Table Of ContentTenth Edition
BRENNER & RECTOR’S
THE KIDNEY VOLUME 1
Karl Skorecki, MD, Maarten W. Taal,
FRCP(C), FASN MBChB, MMed, MD,
Annie Chutick Professor and Chair in FCP(SA), FRCP
Medicine (Nephrology) P
rofessor of Medicine
Technion—Israel Institute of Technology
Division of Medical Sciences and
Director of Medical and Research G
raduate Entry Medicine
Development University of Nottingham
Rambam Health Care Campus Hon
orary Consultant Nephrologist
Haifa, Israel D
epartment of Renal Medicine
Royal Derby Hospital
Glenn M. Chertow, MD Derby, United Kingdom
Norman S. Coplon/Satellite Healthcare
Professor of Medicine Alan S.L. Yu, MD
Chief, Division of Nephrology
Harry Statland and Solon Summerfeld
Stanford University School of Medicine
Professor of Medicine
Palo Alto, California D
irector, Division of Nephrology and
Hypertension and The Kidney Institute
Philip A. Marsden, MD University of Kansas Medical Center
Professor of Medicine Kansas City, Kansas
Elisabeth Hofmann Chair in Translational
Research SPECIAL ASSISTANT TO THE EDITORS
Oreopoulos-Baxter Division Director of
Walter G. Wasser, MD
Nephrology
Vice Chair Research, Department of Attending Physician, Division of
Medicine Nephrology
University of Toronto Mayanei HaYeshua Medical Center
Toronto, Ontario, Canada Bnei Brak, Israel;
Rambam Health Care Campus
Haifa, Israel
i
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
BRENNER AND RECTOR’S THE KIDNEY, TENTH EDITION ISBN: 978-1-4557-4836-5
Copyright © 2016 by Elsevier, Inc. All rights reserved. Volume 1 part number 9996096807
Volume 2 part number 9996096866
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Previous editions copyrighted 2012, 2008, 2004, 2000, 1996, 1991, 1986, 1981, 1976.
Library of Congress Cataloging-in-Publication Data
Brenner & Rector’s the kidney / [edited by] Karl Skorecki, Glenn M. Chertow, Philip A. Marsden,
Maarten W. Taal, Alan S.L. Yu ; special assistant to the editors, Walter G. Wasser.—10th edition.
p. ; cm.
Brenner and Rector’s the kidney
Kidney
Includes bibliographical references and index.
ISBN 978-1-4557-4836-5 (hardcover : alk. paper)
I. Skorecki, Karl, editor. II. Chertow, Glenn M., editor. III. Marsden, Philip A., editor.
IV. Taal, Maarten W., editor. V. Yu, Alan S. L., editor. VI. Title: Brenner and Rector’s the
kidney. VII. Title: Kidney.
[DNLM: 1. Kidney Diseases. 2. Kidney—physiology. 3. Kidney—physiopathology. WJ 300]
RC902
616.6′1—dc23
2015033607
Content Strategist: Kellie Heap
Senior Content Development Specialist: Joan Ryan
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Printed in United States of America.
