Clinical Physiology of Acid-Base and Electrolyte Disorders. 5th Edition

Abstract

This book starts with well-written chapters on renal physiology, including renal function, circulation and glomerular filtration, and the roles of the various parts of the kidney such as the proximal tubule and loop of Henle. This is a very helpful review of their roles and nicely sets the scene for the second section of the book looking at regulation of water and electrolyte balance—an often misunderstood subject even by those working in the specialty. The final part of the book describes the physiological aspects of acid-base and electrolyte disorders, including the latest evidence on hypovolaemic and oedematous states, and the clinical use of diuretics. These chapters are especially helpful for nurses who deal with patients requiring high dependency and intensive care. Overall this is an in-depth but very readable text that is easy to access and extract necessary information from. Recommended as a ward text or for those senior nurses dealing with critically ill patients with kidney problems. Real-life renal ‘cases’ mostly don’t look like anything described in a textbook. They may have all, some or none of the expected signs or symptoms of the condition in question. What is needed is a book that explains the syndrome in the context of real life cases. This book is aimed at everyone from students to junior doctors who may have no prior experience of renal disease so it starts with a brief description of the renal system, normal laboratory values, renal anatomy and investigations. A helpful inclusion is the extensive list of abbreviations. If you’ve ever been on a ward round and wondered what ‘MAHA’ was, but were too embarrassed to ask, you’ll now be able to find out quickly what it stands for (microangiopathic haemolytic anaemia, by the way). The next two chapters look at how to approach the patient and clinical presentations that typify those with renal impairment, i.e. hypertension and urine or renal function abnormalities. Many diverse causes and increasingly complicated sounding names of glomerulonephritis are bewildering; thankfully, the author provided a helpful ‘ABC’ of the conditions, which is a huge help in understanding the conditions. The second part of the book provides the clinical cases. They start in a useful format with the typical details given either as a handover from the casualty department or in an admission or clinic letter from a GP. It guides the reader through the basics of establishing the patient’s safety, examining the information immediately available from prior investigations and care to approaching patients where appropriate to gain more information on their diagnosis. This is followed by sections on important aspects of examining the patient and investigations if needed. Finally, the likely causes are highlighted along with immediate management considerations. This includes helpful practical advice for issues such as fluid prescriptions and possible complications of treatment. It concluded by looking at how the condition relates back to the physiology. The final part of the book is a self assessment question section. This is a very good book, full of helpful diagrams, charts and photographs that provide useful description of the conditions. The information is up to date and comprehensive and brings alive the various conditions in an easy-to-understand way, putting into perspective the conditions we treat yet don’t fully understand. Nephrology: Clinical Cases Uncovered. 1st Edition