Hiromichi Suzuki Knihy

Despite the various advantages of home dialysis compared to in-center hemodialysis, only a fraction of patients in Japan currently opt for peritoneal dialysis or home hemodialysis. However, considerable advances in research and technical improvements have been made lately, advancing the practice of home dialysis therapy in Japan. Japanese research is well-known for its ingenuity and creative energy with regard to the development of new machines and systems for dialysis. New insights regarding peritoneal dialysis and home hemodialysis are presented in the publication at hand: Contributions by leading Japanese experts discuss topics such as educational methods, techniques, tools, novel systems and organization of patients. The book will be of great interest to clinical physicians involved in dialysis care; Moreover, the expertise collected in this volume may contribute to the advancement of home dialysis therapy in a global context.

It is well-known that the daily diet plays an important role in the preservation and integrity of renal function in patients with chronic kidney disease. However, there currently exists some confusion as to the right diet because of the MDRD (Modification of Diet in Renal Disease) study, which has shown that a low-protein diet does not have a major effect on the course of renal dysfunction. To resolve this dilemma, researchers are developing a framework for an appropriate dietary program which will significantly alter the understanding of the role of diet and, eventually, have important implications for the practice of nephrology. This publication provides an update on both laboratory and clinical research, including nutritional status and its assessment in patients with kidney disease, nutritional therapy in hemodialysis, in patients with diabetic nephropathy and after kidney transplantation, as well as considering the roles of sodium, protein intake and phosphate restriction in kidney disease. Part of a long-standing and continuing effort to improve patient outcome, this book provides both a fundamental understanding of diet as well as a practical and up-to-date summary of current knowledge and technology. It will therefore be a helpful tool for the clinician working in the field of chronic kidney disease.

Chronic kidney disease is one of the world’s major public health problems, and the prevalence of kidney failure is rising steadily. Among the risk factors for a faster progression of renal disease are hypertension and proteinuria, many studies clearly demonstrating that hypertension is both a cause and consequence of chronic kidney disease. Namely, renal blood pressure regulation seems to be involved in five major pathophysiological mechanisms (all closely related to the renin-angiotensin system): Pressure-natriuresis, renal sympathetic nervous system, renal blood flow, intraglomerular pressure and tubuloglomerular feedback. This book reviews experimental data which form the basis of our current understanding of the association between hypertension and kidney diseases: The pathogenesis of increased blood pressure, the mechanisms by which systemic hypertension promotes progressive kidney failure, and the impact of antihypertensive agents on experimental renal mechanisms involved in hypertension. Furthermore, the role of angiotensin II receptor blockers in both the control of systemic blood pressure and the reduction of proteinuria is examined in an attempt to define optimal therapeutic strategies to prevent the otherwise inexorable deterioration of renal function in patients with chronic kidney disease.