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedicated to our patients and to our students
—who provide us with the inspiration to learn,
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Contributors
Andrew Advani, BSc, MBChB(Hons), PhD, FRCP(UK) Kara N. Babaian, MD
Assistant Professor of Medicine Assistant Professor of Clinical Urology
University of Toronto Department of Urology
St. Michael’s Hospital University of California, Irvine
Toronto, Ontario, Canada Orange, California
Chapter 13, Vasoactive Molecules and the Kidney Chapter 41, Kidney Cancer
Michael Allon, MD Colin Baigent, FFPH, FRCP
Professor of Medicine Professor of Epidemiology
Division of Nephrology Clinical Trial Service Unit
University of Alabama at Birmingham Nuffeld Department of Population Health
Birmingham, Alabama Oxford, United Kingdom
Chapter 70, Interventional Nephrology Chapter 56, Cardiovascular Aspects of Kidney Disease
Amanda Hyre Anderson, PhD, MPH Sevcan A. Bakkaloglu, MD
Assistant Professor of Epidemiology Professor of Pediatrics
Center for Clinical Epidemiology and Biostatistics Head, Division of Pediatric Nephrology and
Perelman School of Medicine Rheumatology
University of Pennsylvania Gazi University School of Medicine
Philadelphia, Pennsylvania Ankara, Turkey
Chapter 21, Demographics of Kidney Disease Chapter 74, Diseases of the Kidney and Urinary Tract in
Children
Gerald B. Appel, MD
Professor of Medicine George L. Bakris, MD
Director of Clinical Nephrology Professor of Medicine
Division of Nephrology Department of Medicine
Columbia University Medical Center University of Chicago Medicine
New York, New York ASH Comprehensive Hypertension Center
Chapter 33, Secondary Glomerular Disease Chicago, Illinois
Chapter 47, Primary and Secondary Hypertension
Suheir Assady, MD, PhD
Director, Department of Nephrology and Hypertension Gavin J. Becker, MD, FRACP
Rambam Health Care Campus Professor
Haifa, Israel Department of Nephrology
Chapter 79, Near and Middle East Royal Melbourne Hospital and University of Melbourne
Melbourne, Victoria, Australia
Anthony Atala, MD Chapter 82, Oceania Region
Director, Wake Forest Institute for Regenerative
Medicine Rachel Becker-Cohen, MD
William H. Boyce Professor and Chair Pediatric Nephrology
Department of Urology Shaare Zedek Medical Center
Wake Forest School of Medicine The Hebrew University School of Medicine
Winston-Salem, North Carolina Jerusalem, Israel
Chapter 86, Tissue Engineering, Stem Cells, and Cell Therapy Chapter 76, Renal Replacement Therapy (Dialysis and
in Nephrology Transplantation) in Pediatric End-Stage Kidney Disease
Paul Ayoub, MD Theresa J. Berndt
Specialized Medicine Department of Medicine
University of Montréal Division of Nephrology and Hypertension
Montréal, Quebec, Canada Mayo Clinic College of Medicine
Chapter 69, Elimination Enhancement of Poisons Mayo Clinic
Rochester, Minnesota
Chapter 7, The Regulation of Calcium, Magnesium, and
Phosphate Excretion by the Kidney
iv
CONTRIBUTORS v
Jeffrey S. Berns, MD Richard M. Breyer, PhD
Professor of Medicine Professor of Medicine
Perelman School of Medicine Professor of Biochemistry
University of Pennsylvania Ruth King Scoville Chair in Medicine
Philadelphia, Pennyslvania Professor of Pharmacology
Chapter 21, Demographics of Kidney Disease Vanderbilt University
Nashville, Tennessee
Prof John F. Bertram, BSc(Hons), PhD, FASN, DSc Chapter 14, Arachidonic Acid Metabolites and the Kidney
Professor of Anatomy and Developmental Biology
Monash University Dennis Brown, PhD
Clayton, Victoria, Australia Department of Medicine
Chapter 23, Nephron Endowment and Developmental Harvard Medical School
Programming of Blood Pressure and Renal Function Center for Systems Biology
Program in Membrane Biology and Division of
Vivek Bhalla, MD Nephrology
Assistant Professor of Medicine/Nephrology Massachusetts General Hospital
