دانلود کتاب رویکردهای معاصر به اختلالات عروق کلیوی

Arterial hypertension is a major risk factor for cardiovascular mortality, with an extremely high prevalence among patients with renal disease. The presence of hypertension accelerates the progression of renal damage, while renal disease itself can lead to hypertension, creating a harmful vicious cycle. Both conditions synergize to promote the development and progression of cardiovascular disease. Despite clear evidence, the role of renal vasculature in these processes is often underestimated and poorly understood. Beyond the activation of the renin–angiotensin system and the autonomic nervous system, recent research has uncovered new biochemical and molecular mechanisms underlying kidney damage in hypertension. Damage to the renal microcirculation has been associated with increased oxidative stress, endothelial dysfunction, and a chronic state of subclinical infection. Understanding these mechanisms, which underlie hypertensive nephroangiosclerosis, has led to new research to control these factors. In addition to microcirculation, diseases and abnormalities of the renal large arterial and venous vessels can lead to pathological conditions that threaten systemic health. Significant advances have been made in the early identification and treatment of these conditions. The approach to atherosclerotic nephrovascular disease has evolved, emphasizing the optimization of pharmacologic intervention and reserving revascularization for selected cases, in line with personalized medicine principles based on the clinical condition of individual patients. Kidney transplantation and its associated renal vascular issues are also critical topics. Kidney transplantation is often considered the treatment of choice for eligible patients with kidney failure, offering numerous advantages over dialysis, such as decreased mortality risk, longer life expectancy, and improved quality of life. However, vascular complications in renal transplantation, including transplant renal artery stenosis, thrombosis, and biopsy-induced vascular injuries, remain relatively common and can lead to allograft damage. Understanding these complications and the perioperative vascular considerations is essential for improving patient outcomes and graft survival. Finally, recent guidelines from hypertension scientific societies have renewed the importance of renal denervation techniques for treating resistant forms of hypertension, based on the latest randomized trials. Additionally, new evidence suggests that renal denervation may provide benefits beyond treating resistant hypertension, impacting renal, arrhythmic, and metabolic diseases. This book, coordinated by two experts in the field, Prof. Adrian Covic and Prof. Alexandru Burlacu, addresses all these topics, providing a comprehensive overview of subjects that are often insufficiently known and considered. It aims to be a valuable resource of knowledge and clinical intervention, not only for nephrologists but also for cardiologists and physicians dealing with metabolic diseases.