How do we cope with the ever-increasing yearly load of new information and concepts to update our clinical practice? One possible answer is to bring together in a single volume the progresses made in a precise, sufficiently broad field. This is the aim pursued by Sweny et al. in the present monography on infectious complications of renal disease.
The book is divided into three partsbasic mechanisms (four chapters), diagnosis and (very often) therapy of infectious complications encountered in renal diseases, renal failure and renal transplantation (12 chapters) and, finally, prevention and management (five chapters). Authors originate almost exclusively from the UK (10 chapters) and the USA (nine chapters) with only one each from Belgium and Canada.
Each chapter of the first part provides a very useful background to the infectious problems of renal failure, of therapeutic immunosuppression, of peritoneal dialysis and of renal transplantation. In the latter chapter, R. Rubin introduces the reader to several subsequent topics of the second part devoted to a more in-depth review.
The second and largest part (273 out of 448 pages) is very heterogeneous. It covers infectious complications of glomerular disease and of the diabetic state, the sepsis syndrome in acute renal failure or peritoneal dialysis, the clinical syndromes produced by mucormycosis, hepatitis C and B and HIV, a number of post-transplant conditions due to cytomegalovirus infection, virus-related tumours, bacterial, fungal and parasitic infections. Unfortunately, redundancies abound in this part without cross-references. As each chapter follows its own structure, the reader cannot easily find specific information. The number of references is also highly variable ranging from less than 20 to more than 240. As very often in a multi-authored book, only a few concern 2000 and 2001, probably a reflection of the authors faithfulness to their assigned deadline!
Clinical nephrologists will be probably more interested in the first four chapters of the last part, devoted to prevention and management: the control of infection in the renal unit, the prevention and treatment of infection in vascular access, travel and vaccination in renal patients and, most important, the care of the feet in renal patients. Each contribution offers practical and informative approaches to daily problems. The last chapter on antibiotic dosing is already available as such in numerous textbooks; it lacks references to the interactions between antibiotics and a number of other drugs given to renal patients such as immunosuppressive agents.
Overall, Infectious Complications of Renal Disease assembles a wealth of information for the clinical nephrologist. In such an endeavour the editors accept that their state of the art review is delayed by the time needed to assemble the manuscripts with the hope that an integrated approach more than compensates for this drawback.
As always, success is uneven but the present result is already praiseworthy.