Stanford University School of Medicine Boston, Massachussets
Stanford, California Chapter 11, The Cell Biology of Vasopressin Action
Chapter 12, Aldosterone and Mineralocorticoid Receptors:
Renal and Extrarenal Roles Carlo Brugnara, MD
Professor of Pathology
Daniel G. Bichet, MD Harvard Medical School
Professor of Medicine and Physiology Director, Hematology Laboratory
University of Montréal Boston Children’s Hospital
Nephrologist Boston, Massachusetts
Department of Medicine Chapter 57, Hematologic Aspects of Kidney Disease
Hôpital du Sacré-Coeur de Montréal
Montréal, Quebec, Canada Stéphan Busque, MD
Chapter 45, Inherited Disorders of the Renal Tubule Professor of Surgery (Abdominal Transplantation)
Director, Adult Kidney and Pancreas Transplant Program
Alain Bonnardeaux, MD, PhD Stanford University
Full Professor of Medicine Stanford, California
University of Montréal Chapter 72, Clinical Management of the Adult Kidney
Nephrologist Transplant Recipient
Hôpital Maisonneuve-Rosemont
Montréal, Quebec, Canada Juan Jesús Carrero, Pharm, PhD, MBA
Chapter 45, Inherited Disorders of the Renal Tubule Associate Professor
Karolinska Institutet
William D. Boswell, Jr., MD, FACR Stockholm, Sweden
Professor and Chairman Chapter 58, Endocrine Aspects of Chronic Kidney Disease
Department of Radiology
City of Hope National Medical Center Daniel Cattran, MD, FRCP(C), FACP
Duarte, California Professor of Medicine
Chapter 28, Diagnostic Kidney Imaging University of Toronto
Senior Scientist
Barry M. Brenner, MD, AM(Hon), DSc(Hon), Toronto General Research Institute
DMSc(Hon), MD(Hon), Dipl(Hon), FRCP(London, Toronto General Hospital
Hon) Toronto, Ontario, Canada
Samuel A. Levine Distinguished Professor of Medicine Chapter 34, Overview of Therapy for Glomerular Disease
Harvard Medical School
Director Emeritus, Renal Division, and Senior Physician James C. M. Chan, MD
Department of Medicine Professor of Pediatrics
Brigham and Women’s Hospital Tufts University School of Medicine
Boston, Massachusetts Director of Research
Chapter 3, The Renal Circulations and Glomerular The Barbara Bush Children’s Hospital
Ultrafltration Maine Medical Center
Portland, Maine
Chapter 75, Fluid, Electrolyte, and Acid-Base Disorders
in Children
vi CONTRIBUTORS
Anil Chandraker, MD Shawn E. Cowper, MD
Associate Professor of Medicine Associate Professor of Dermatology and Pathology
Harvard Medical School Yale University
Brigham and Women’s Hospital New Haven, Connecticut
Schuster Family Transplantation Research Center Chapter 60, Dermatologic Conditions in Kidney Disease
Boston, Massachusetts
Chapter 71, Transplantation Immunobiology Paolo Cravedi, MD, PhD
IRCCS-Istituto di Ricerche Farmacologiche Mario Negri
Katrina Chau, MBBS, FRACP Centro Anna Maria Astori, Science and Technology Park
Department of Nephrology Kilometro Rosso
University of British Columbia Bergamo, Italy
Vancouver, British Columbia, Canada; Chapter 35, Microvascular and Macrovascular Diseases
Department of Nephrology of the Kidney
Liverpool Hospital
Sydney, Australia Vivette D’Agati, MD
Chapter 26, Laboratory Assessment of Kidney Disease: Professor of Pathology
Glomerular Filtration Rate, Urinalysis, and Proteinuria Columbia University College of Physicians and Surgeons
Director, Renal Pathology Laboratory
Glenn M. Chertow, MD, MPH Columbia University Medical Center
Norman S. Coplon/Satellite Healthcare New York, New York
Professor of Medicine Chapter 33, Secondary Glomerular Disease
Department of Medicine, Division of Nephrology
Stanford University School of Medicine Mogamat Razeen Davids, MD
Palo Alto, California Division of Nephrology
Chapter 84, Health Disparities in Nephrology Stellenbosch University and Tygerberg Hospital
Cape Town, South Africa
Devasmita Choudhury, MD Chapter 27, Interpretation of Electrolyte and Acid-Base
