During the past 4O years there have been major conceptual and technical advances in the domain of dialysis methods and renal/organ transplantation for long-term treatment of patients with End-Stage Renal Failure (ESRF). This now enables better defined, more selective strategies of treatment to be undertaken, according to patient-specific criteria such as age or underlying renal disease also taking into account the lifetime duration of these treatments. For many patients this implies necessary successive changes of mode of therapy depending on their availability, occurrence of medical/technical complications or failure and social-environmental and economic factors. This rationale has inspired the structure of this volume which is divided into four sections: 1/ A descriptive overview of the various modes of renal replacement therapy (RRT): Extracorporeal dialysis/filtration, peritoneal dialysis, kidney and multi-organ transplantation.2/ Most appropriate indications and use of these methods, respective advantages, drawbacks and outcome in children, pregnant women and elderly patients 3/ In diabetic patients and in patients with hereditary/congenital diseases. 4/ The ethical issues generated by this new domain in Medicine by limitations in treatment facilities or medical dilemmas for acceptance, best technical choices, withdrawal or termination of RRT in individual patients. Finally, contributors form Eastern European Countries, Africa and Far Eastern Countries analyse the current status of RRT in their respective geographical area and the ways and means required for a wider implementation of RRT in thus far lesser economically developed countries where the great majority of the populations still have no access to these life-saving therapeutic procedures.

During the past 4O years there have been major conceptual and technical advances in the domain of dialysis methods and renal/organ transplantation for long-term treatment of patients with End-Stage Renal Failure (ESRF). This now enables better defined, more selective strategies of treatment to be undertaken, according to patient-specific criteria such as age or underlying renal disease also taking into account the lifetime duration of these treatments. For many patients this implies necessary successive changes of mode of therapy depending on their availability, occurrence of medical/technical complications or failure and social-environmental and economic factors. This rationale has inspired the structure of this volume which is divided into four sections: 1/ A descriptive overview of the various modes of renal replacement therapy (RRT): Extracorporeal dialysis/filtration, peritoneal dialysis, kidney and multi-organ transplantation.2/ Most appropriate indications and use of these methods, respective advantages, drawbacks and outcome in children, pregnant women and elderly patients 3/ In diabetic patients and in patients with hereditary/congenital diseases. 4/ The ethical issues generated by this new domain in Medicine by limitations in treatment facilities or medical dilemmas for acceptance, best technical choices, withdrawal or termination of RRT in individual patients. Finally, contributors form Eastern European Countries, Africa and Far Eastern Countries analyse the current status of RRT in their respective geographical area and the ways and means required for a wider implementation of RRT in thus far lesser economically developed countries where the great majority of the populations still have no access to these life-saving therapeutic procedures.

First edition edited by Janel Parker in 1998

Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance for the management of critically ill patients with acute renal failure, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice.

An international group of contributors provides a comprehensive, evidence-based overview of supportive care for the nephrology patient, emphasising the continuum of palliative care from the time of diagnosis through to end-of-life care and the issues surrounding withdrawal of dialysis.

Chronic kidney disease is an urgent public health problem in the U.S., affecting 15% of all adults, and more than 740,000 have progressed to end-stage renal disease (ESRD), requiring life-sustaining renal replacement therapy (RRT). ESRD has devastating health, quality-of-life, and economic consequences, rendering most patients unable to maintain employment and costing Medicare $36 billion in 2017. Arguably, the most disadvantaged subgroup is the subset of patients that received no or minimal pre-ESRD nephrology care, which currently accounts for one third of the total ESRD population. This subgroup suffers increased morbidity and mortality, and has limited access to kidney transplantation, the optimal RRT. Despite this subgroup representing a large minority of the ESRD patient population, there has been no U.S.-based examination of their ESRD diagnosis experiences, coping styles and strategies, and RRT decision-making preferences. Therefore, we conducted a study that compared the ESRD diagnosis experiences, coping styles and strategies, and RRT decision-making preferences among patients with varying amounts of pre-ESRD nephrology care. We also assessed nephrologists' current practices and perspectives on the manner and timing of RRT education for patients with varying amounts of pre-ESRD care. This mixed methods study provides a comprehensive understanding of the diagnosis experiences, coping styles and strategies, and RRT decision-making preferences of patients facing sudden and unexpected ESRD diagnosis. The study contributes important knowledge about this subgroup of patients that can influence and improve health care delivery. The results of this research will inform future intervention-based investigations to improve care for patients with minimal or no pre-ESRD nephrology care.

The present book contains the Proceedings of a two day Symposium on Uremic Toxins organized at the University of Ghent in Belgium. A series of guest lectures, free communications and posters have been presented. An international audience of 163 scientists from 16 nationalities listened to and discussed extensively a spectrum of topics brought forward by colleagues and researchers who worked for many years in the field of Uremic Toxins. There is a striking contrast between all the new dialysis strategies available in the work to "clean" the uremic patients and the almost non-progression of our knowledge on uremic toxins in the past decade. In this sense the symposium was felt by all participants as a new start for the research in the biochemical field of the definition of uremia. If the present volume would stimulate new work in this field in order to define uremia, or identify the uremic toxins, the purpose of the organizers would be maximally fulfilled.