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Papper's Clinical Nephrology
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Third edition. Francisco Llach. 596 pages. Boston: Little, Brown; 1993. $90.00.
This text updates a classic clinical nephrology reference for primary care physicians, housestaff, or medical students. It is a general renal text that is broad in scope, although not detailed enough to serve as a reference for the practicing nephrologist. The selected reading lists at the end of each chapter focus on specific topics and are particularly useful because they include classic papers as well as representative current literature.
Each topic is presented in a readable format that proceeds logically from the key elements of structural and functional abnormalities to clinical features and differential diagnosis and concludes with treatment recommendations. The final chapter is a useful and current handbook of tests, procedures, and treatments; the treatment section focuses on drug dosage adjustments necessary for renal failure management and appropriate dietary manipulation.
As is true of many texts in this rapidly advancing field, this book has sections in need of revision at publication. For example, diabetic renal disease, which afflicts more than one third of all patients with end-stage renal disease who require dialysis or transplantation services, is only allotted nine pages, and these pages neglect the role of angiotensin-converting enzyme inhibitors in slowing the progression of diabetic glomerulosclerosis. Peritoneal dialysis accounts for the treatment of 6% to 50% of patients who have end-stage renal failure, but it is covered here in a single paragraph.
Despite these deficiencies, understandable in a relatively small text that deals with a burgeoning subject, the book is highly readable, fact-filled and recommended for the student, resident, or primary care physician.
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