Associate Professor of Medicine Parameters in Blood and Urine
University of Virginia School of Medicine
Virginia Tech-Carilion School of Medicine Scott E. Delacroix, Jr., MD
Chief of Nephrology Assistant Professor of Urology
Director of Dialysis and Interventional Nephrology Director of Urologic Oncology
Salem Veterans Affairs Medical Center Department of Oncology
Salem, Virginia Louisiana State University School of Medicine
Chapter 24, Aging and Kidney Disease New Orleans, Louisiana
Chapter 41, Kidney Cancer
John F. Collins, MBChB, FRACP
Clinical Associate Professor of Renal Medicine Bradley M. Denker, MD
Auckland City Hospital Associate Professor of Medicine
Auckland, New Zealand Harvard Medical School
Chapter 82, Oceania Region Clinical Chief, Renal Division
Beth Israel Deaconess Medical Center
H. Terence Cook, MB, BS, FRCPath Boston, Massachusetts
Professor, Department of Medicine Chapter 68, Plasmapheresis
Centre for Complement and Infammation Research
Imperial College London Thomas A. Depner, MD
Hammersmith Hospital Professor of Medicine
London, United Kingdom Department of Internal Medicine/Nephrology
Chapter 29, The Kidney Biopsy University of California Davis Health System
Sacramento, California
Ricardo Correa-Rotter, MD Chapter 65, Hemodialysis
Head, Department of Nephrology and Mineral
Metabolism Thomas D. DuBose, Jr., MD
Instituto Nacional de Ciencias Médicas y Nutrición Professor Emeritus of Medicine
Salvador Zubirán Department of Internal Medicine
Mexico City, Mexico Wake Forest School of Medicine
Chapter 66, Peritoneal Dialysis Winston-Salem, North Carolina
Chapter 17, Disorders of Acid-Base Balance
CONTRIBUTORS vii
Vinay A. Duddalwar, MD, FRCR Harold I. Feldman, MD, MSCE
Associate Professor of Clinical Radiology and Urology Professor of Epidemiology and Medicine
Section Chief, Abdominal Imaging Perelman School of Medicine
Medical Director, Imaging University of Pennsylvania
USC Norris Comprehensive Cancer Center and Hospital Philadelphia, Pennyslvania
University of Southern California Chapter 21, Demographics of Kidney Disease
Keck School of Medicine
Los Angeles, California Bo Feldt-Rasmussen, MD, DMSc
Chapter 28, Diagnostic Kidney Imaging Professor and Head of Clinic
Department of Nephrology
Kai-Uwe Eckardt, MD Rigshospitalet University of Copenhagen
Professor of Medicine Copenhagen, Denmark
Chair of Nephrology and Hypertension Chapter 39, Diabetic Nephropathy
Friedrich-Alexander University Erlangen-Nürnberg
Erlangen, Germany Robert A. Fenton, PhD
Chapter 57, Hematologic Aspects of Kidney Disease Professor of Molecular Cell Biology
Department of Biomedicine
Meghan J. Elliott, MD Aarhus University
Nephrology Resident Aarhus, Denmark
Department of Medicine Chapter 2, Anatomy of the Kidney
University of Calgary Chapter 10, Urine Concentration and Dilution
Calgary, Alberta, Canada Chapter 11, The Cell Biology of Vasopressin Action
Chapter 85, Care of the Older Adult with Chronic
Kidney Disease Andrew Z. Fenves, MD, FACP, FASN
Inpatient Clinical Educator
William J. Elliott, MD, PhD Massachusetts General Hospital
Professor of Preventive Medicine Associate Professor of Medicine
Internal Medicine and Pharmacology Harvard Medical School
Pacifc Northwest University of Health Sciences Boston, Massachusetts
Yakima, Washington Chapter 25, Approach to the Patient with Kidney Disease
Chapter 47, Primary and Secondary Hypertension
Kevin W. Finkel, MD, FACP, FASN, FCCM
David H. Ellison, MD Department of Internal Medicine
Professor of Internal Medicine Director, Division of Renal Diseases and Hypertension
Oregon Health & Science University University of Texas Health Science Center at Houston
Portland, Oregon Department of Internal Medicine
Chapter 51, Diuretics Section of Nephrology
The University of Texas MD Anderson Cancer Center
Michael Emmett, MD Houston, Texas
