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Clinical Disturbances of Water Metabolism
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Donald W. Seldin and Gerhard Griebisch; eds. 295 pages. New York: Raven Press; 1993. $150.00.
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Clinical Disorders of Fluid and Electrolyte Metabolism
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Fifth edition. Robert G. Narins; ed. 1712 pages. New York: McGraw-Hill; 1993. $185.00.
Although they share the subject of fluid and electrolytes, these two books are disparate in many ways. Seldon and Griebisch's slim book has been written to provide the reader with up-to-date information on the physiology and pathophysiology of water metabolism. Composed of readable chapters ranging from 10 to 40 pages in length, it holds the reader's interest and attention throughout. The first of three sections covers normal distribution and excretion of water and has subdivisions on the internal distribution of water and the renal excretion of water. The second focuses on abnormal distribution and excretion of water and has subdivisions on the pathogenesis of abnormalities in water distribution and excretion and the clinical responses to abnormalities in water distribution. The third provides an overview of integrated renal responses to abnormalities in tonicity. The chapters overlap, but this does not detract from the book, which is packed with relevant facts and written by a distinguished group of authors who have made many contributions to our knowledge of water metabolism. I found the chapters on thirst and sodium appetite and renal osmolytes particularly important. The chapters on the clinical consequences and therapy of both hyponatremia and hypernatremia are models of clarity. The chapter by Halperin and colleagues on hyperglycemia is unorthodox, stimulating, and important. This book should be read by all nephrologists and is well worth owning.
Clinical Disorders of Fluid and Electrolyte Metabolism is a massive book; unlike the fourth edition, it has been edited solely by Dr. Narins. It is a classic, running the gamut of water and electrolyte metabolism. The first 520 pages are devoted to the physiology of water and electrolyte metabolism. Most of the 17 chapters are 20 to 40 pages in length and are easily digested. Part 2 is concerned with clinical syndromes of disordered fluid and electrolyte metabolism (32 chapters). The authors are a distinguished group of U.S. and Canadian researchers, which may explain the bias for English-language publications. All aspects of fluid and electrolyte physiology and pathophysiology are covered in depth, but there is much repetition. However, a book of this size is only read cover to cover by reviewers, and the ordinary reader will consult the book according to his or her daily interest. Thus, the repetition of basic principles in many chapters may enhance the intellectual value of this book to the fellow or attending looking up a particular point or an entire subject.
Dr. Narins has done an admirable job in continuing Maxwell and Kleeman's tradition by providing an authoritative, up-to-date description of the entire topic of fluid and electrolytes. The book's major fault is that it is a strain on the wrists, and it probably should have been published in two volumes. All practicing nephrologists should buy this edition of this multiauthor work; they will often consult it. Dr. Narins is to be congratulated for taking on the daunting task of editing this work single-handedly and for having maintained the fine standards of this fluid and electrolyte bible.
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