Infectious Complications of Renal Disease

Author: Herman Melville
Published: January 2003
Publisher: Oxford University Press
ISBN: 0192632949
Hardcover Book
Number of Pages: 480

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"This book covers the whole range of infections that patients at all stages of renal disease may encounter for example acute renal failure, chronic renal failure, nephrotic syndrome, glomerulonephritis, vasculitis, peritoneal dialysis, haemodialysis and transplantation. The diabetic with renal disease merits a separate chapter. As far as is possible a clinical chapter is balanced by a chapter dealing with pathophysiology.L The book is divided in to three sections: 1)Basic Mechanisms, 2)Infectious complications of common renal conditions, renal failure and transplantation, 3)Prevention and management.L The uraemic condition as a state of immunosupression is discussed to set the set the scene for why renal patients are prone to so many diverse infections. Increasingly potent immunosupressive drugs are being deployed in a variety of primary conditions and also to prevent renal allograft rejection. The mechanisms by which these drugs predispose to infection are discussed. A chapter deals specifically with peritoneal defence mechanisms of critical importance in the management of infection complicating continuous ambulatory peritoneal dialysis.L The second section of the book deals specifically with infectious complications in defined situations. For example, diabetes mellitus is discussed in detail as this is now the major cause of endstage chronic renal failure. Infectious complications of glomerulonephritis and vasculitis are discussed, and this relates to the effects of the potent immunosuppressive agents now deployed. Specific chapters are devoted to infectious complications of peritoneal dialysis and haemodialysis including a chapter on mucormycosis. Hepatitis B and hepatitis Chave each been given a chapter and the impact of these hepatitis viruses on the renal patient from chronic renal failure through dialysis to transplantation. Infectious complcation of transplatation follows and reviews the common infections as well as presenting some new data on viral induced tumours.LIn the final section of the book, prevention of infection is discussed with particular emphasis to vascular access and the care of the uraemic ischaemic/diabetic foot. The general principles relating to limiting the spread of infection within the Renal Unit are discussed in detail. Increasing patient mobility and travel requires that travel and vaccination in renal patients are discussed. The book ends with a practical chapter on prescribing advice for the use of common anti-microbial agents." Containing a total of 21 contributions, this volume addresses basic mechanisms at work in renal disease and how this sets up renal patients for so many diverse infections. Contributions in the second part deal with infectious complications in defined situations such as diabetes mellitus, glomerulo-nephritis and vasculitis, peritoneal dialysis, mucormycosis, hepatitis B and C, virus-induced tumors, and other problems. The last part of the volume addresses the prevention of infection, with an emphasis on vascular access and the care of the uraemic ischaemic/diabetic foot. Contributors include immunologists, molecular pathologists, nephrologists, foot clinicians, and many other specialists from the US, UK, Canada, India, and Belgium.

Table of Contents
List of contributors
Abbreviations
Pt. I Basic Mechanisms
1 Renal failure as an immunodeficiency state 3
2 The effect of immunosuppressive agents on the defence against infection 21
3 Peritoneal host defence in patients with end-stage renal failure treated by peritoneal dialysis 41
4 Infection in renal transplantation 69
Pt. II Infectious Complications of Common Renal Conditions, Renal Failure, and Transplantation
5 Infectious complications of vasculitis, glomerulonephritis, and the nephrotic syndrome 85
6 Infectious complications of the diabetic patient with renal failure 107
7 Sepsis syndrome and infective complications of acute renal failure 131
8 Infections in peritoneal dialysis 153
9 Mucormycosis in dialysis patients 177
10 Hepatitis C in end-stage renal disease 191
11 Hepatitis B in end-stage renal disease 229
12 Management of renal disease in patients with human immunodeficiency virus infection 255
13 Cytomegalovirus in the renal allograft recipient 273
14 Virus-related tumours 289
15 Bacterial infections in renal allograft recipients 309
16 Fungal and parasitic infections in the renal transplant patient 331
Pt. III Prevention and Management
17 Control of infection in the renal unit 359
18 Prevention and treatment in infections in vascular access 385
19 Infections complicating diseases of the feet in renal patients 399
20 Travel and vaccination in renal patents 417
21 Antimicrobial dosing regimens in renal patients 431
Index 449

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