Chief of Internal Medicine Chapter 42, Onco-Nephrology: Kidney Disease in Patients
Department of Internal Medicine with Cancer
Baylor University Medical Center
Dallas, Texas; Paola Fioretto, MD
Professor of Medicine Associate Professor
Internal Medicine Department of Medical and Surgical Sciences
Texas A&M College of Medicine University of Padova Medical School
Baylor University Medical Center Padova, Italy
Denton, Texas; Chapter 39, Diabetic Nephropathy
Clinical Professor of Medicine
University of Texas Southwestern Medical School Damian G. Fogarty, BSc, MD, FRCP
Dallas, Texas Consultant Nephrologist
Chapter 25, Approach to the Patient with Kidney Disease Regional Nephrology and Transplant Unit
Belfast City Hospital at the Belfast Health and
Ronald J. Falk, MD Social Care Trust
Chair, Department of Medicine Belfast, Northern Ireland
Director, UNC Kidney Center Chapter 62, A Stepped Care Approach to the Management of
The University of North Carolina Chronic Kidney Disease
Chapel Hill, North Carolina
Chapter 32, Primary Glomerular Disease
viii CONTRIBUTORS
Denis Fouque, MD, PhD Mitchell L. Halperin, MD
Professor of Nephrology Division of Nephrology
Chief, Division of Nephrology St. Michael’s Hospital
Université Claude Bernard and Centre Hospitalier Lyon University of Toronto
Sud Toronto, Canada
Lyon, France Chapter 27, Interpretation of Electrolyte and Acid-Base
Chapter 61, Dietary Approaches to Kidney Diseases Parameters in Blood and Urine
Yaacov Frishberg, MD Donna S. Hanes, MD, FACP
Director, Pediatric Nephrology Clinical Associate Professor of Medicine
Shaare Zedek Medical Center Clerkship Director, Internal Medicine
The Hebrew University School of Medicine University of Maryland Medical Systems
Jerusalem, Israel Baltimore, Maryland
Chapter 76, Renal Replacement Therapy (Dialysis and Chapter 50, Antihypertensive Therapy
Transplantation) in Pediatric End-Stage Kidney Disease
Chuan-Ming Hao, MD
Jørgen Frøkiaer, MD, DMSci Professor
Head of Department of Nuclear Medicine and Medicine/Nephrology
Molecular Imaging Huashan Hospital Fudan University
Department of Clinical Medicine Shanghai, China
Aarhus University and Aarhus University Hospital Chapter 81, The Far East
Aarhus, Denmark
Chapter 38, Urinary Tract Obstruction David C. H. Harris, MD, BS, FRACP
Associate Dean and Head of School
John W. Funder, MD, PhD, FRCP, FRACP Sydney Medical School—Westmead
Distinguished Scholar The University of Sydney
Steroid Biology Sydney, New South Wales, Australia
Hudson Institute of Medical Research Chapter 82, Oceania Region
Clayton, Victoria, Australia
Chapter 12, Aldosterone and Mineralocorticoid Receptors: Peter C. Harris, PhD
Renal and Extrarenal Roles Professor of Biochemistry/Molecular Biology
Professor of Medicine
Marc Ghannoum, MD Nephrology and Hypertension
Associate Professor Mayo Clinic
Specialized Medicine Rochester, Minnesota
University of Montréal Chapter 46, Cystic Diseases of the Kidney
Verdun Hospital
Montréal, Quebec, Canada Raymond C. Harris, MD
Chapter 69, Elimination Enhancement of Poisons Ann and Roscoe Robinson Professor of Medicine
Chief, Division of Nephrology and Hypertension
Richard E. Gilbert, MBBS, PhD, FRACP, FRCPC, Vanderbilt University School of Medicine
FACP, FASN Nashville, Tennessee
Professor of Medicine Chapter 14, Arachidonic Acid Metabolites and the Kidney
University of Toronto
St. Michael’s Hospital Richard Haynes, DM, FRCP
Toronto, Ontario, Canada Associate Professor
Chapter 13, Vasoactive Molecules and the Kidney Clinical Trial Service Unit and Epidemiological
Studies Unit
Paul Goodyer, MD Nuffeld Department of Population Health
Professor of Pediatrics Honorary Consultant in Nephrology
McGill University Oxford Kidney Unit
Montréal, Quebec, Canada Churchill Hospital
Chapter 23, Nephron Endowment and Developmental Oxford, United Kingdom
