This book provides a comprehensive overview of the unique challenges inherent in pediatric kidney transplantation. The text reviews the problems faced during each stage of the kidney transplantation process, including the occurrence of infections during the pre-transplant stage, surgical challenges during the actual transplantation, and medication issues during the post-transplant stage. The book also features high-yield case presentations of typical pediatric transplant scenarios, from the pre-transplant management of a child with CAKUT to the evaluation and treatment of antibody mediated rejection in children. Written by experts in the field, Challenges in Pediatric Kidney Transplantation: A Practical Guide is a valuable resource for clinicians, practitioners, and trainees who manage or are interested in this challenging group of patients.

A detailed, contributed reference offering broad coverage of renal transplantation in children. Diagnosis, the patient's medical management, operative methods, surgical and medical complications, donor selection, immunosuppression, late effects on growth and development and psychosocial factors are among the topics discussed. Features a chapter on how to set up and manage a pediatric renal transplant program.

Nolph and Gokal's Text Book of Peritoneal Dialysis, Third Edition, covers advances made in the field for the past 30 years. During the past two decades, the time during which this therapy has been increasingly utilized, this text has continued to be recognized as the major source of the discipline's base knowledge. The evolution of this text to its newest edition parallels the growth of peritoneal dialysis from Continuous Ambulatory Peritoneal Dialysis in the eighties to the current therapy that encompasses manual and automated therapies with full emphasis on adequacy of dialysis dose. Peritoneal dialysis represents an intracorporeal technique for blood purification. This unique dialysis system represents one of many human attempts to manipulate nature for sustenance of life. The past few years of advances have focused on further improvement of the technique. Areas that have fueled the interest of researchers include: (1) Physiology of high transporters (and the role of genetics and inflammation); (2) Continued debate over the most appropriate adequacy indices (small solute clearances, large solute clearances, clinical assessment etc.); (3) Understanding, preventing and treating the MIA syndrome in PD patients ( including the roles of leptin, and adiponectin); (4) Pathogenesis and newer management strategies of vascular calcification; (5) Continued improvements in infectious complications including peritonitis; (6) Further improvements in catheter technology; (7) Automated techniques; (8) Explaining and correcting PD underutilization; (9) Rationale and applications of newer dialysis solutions; (10) New understanding and approaches to management of osteodystrophy; (11) Refinements in anemia management including new insights in iron metabolism in PD patients; (12) Further definition of indications for PD; (13) The ideal time to initiate dialysis. Newer insight into host defense mechanisms have also made the past decade of advances in the field more meaningful for clinicians. This text also covers the knowledge gained from animal models of peritoneal dialysis. Nolph and Gokal's Textbook of Peritoneal Dialysis, Third Edition is a compilation of the latest knowledge in the field. It cites and describes in great detail, the new discoveries and the evolution of understanding the subject of these discoveries.

Living donor kidney (LDK) transplantation has become the definitive approach to the treatment of end-stage renal failure, providing a better quality of life and the best opportunity for survival when compared with dialysis or transplantation from a deceased donor. A timely compendium of the modern day practice of LDK transplantation from a group of outstanding international experts, this text explores a number of controversial aspects of this innovative new technique. Discussing in detail the current situation, the authors also focus on the responsibility of the medical community to the live kidney donor as a patient, and the potential for complacency regarding donor risk. Emphasizing the ethical principles that must dictate medical practice in LDK transplantation for the foreseeable future - voluntarism, informed consent and medical follow-up - this book comprehensively records the best practices currently available.

The responsibilities of the Pediatric Nephrologist in the Nephrologist and other involved specialists is vital to critical care setting are multifaceted. Management of optimize the outcome for each individual child. acute renal failure with and without renal replacement In this first edition of the book, we have included therapy, fluid and electrolyte abnormalities and hyper- chapters focused on general topics in pediatric nephr- tensive emergencies are only some of the major clinical ogy that are most germane to the care of the critically circumstances where the renal specialist is involved in ill child. We have tried to look at the clinical situations the care of children admitted to the Pediatric Intensive from the aspect of both the Pediatric Intensivist and Care Unit. Due to the complex and specialized care renal specialist. We hope that this book will supply the required, critical care nephrology could even be consid- medical providers with a framework to approach the ered a separate entity compared to the clinical scenar- challenges faced in practicing Pediatric Intensive Care ios treated in the outpatient setting or on the inpatient Nephrology. pediatric ward.

The role of immunosuppression is essential to maintain the integrity of a renal transplant by preventing acute rejection. Among adult patients with solid organ transplants, standard immunosuppression does not vary among the major transplant centres in the USA and Europe, and consists of corticosteroids, calcineurin inhibitors and mycophenolic acid. However, children with renal transplants are more susceptible than adults to suffer adverse events related to this standard protocol, including short stature, nephrotoxicity, lymph proliferative disease and infections. For this reason, paediatric nephrologists have explored alternatives to standard immunosuppression while still maintaining acceptable graft outcomes. This book will explore this theme, which will include several chapters that present alternative immunosuppression protocol, in addition to other chapters that address challenging and controversial issues in paediatric renal transplantation. The first three chapters will describe immunosuppression protocols which may have specific benefits in children with renal allografts compared to standard regimens in adults. This includes the use of steroid-avoidance, which obviates many of the problems associated with corticosteroid use in children especially short stature and obesity. Secondly, the mTOR inhibitor Sirolimus is thoroughly discussed, including the potential benefits of this agent because of its lack of nephrotoxicity and possible anti-neoplastic properties. Lastly, induction therapy with Alemtuzumab is described, including recent studies that suggest that this agent may have definite benefits in children compared to standard induction with anti-thymocyte globulin.