This book by Claude Jacobs and other well known clinical nephrologists from Europe and the US is a valuable contribution to available modalities and optimal strategies for the treatment of end-stage renal disease (ESRD). The first part of the book includes general chapters on extra-corporeal renal replacement therapy (RRT), peritoneal dialysis, renal transplantation and multi-organ transplantation. The second part is devoted to optimal care with respect to defined sub-categories of kidney disease populations such as paediatric and elderly patients, pregnant women, diabetic patients and patients with hereditary and congenital nephropathies who require RRT. The last part of the book deals with ethical aspects on the one hand, and the special situation of developing countries on the other.
The book provides concise information on all types of RRT modalities. This is of immense practical interest to all those who are involved in the care of ESRD patients, including physicians, young doctors in training, nurses, dieticians and other health care personnel. It should also be of interest to ESRD patients themselves and to their relatives. The first series of chapters contains succinct descriptions of theoretical and practical aspects of all treatment modalities, their relative benefits and disadvantages, their complications, the preparation of the patient for a given treatment modality, patient surveillance, concomitant medical treatments, and for the case of transplantation, surgical techniques as well as the choice of the donor and problems of organ procurement.
The chapters on specific problems in the paediatric and elderly population, respectively, and on the special problems arising from pregnancy and diabetes, are very useful contributions where the interested reader can find valuable practical recommendations, in addition to demographic and aetiological information.
The inclusion in this book of the management of a variety of inherited kidney disorders once ESRD has occurred is not only of interest to paediatric nephrologists, but also to all those who care for adult patients. An increasing number of ESRD children reach adulthood at present due to the steady improvement in RRT.
The chapter on ethical aspects contains useful discussions on the problems of RRT rationing, cost and stopping dialysis treatment.
The final chapter on treatment strategy for ESRD patients in developing countries is a striking innovation which probably cannot be found in other books dealing with RRT. The outline of the particular problem in various continents or sub-continents and the proposal of treatment solutions is a remarkable achievement.
Literature citations show that the authors have largely taken into account most recent developments in the field of interest, including the USRDS annual data report, and the K/DOQI guidelines for the year 2000.
Besides these positive aspects of the book, one could say on the negative side that a more formal comparison of the different treatment modalities would have been desirable; in particular, with respect to the choice made by each patient and with respect to outcome. A special chapter on the management of ESRD patients with severe cardiovascular disease could have been included, since this has become an increasingly important problem in recent years. Finally, concerning the management of patient categories, one would have wished to see a chapter on the management of ESRD patients with significant psychiatric disorders, although a small paragraph has been devoted to RRT indications and contra-indications in such patients.
In conclusion, this book is a timely contribution to the management of ESRD patients. It is, in my opinion, to be widely distributed and frequently consulted by all those who are directly or indirectly involved in the care of uraemic patients, and whose failing kidney function requires one or the other form of RRT.