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	<section class="book">

		<h1 class="catchCopy">ズバリ，CKD患者はこう診る！患者を末期腎不全にしないための診療のコツ</h1>
		

		<h2 class="series">BEAM（Bunkodo Essential & Advanced Mook）&nbsp;&nbsp;</h2>
		<h1 class="copy">患者を末期腎不全にしないための</h1>
		<h1 class="title">CKD診療のコツ（電子版のみ）<span class="version"></span></h1>
		

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					編集：今井圓裕（中山寺いまいクリニック院長）
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				<ul class="property"><li class="disc">B5判・260頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-8151-6</li><li class="disc">2013年5月6日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">若手医師が求める日常診療のエッセンスをよりすぐり，かつ一歩進んだ知識を提供するムックシリーズ第11弾．レジデントがＣＫＤ患者を受け持った時，どうマネジメントしてゆけばよいか？ＣＫＤから末期腎不全へ進展させずに管理するための診療のコツを，『ＣＫＤ診療ガイド2012』に準拠しわかりやすく解説．初期～後期研修医が自分のレベルに応じて理解していけるようステップを踏んで学べる目次構成となっている．日本のＣＫＤ診療第一人者らによるClinical Pearl満載の一冊．<br>☆図版78点，表組51点，カラー写真5点，モノクロ写真9点<br><br>▽BEAM（Bunkodo Essential &amp; Advanced Mook）編集委員会<br>　宮地良樹（京都大学皮膚科教授）<br>　上田裕一（名古屋大学心臓血管外科教授）<br>　郡　義明（天理よろづ相談所病院総合診療部長）<br>　服部隆一（市立島田市民病院院長）</section><section class="preface">新しいCKD の治療を知るために<br><br>　CKD（慢性腎臓病）の定義が2002年に提唱されてから10年がたち，その内容に関する再評価がなされ，CKD に関連するガイドラインがIGO（Kidney Disease：Improving Global Outcomes）から2012年に4種類出版された．1つは，CKDの定義と重症度分類，マネジメントに関するものである．従来，CKDの重症度はGFRのみで評価していたが，新しく原因（cause），腎機能（GFR），蛋白尿（アルブミン尿）に基づいたCGA分類による評価へと変更された．GFRステージ3（GFR30〜59mL/分/1.73m<sup>2</sup>）は，45mL/分/1.73m<sup>2</sup>でG3aとG3bの2つに分けられた．重症度分類の図はその程度に応じて色分けされており，リスクが最も低い状態を緑とし，以降，黄，オレンジ，赤の順にリスクが高くなる．これ以外に，<br>腎炎の診断と治療に関するガイドライン，CKD患者の貧血に関するガイドライン，CKD患者の血圧に関するガイドラインが出版されている．<br>　このCKD診療の大変革ともいえるガイドライン改訂を，わが国のCKD診療に反映させるために『CKD診療ガイド』の発行が日本腎臓学会で決定されたのは2010年であった．日本文化の特色である換骨奪胎の精神で，単にKDIGOのガイドラインを翻訳して提供するのではなく，日本人のCKD診療を改善する好機と捉えて，わが国の診療にふさわしいCKD診療ガイドの作成が使命であった．たとえばGFR（糸球体濾過量）は日本人の血清クレアチニンの推算式（eGFRcreat）で推算することを推奨し，るい痩または下肢切断者などの筋肉量が極端に少ない患者については，シスタチンCの推算式eGFRcys）の使用を推奨した．また重症度はアルブミン尿定量で分類されるが，糖尿病患者以外は保険適用の範囲を考慮し，蛋白尿で評価することとした．<br>　本書は，末期腎不全にしないために，新しく変わったCKD診療におけるコツを研修医にわかりやすく伝えることを意図したものである．執筆者の多くはCKD診療のエキスパートである．本書を読むことにより最新のCKD診療に関するこれらエキスパートの直接の指導を実感していただきたい．<br><br>平成25年5月吉日<br>中山寺いまいクリニック 院長<br>今井圓裕</section><section class="indexes">I.　CKDとはどんな病気ですか？　　　　　　　<br>　1．総論　CKDとはどんなもの？<br>　2．糖尿病合併CKD患者は気をつけろ　  <br>　3．慢性腎炎の診療は難しくない	    <br>　4．腎代替療法をいつ、どのようにインフォームドコンセントするか？<br>　ミニレクチャー　ここが違うよCKD診療～診療の常識・非常識～<br>II.　初期研修医でもこれだけは知っておきたい　　　　　　　　　　　　　　<br>　1. CKD患者の検査結果を解釈する・腎機能を評価する<br>　2．高血圧管理の考え方は？　<br>　ミニレクチャー  利尿薬の使い方は？    <br>　ミニレクチャー  RAS阻害薬の使い方のコツ<br>　3．CKD患者の糖尿病管理はここが違う　<br>　ミニレクチャー　糖尿病CKD患者の食事療法は高カロリー？<br>　4．食事・栄養評価はどうする？　	   <br>　5．CKD患者への投薬はここに気をつけろ！　<br>　ミニレクチャー　造影剤腎症を起こさないために　<br>　6．電解質がおかしい？	　<br>　7．骨・ミネラル代謝異常にどう対処するか？　<br>　8．CKD患者の酸塩基平衡を理解しよう   <br>　9．腎性貧血の管理はどうする？　　　 <br>　10．難しくない体液量の評価　　 　<br>III.　代表的な疾患別のマネジメント　　　　　　　　　　　　　　　　　　　　　　　<br>　1．IgA腎症はどう治療する？	    <br>　2．ネフローゼ症候群はどう治療する？ <br>　ミニレクチャー　ネフローゼ症候群でない膜性腎症はどう治療するか?<br>　ミニレクチャー　CKD患者の脂質異常治療薬の投与法は?<br>　3．腎硬化症をどう診断し､治療するか?　 <br>　4．多発性嚢胞腎の診療チェックポイント <br>　ミニレクチャー　CKD患者の高尿酸血症について　　<br>　ミニレクチャー　 血栓性微血管障害って何？　 	 <br>IV.　Step Up!  腎臓専門医をめざす後期研修医はこれができる 　　　　　<br>　1．急激に腎機能が低下した時にどうする？（AKI合併）<br>　2．虚血性心疾患を合併した場合はどうする？  <br>　3．アミロイドーシスによるCKDをどう診るか? <br>　4．ループス腎炎によるCKDはどう治療するか?<br>　5．ANCA関連腎炎の患者をどう治療するか？<br>　6．腎移植患者の腎機能が低下した時の対策は？<br>　7．CKD患者の感染症をどう診療する？    <br>　ミニレクチャー　CKD患者の尿路感染症、何に気を付ける？ <br>　8．妊娠したCKD患者をどう診るか？　<br>　9．高齢者のCKDをどう診るか？　       <br>　ミニレクチャー　肝硬変を合併するCKD患者はどう対応する?<br>付録：Further Readings<br>索引</section></article>
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