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Doody's Review ServiceReviewer: Francis Dumler, MD (Wayne State University)
Description: Healthcare and social planners are focusing on the explosive population growth of those over 75, 85, and even 100 years of age in the 21st Century. The John H. Hart Foundation has taken the challenge of improving geriatric care across all specialties and has sponsored a series of Geriatric Education Retreats. This book is the proceedings of such a retreat.
Purpose: The purpose is to provide a compendium of strategies to improve the delivery of nephrology care to elderly patients.
Audience: Practicing nephrologists, nephrology fellows, general internists working in the field, and nurse clinicians and/or physician assistants caring for elderly patients with renal disease are the intended audience. There are 30 contributors from four different countries.
Features: A broad list of topics is covered: general nephrology and renal physiology, fluid and electrolyte balance, glomerular and vascular disease, acute and chronic renal failure, diabetic nephropathy, renal osteodystrophy, peritoneal and hemodialysis, transplantation, urinary incontinence, obstructive uropathy, managed care challenges, and issues relating to training and education of health professionals. Contributors develop themes in a logical sequence. The writing is succinct and clear. Some illustrations are taken directly from color slides and thus make poor black-and-white figures. The chapters on renal osteodystrophy and urinary incontinence are noteworthy. The chapters on drug-related dysfunction, glomerular disease, vascular disease, and diabetic nephropathy are also good. The remaining chapters are simple, short reviews. The team approach outlined at the end is a good starting point for improving services.
Assessment: There are no recent (1990 or later editions) textbooks covering geriatric nephrology. This book is small and very concise. The noteworthy chapters make it a reasonable addition to the library of medical professionals caring for patients with renal disease.