It is not everyday you read a medical textbook that ‘breaks the mould’, but that is precisely what Doctors Rayner, Thomas and Milford have done with ‘Understanding Kidney Diseases’. Historically, renal physiology and kidney medicine have been poorly understood by medical students and junior Doctors due to the way the subjects are/were taught at medical school. This book goes a long way to remediating these deficiencies and is a must have for any medical student or junior Doctor struggling with the subject as well as for Doctors in training considering a career in renal medicine.
The physiology chapter distils some of the most complex human physiology into bite-size pieces that are written simply and clearly explained. The early chapters also give essential explanations of why the practices in renal medicine have evolved and led to the way we work today and the tests we currently use, clearly highlighting limitations to the reader. The clinical chapters in the book are organised sensibly into the syndromes encountered in renal disease (CKD, AKI etc), specific diseases that affect the kidney and systemic diseases that lead to or result from kidney disease. Once again the information is clearly laid out and well written. Importantly the authors openly discuss areas of controversy and the limitations of knowledge - where evidence based medicine ends and considered best-practice begins. The chapters contain case studies that illustrate the text and contextualise the information enhancing its relevance to the reader.
The stand-out chapter is entitled ‘Make a Plan’. In this chapter the authors give tremendous insight into the complexities of preparing a patient for dialysis or renal transplant. The authors don’t just focus on the technical/medical practicalities however, and are to be commended for giving equal focus to the psychological and social factors that require just as much attention to ensure patients have the best possible experience of their care. They consider the roles of all members of the allied health professionals who contribute so much to the care of patients with renal disease and the chapter is a testament to modern multi-disciplinary team working.
In this book the authors don’t just manage to impart knowledge and information, but a careers’ worth of experience. This book can be used well as a reference tool, but is better read cover-to-cover, as subtle experiences and explanations embroidered with personal anecdotes and experiences that act as ‘aide-memoires’ are scattered throughout.
Dr Matthew Graham-Brown
BSc, MBChB (hons), MRCP(UK)
Specialist Registrar and Doctoral Research Fellow Renal Medicine, The John Walls Renal Unit, Leicester General Hospital and the National Centre for Sports and Exercise Medicine, Loughborough University
Co-founder and Junior Editor RenalMed.co.uk (www.renalmed.co.uk)