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Clinical paediatric nephrology, 3rd edition
  1. M Hamilton-Ayres

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    Edited by Nicholas Webb and Robert Postlethwaite. Oxford: Oxford University Press, 2003. Hardback, pp 509, £85.00. ISBN 0 19 26328

    Since its first publication in 1986, Clinical paediatric nephrology has been “the” reference textbook on the subject that seems to create a great deal of anxiety in general paediatric departments. This, the third edition, is truly comprehensive and provides extremely clear, child focused guidance to any professional interested and involved in paediatric care. It represents a total rethink of the last edition which was published in 1994. Its attractive red and yellow book cover, with the charming schoolgirl drawings about a child in hospital contrast with the earlier “scanning electron micrograph of a normal rat glomerular capillary loop” and dramatically announce these differences. Nicholas Webb now joins Robert Postlewhaite as editor and the number of contributors, all internationally well known in their field, has increased to 50. The second edition’s 32 chapters and 398 pages have been completely revised and rewritten, providing this edition with 28 chapters and 509 pages.

    The chapters all follow a problem solving approach, focusing on presenting clinical symptoms in the child. Whether you are a general practitioner, paediatrician, nephrologist, urologist, or intensivist, trainee or qualified, doctor or even clinical nurse specialist, the clear algorithms simplify even the most daunting of problems. All chapters are referenced and where evidence is lacking or controversy exists, a clear “take home” opinion is provided. Layout and typography are clean, clear, and structured, while key point boxes highlight important messages. Illustrative case histories further emphasise the guidance provided. Up to date information is provided on all common renal and urological presenting symptoms. “How and when to measure blood pressure” is an essential read for anyone examining a child. In “Imaging in paediatric nephrology” the reader is reminded that liaison with the clinical team involved in managing the child is paramount. Rather than dwell on complicated algorithms for investigations of common problems, this chapter reviews each investigation in detail. Dosimetry, a subject that many parents ask about these days, is also covered.

    The words “nephrotic” and “nephritic” often raise apprehension among non-nephrologists. Even Microsoft Word spellchecker rejects the word “nephrotic” in favour of “nephritic”. In this edition, two relevant chapters help in understanding all aspects of these two presenting problems. “The child with nephrotic syndrome” combines two chapters from the previous edition to facilitate practical use, and this is successful, although case studies would have been interesting here. “The child with acute nephritic syndrome”, a new chapter, together with “The child with acute renal failure”, illustrate how well a text can address itself to clinicians of all levels. Different authors have rewritten the various chapters on renal malformations, inherited renal disease, and antenatal diagnosis, and up to date information is provided, covering all aspects in satisfactory detail, often with useful reference tables and illustrations. Subjects such as disorders of micturition, the neuropathic bladder, as well as one of the most common problems encountered in paediatrics, “The child with urinary tract infection”, are presented honestly, evidence based where possible, and in a clear practical manner. “The management of chronic renal failure” now includes useful paragraphs on education and preparation to end stage renal failure. “Psychosocial care of children and their families” is a concise and yet very comprehensive new chapter, well illustrated with seven case examples. “Meeting the information needs of children and their families” brings this textbook into the 21st century and the three appendices are an invaluable and accurate resource. “Practical guidelines for drug prescribing in children with renal disease” provides information not readily available elsewhere. The chapter relating to “Paediatric nephrology in developing countries” is a humble reminder that international collaboration is essential. The final chapter provides important reference data for paediatric nephrology, and the list of abbreviations at the beginning of the book is very useful.

    Anyone involved in the care of children should ensure that this book is readily available for reference in their department library or clinical area. It is an invaluable resource companion, and while there is a current trend in paediatric textbooks to present topics in a “child focused” rather than an “academic manner”, this third edition follows that trend but does it rather better than the others.

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