Evaluation of patients with renal disease.- 1. Introduction.- 2. Identifying Renal Disease.- 2.1. History.- 2.2. Family history.- 2.3. Physical examination.- 2.4. Urinalysis.- 2.5. The chemical data base.- 2.6. Radiologic techniques.- 2.7. Percutaneous renal biopsy.- 2.8. Risks and cost of procedures.- 3. Syndromes of Renal Disease.- 3.1. Acute renal failure.- 3.2. Chronic renal failure.- 3.3. Acute nephritic syndrome.- 3.4. Nephrotic syndrome.- 3.5. Urinary tract infection.- 3.6. Obstructive nephropathy.- 3.7. Renal tubular dysfunction.- 3.8. Nephrolithiasis.- 3.9. Accelerated hypertension.- 4. Conclusion.- 2. Disorders of water, sodium and potassium metabolism.- 1. Maintenance of Osmotic Homeostasis.- 1.1. General considerations.- 1.2. Free-water clearance.- 1.3. Renal concentrating and diluting mechanisms.- 1.4. Antidiuretic hormone.- 1.5. Summary of requirements for maximum water diuresis $$\left( {{C_{{H_2}O}}} \right)$$.- 2. Clinical States Associated with Hypo-osmolality.- 2.1. True dilutional hyponatremia.- 2.2. Renal failure.- 2.3. Decreased delivery of filtrate to diluting segment of the nephron.- 2.4. Syndrome of inappropriate ADH (SIADH).- 2.5 Drugs associated with impaired free-water clearance.- 2.6. Endocrine deficiencies.- 2.7. Reset osmostat.- 2.8. Summary of the diagnostic approach to hyponatremia.- 3. Hypernatremia and Disorders of Urine Concentration.- 3.1. Low circulating levels of ADH.- 3.2. Renal tubular hyporesponsiveness to ADH (nephrogenic diabetes insipidus).- 3.3. Diagnostic approach to the patient with a disorder of urinary concentration.- 4. Disorders of Sodium Metabolism.- 4.1. Determinants of renal sodium excretion.- 4.2. Sodium retaining states (edema).- 4.3. Diuretic therapy.- 5. Disorders of Potassium Metabolism.- 5.1. Internal potassium balance.- 5.2. External potassium balance.- 5.3. Hyperkalemia.- 5.4. Hypokalemia.- 3. Acid-base disturbances.- 1. Introduction.- 1.1. Physiologic buffers.- 1.2. Respiratory control of pH.- 1.3. Renal control of H + excretion.- 1.4. Clinical definitions.- 1.5. Diagnostic approach.- 2. Metabolic Acidosis.- 2.1. Anion gap.- 2.2. Metabolic acidosis with an increased anion gap.- 2.3. Metabolic acidosis associated with a normal anion gap (hyperchloremic).- 2.4. Treatment of metabolic acidosis.- 3. Metabolic Alkalosis.- 3.1. Metabolic alkalosis associated with low urinary Cl -.- 3.2. Metabolic alkalosis associated with normal or increased urinary Cl -.- 3.3. Treatment of metabolic alkalosis.- 4. Respiratory Alkalosis.- 5. Respiratory Acidosis.- 6. Mixed Acid-Base Disorders.- 4. Glomerulonephropathies.- 1. Introduction.- 2. Asymptomatic Urinary Abnormalities.- 2.1. Hematuria.- 2.2. Asymptomatic proteinuria.- 2.3. Asymptomatic proteinuria and hematuria.- 3. Nephrotic Syndrome.- 3.1. Definition.- 3.2. Pathogenesis of proteinuria.- 3.3. Patient presentation and evaluation.- 3.4. Clinicopathological correlation.- 4. Acute Nephritic Syndrome.- 4.1. Definition.- 4.2. Patient presentation and evaluation.- 4.3. Clinicopathological correlation.- 4.4. Management of acute nephritic syndrome.- 4.5. Prognosis.- 5. Rapidly Progressive Glomerulonephritis (RPGN).- 5.1. Definition.- 5.2. Patient presentation and evaluation.- 5.3. Clinicopathological correlation.- 6. Chronic Nephritic Syndrome.- 6.1. Definition.- 6.2. Patient presentation and evaluation.- 7. Glomerulonephritis and Systemic Disease.- 7.1. Metabolic and inherited diseases.- 7.2. Hereditary nephritis.- 7.3. Infectious disease.- 7.4. Toxic nephropathy.- 7.5. Collagen vascular disease.- 7.6. Dysproteinemias.- 7.7. Pregnancy.- 5. Urinary tract infection and pyelonephritis.- 1. Prevalence.- 1.1. Overall incidence.- 1.2. Prevalence of urinary tract infection in children.- 1.3. Prevalence of urinary tract infection in adults.- 2. Clinical Significance of Bacteriuria.- 2.1. Pregnancy and urinary tract infection.- 2.2. Hypertension and urinary tract infection.