Malluche HH et al. (Eds; 2005) Clinical Nephrology, Dialysis and Transplantation. Deisenhofen: Dustri-Verlag Dr. Karl Feistle

Chronic kidney disease (CKD) is a worldwide epidemic; the number of individuals with CKD is rapidly increasing and there are not enough nephrologists to take care of these patients. Simultaneously, nephrology is becoming increasingly complex. To acquire and maintain an understanding of research developments in this area is especially difficult for renal fellows. Practicing nephrologists are similarly struggling to keep pace with the explosion of new knowledge after their training is complete. Textbooks have the capacity to summarize extensive amounts of literature and tell a story in a way that no journal can.

Clinical Nephrology, Dialysis and Transplantation aims to provide readers with up-to-date and succinct information in the field. The ring-binder format enables readers to remove chapters from the book for use during rounds, conferences, and so on. This feature is highlighted by the editors as a particular advantage of the book, and we did indeed find it to be a major plus point compared with other textbooks.

This book discusses the entire spectrum of nephrology, including renal replacement therapy. It is written at the level of clinical nephrologists and nephrology fellows and aims to bring about an understanding of the pathophysiology and treatment of renal diseases and kidney transplantation. The book comprises three parts, spread over two volumes. Part I covers clinical nephrology—including electrolyte and acid-base disorders; glomerular, vascular, tubulointerstitial and urologic disorders; and acute and chronic renal failure—and hypertension. Part II covers various facets of renal replacement therapy, such as hemodialysis, peritoneal dialysis, continuous renal replacement therapy, and plasmapheresis. Part III covers renal transplantation in depth. The authors of the various chapters are well-recognized leaders in their fields and have made a tremendous effort to pass on the current knowledge in their subspecialties. The graphics and tables that are included in several chapters allow a quick review of the salient points.

This book is primarily geared towards trainees in the field of nephrology who are acquiring new knowledge at a rapid pace in a short period of time. For those who are not too familiar with the topics covered, particularly medical students and residents, this might not be the ideal reference point for gaining knowledge in the field of nephrology; the book must be used as a supplementary rather than a sole resource for these less experienced learners.

Some topics are covered better than others. The text is accurate for the most part, but the material in some chapters is not well organized and is potentially confusing. For example, some sections of the book have not been organized into traditional sections such as etiology/pathophysiology, diagnosis and treatment. The text frequently jumps between these subcategories, making the chapters hard to follow. In addition, figures are sometimes challenging to interpret, and some tables contain definitions that are not well explained in the text. Further, certain diagnostic and therapeutic methods are based on the authors' opinion rather than on the available evidence. It would have been useful if the authors had provided more evidence-based information where relevant, including a brief description of the studies and their applicability to clinical practice. The opinion of the authors is valuable too, but it should be stated as such. This would encourage critical thinking among readers.

Timeliness in a textbook is often a concern. Some chapters of Clinical Nephrology, Dialysis and Transplantation are updated yearly. Several chapters, however, have references only before 1999, and thus newer randomized controlled trials that could enhance clinical decision-making are not mentioned. For example, in the chapter on dialysis adequacy there is no reference to the HEMO study.1 The International Society for Peritoneal Dialysis guidelines2 escape mention in the treatment of peritonitis, as does the influence of residual renal function on survival in peritoneal dialysis patients demonstrated in the CANUSA study.3 The issue of iron supplementation for dialysis patients receives a bare 10 lines of text and there is no mention of iron dextran causing anaphylaxis,4 or discussion of the trials of non-dextran irons showing superior safety.5 On the upside, the chapter on diabetic nephropathy discusses the newer trials with angiotensin receptor blockers and their significance. More frequent updates might, therefore, be necessary to ensure the timeliness of this book.

Compared with various standard nephrology textbooks, Clinical Nephrology, Dialysis and Transplantation has the advantage of being concise and portable, but it is somewhat less well written than the online texts currently available, such as UpToDate.6 Anyone who cares for patients with kidney disease will find some of the information in this book useful. Although this publication doesn't supplant the currently available, more widely used nephrology textbooks, the editors and contributing authors are to be commended for undertaking the complex task of writing and publishing this comprehensive resource.