Programming of Blood Pressure and Renal Function Chapter 56, Cardiovascular Aspects of Kidney Disease
Yoshio N. Hall, MD, MS Brenda R. Hemmelgarn, MD, PhD
Associate Professor of Medicine Professor of Medicine
Department of Medicine, Division of Nephrology University of Calgary
University of Washington Calgary, Alberta, Canada
Seattle, Washington Chapter 85, Care of the Older Adult with Chronic
Chapter 84, Health Disparities in Nephrology Kidney Disease
CONTRIBUTORS ix
Friedhelm Hildebrandt, MD Holly Hutton, MBBS, FRACP
Warren E. Grupe Professor of Pediatrics Department of Nephrology
Harvard Medical School University of British Columbia
Investigator, Howard Hughes Medical Institute Vancouver, British Columbia, Canada;
Chief, Division of Nephrology Department of Nephrology
Boston Children’s Hospital Monash Health
Boston, Massachusetts Clayton, Victoria, Australia
Chapter 43, Genetic Basis of Kidney Disease Chapter 26, Laboratory Assessment of Kidney Disease:
Glomerular Filtration Rate, Urinalysis, and Proteinuria
Michelle A. Hladunewich, MD, MSc
Associate Professor of Medicine Hossein Jadvar, MD, PhD, MPH, MBA, FACNM
University of Toronto Associate Professor of Radiology
Scientist, Sunnybrook Research Institute Associate Professor of Biomedical Engineering
Sunnybrook Health Sciences Centre University of Southern California
Toronto, Ontario, Canada Keck School of Medicine
Chapter 34, Overview of Therapy for Glomerular Disease Los Angeles, California
Chapter 28, Diagnostic Kidney Imaging
Kevin Ho, MD
Associate Professor of Medicine & Clinical and J. Charles Jennette, MD
Translational Science Kenneth M. Brinkhous Distinguished Professor and Chair
Renal-Electrolyte Division Department of Pathology and Laboratory Medicine
University of Pittsburgh The University of North Carolina
Pittsburgh, Pennsylvania Chapel Hill, North Carolina
Chapter 87, Quality Improvement Initiatives in Kidney Disease Chapter 32, Primary Glomerular Disease
Ewout J. Hoorn, MD, PhD Eric Jonasch, MD
Associate Professor Associate Professor
Department of Internal Medicine, Division of Nephrology Department of Genitourinary Medical Oncology
and Transplantation Division of Cancer Medicine
Erasmus Medical Center The University of Texas MD Anderson Cancer Center
Rotterdam, The Netherlands Houston, Texas
Chapter 51, Diuretics Chapter 41, Kidney Cancer
Thomas H. Hostetter, MD Kamel S. Kamel, MD
Professor of Medicine Division of Nephrology
Case Western Reserve University School of Medicine St. Michael’s Hospital
Vice Chairman, Research Services University of Toronto
University Hospitals Case Medical Center Toronto, Canada
Cleveland, Ohio Chapter 27, Interpretation of Electrolyte and Acid-Base
Chapter 54, The Pathophysiology of Uremia Parameters in Blood and Urine
Fan-Fan Hou, MD S. Ananth Karumanchi, MD
Director of Guangdong Provincial Institute of Nephrology Professor
Chief and Professor of Division of Nephrology Department of Medicine, Obstetrics, and Gynecology
Nanfang Hospital Harvard Medical School
Professor of Medicine Howard Hughes Medical Institute and Beth Israel
Southern Medical University Deaconess Medical Center
Guangzhou, China Boston, Massachusetts
Chapter 81, The Far East Chapter 49, Hypertension and Kidney Disease in Pregnancy
Chi-yuan Hsu, MD Frieder Keller, MD
Professor and Division Chief Professor of Nephrology
Division of Nephrology Department of Internal Medicine 1
University of California, San Francisco Ulm University
San Francisco, California Ulm, Germany
Chapter 20, Epidemiology of Kidney Disease Chapter 64, Drug Dosing Considerations in Patients with
Acute Kidney Injury and Chronic Kidney Disease
Raymond K. Hsu, MD
Assistant Professor of Medicine
Division of Nephrology
University of California, San Francisco
San Francisco, California
Chapter 20, Epidemiology of Kidney Disease
