROTIC SYNDROME Introduction Pathophysiology of oedema formation Glomerular anatomy and the filtration barrier Normal and abnormal proteinuria Nephrotic syndrome Natural history and response to treatment 7 GLOMERULONEPHRITIS AND THE ACUTE NEPHRITIC SYNDROME Introduction Urinary sediment examination Presentation and consequences of glomerular disease Investigation of glomerulonephritis Differential diagnosis of acute glomerulonephritis Pathogenesis of acute glomerulonephritis Outcome of glomerulonephritis Clinicopathological correlations in glomerulonephritis 8 DIABETIC NEPHROPATHY AND CHRONIC KIDNEY DISEASE Introduction Presentation of chronic kidney disease Stages of chronic kidney disease Causes of chronic kidney disease _ Pathology of diabetic nephropathy and chronic kidney disease Main consequences of chronic kidney disease Progression of chronic kidney disease Principles of treatment 9 END-STAGE KIDNEY DISEASE AND REPLACEMENT OF RENAL FUNCTION Introduction Replacement of kidney function Principles and modes of dialysis Principles and modes of transplantation Conservative therapy for advanced chronic kidney disease 10 HYPERTENSION AND THE KIDNEY Introduction Determinants of normal blood pressure and role of the kidney Pathogenesis of essential hypertension The pathology of hypertension Principles in the management of hypertension Secondary hypertension 11 PREGNANCY AND THE KIDNEY Introduction Structural changes in the urinary tract during pregnancy Urinary tract infection in pregnancy Renal physiology changes in pregnancy Blood pressure and pregnancy Hypertension in pregnancy Management of hypertension in pregnancy Follow-up of patients with hypertension in pregnancy Pregnancy in patients with pre-existing kidney disease 12 URINARY TRACT OBSTRUCTION AND STONES Introduction Differential diagnosis of loin pain and haematuria Imaging of the urinary tract Pathophysiology of urinary tract obstruction Renal calculi Principles of treatment 13 RENAL MASSES AND URINARY TRACT TUMOURS Introduction Differential diagnosis of a renal mass Renal cell carcinoma Differential diagnosis of microscopic haematuria Transitional cell carcinoma of the bladder Other urinary tract tumours 14 DRUGS AND THE KIDNEY Introduction PART A Effect of renal impairment on drug excretion Altered pharmacokinetics in renal disease Drug dosing in renal failure PART B Renal impairment induced by drugs Renal actions of non-steroidal anti-inflammatory drugs Mechanisms of nephrotoxicity Important causes of nephrotoxicity Appendix: normal ranges Glossary Index
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