- 2.3. Diabetes and urinary tract infection.- 2.4. Bacteriuria in non-pregnant women.- 2.5. Bacteriuria in children.- 2.6. Bacteriuria in men.- 2.7. Nosocomial urinary tract infections.- 3. Pathogenesis.- 3.1. Local barriers of invasion.- 3.2. Cervico-vaginal antibodies.- 3.3. Uroepithelial antibodies.- 3.4. Systemic antibody response.- 3.5. Other mechanisms.- 3.6. Vesicoureteral valve.- 4. Etiology.- 4.1. Bacterial infection.- 4.2. Fungal infections.- 4.3. Viral infection.- 5. Clinical Manifestations.- 6. Diagnosis.- 6.1. Urine collection.- 6.2. Microscopic examination.- 6.3. Localization.- 7. Management.- 7.1. Asymptomatic bacteriuria.- 7.2. Acute pyelonephritis.- 7.3. Recurrent infections.- 7.4. Antibiotics.- 7.5. Prophylaxis.- 6. Tubulo-interstitial nephritis.- 1. Hereditary Kidney Diseases.- 1.1. Medullary cystic disease.- 1.2. Medullary sponge kidney.- 1.3. Hereditary familial nephritis (Alport's syndrome).- 2. Metabolic Kidney Diseases.- 2.1. Hypercalcemia.- 2.2. Hypokalemia.- 2.3. Oxalate nephropathy.- 2.4. Gouty nephropathy.- 3. Hematologic Diseases.- 3.1. Hemolytic-uremic syndrome.- 3.2. Sickle cell anemia.- 4. Vascular Diseases.- 5. Neoplastic Diseases.- 6. Infections.- 7. Immunological Diseases.- 7.1. Antitubular basement membrane antibodies.- 7.2. Immune complex interstitial nephritis.- 7.3. Reflux nephropathy.- 7.4. Drug-related interstitial nephritis.- 7.5. Renal allografts.- 7.6. Sjögren's syndrome.- 8. Analgesic Nephropathy.- 8.1. Aspirin.- 8.2. Phenacetin.- 8.3. Pathology.- 8.4. Pathogenesis.- 8.5. Clinical manifestations.- 9. Heavy Metals.- 10. Balkan Nephropathy.- 11. Radiation Nephritis.- 7. Cystic diseases of the kidney.- 1. Introduction.- 2. Cystic Dysplasia.- 2.1. Renal aplasia.- 2.2. Congenital multicystic kidney.- 2.3. Pathology.- 2.4. Etiology and pathogenesis.- 2.5. Clinical presentation.- 2.6. Diagnosis.- 2.7. Prognosis and therapy.- 3. Polycystic Disease.- 3.1. Infantile polycystic disease.- 3.2. Adult polycystic disease.- 4. Medullary Cysts of the Kidney.- 4.1. Medullary sponge kidney.- 4.2. Medullary cystic disease.- 4.3. Renal-retinal dysplasia.- 5. Cysts of the Renal Cortex.- 6. Renal Cysts in Hereditary Syndromes.- 8. Urolithiasis.- 1. Introduction.- 2. Pathogenesis of Stone.- 3. Diagnosis of Stone Disease.- 3.1. History.- 3.2. Physical examination.- 3.3. Urinalysis.- 3.4. Radiography.- 4. Management of Stone Disease.- 4.1. General principles.- 4.2. Identification of anatomic or metabolic disorders.- 4.3. Fluid intake.- 4.4. Diet.- 4.5. Urinary tract infection.- 4.6. Classification of stone activity.- 5. Cystine Stones.- 6. Uric Acid Stones.- 7. Xanthine Stones.- 8. Calcium Stones.- 8.1. Hypercalciuria.- 8.2. Other causes of calcium stone formation.- 9. The Evaluation of the Recurrent Stone Former.- 10. Timing of Surgical Intervention.- 9. Drug-related nephropathy.- 1. Introduction.- 2. Acute Tubular Necrosis.- 2.1. Predisposing factors.- 2.2. Incidence.- 2.3. Clinical features.- 3. Tubulo-Interstitial Disease.- 3.1. Acute tubulo-interstitial disease.- 3.2. Chronic tubulo-interstitial disease.- 4. Glomerulonephritis, Nephrotic Syndrome and Vasculitis.- 4.1. Acute glomerulonephritis.- 4.2. Chronic glomerulopathy.- 4.3. Vasculitis.- 5. Hemolytic-Uremic Syndrome.- 6. Obstructive Uropathy.- 7. Fluid, Electrolyte and Acid-Base Disorders.- 7.1. Antidiuresis and dilutional hyponatremia.- 7.2. Diabetes insipidus.- 7.3. Potassium imbalance.- 7.4. Acid-base imbalance.- 10. Acute renal failure.- 1. Clinical Recognition of Acute Renal Failure.- 1.1. Urine volume.- 1.2. Azotemia.- 1.3. Urine sediment.- 1.4. Urine chemistries.- 1.5. Radiologic investigation.- 2. Management of ARF.- 2.1. Prevention.- 2.2. Established parenchymal ARF.- 3. The Recovery Phase.- 11. Chronic renal failure.- 1. Introduction.- 2. Pathophysiology of Chronic Renal Failure.- 2.1. Compensatory growth.- 2.2 Adaptive mechanisms.- 3. Uremia.- 3.1. Pathogenesis of uremia.- …