Trigonometric functions

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https://en.wikipedia.org/wiki/Trigonometric_functions

 

Trigonometry

Basis of trigonometry: if two right triangles have equal acute angles, they are similar, so their side lengths are proportional.

In mathematics, the trigonometric functions (also called circular functions, angle functions or goniometric functions) are real functions which relate an angle of a right-angled triangle to ratios of two side lengths. They are widely used in all sciences that are related to geometry, such as navigation, solid mechanics, celestial mechanics, geodesy, and many others. They are among the simplest periodic functions, and as such are also widely used for studying periodic phenomena through Fourier analysis.

The trigonometric functions most widely used in modern mathematics are the sine, the cosine, and the tangent. Their reciprocals are respectively the cosecant, the secant, and the cotangent, which are less used. Each of these six trigonometric functions has a corresponding inverse function, and an analog among the hyperbolic functions.

The oldest definitions of trigonometric functions, related to right-angle triangles, define them only for acute angles. To extend the sine and cosine functions to functions whose domain is the whole real line, geometrical definitions using the standard unit circle (i.e., a circle with radius 1 unit) are often used; then the domain of the other functions is the real line with some isolated points removed. Modern definitions express trigonometric functions as infinite series or as solutions of differential equations. This allows extending the domain of sine and cosine functions to the whole complex plane, and the domain of the other trigonometric functions to the complex plane with some isolated points removed.

Notation

Conventionally, an abbreviation of each trigonometric function's name is used as its symbol in formulas. Today, the most common versions of these abbreviations are "sin" for sine, "cos" for cosine, "tan" or "tg" for tangent, "sec" for secant, "csc" or "cosec" for cosecant, and "cot" or "ctg" for cotangent. Historically, these abbreviations were first used in prose sentences to indicate particular line segments or their lengths related to an arc of an arbitrary circle, and later to indicate ratios of lengths, but as the function concept developed in the 17th–18th century, they began to be considered as functions of real-number-valued angle measures, and written with functional notation, for example sin(x). Parentheses are still often omitted to reduce clutter, but are sometimes necessary; for example the expression ${\displaystyle \sin x+y}$ would typically be interpreted to mean ${\displaystyle \sin (x)+y,}$ so parentheses are required to express ${\displaystyle \sin (x+y).}$

A positive integer appearing as a superscript after the symbol of the function denotes exponentiation, not function composition. For example ${\displaystyle {\sin }^{2}x}$ and ${\displaystyle {\sin }^2(x)}$ denote ${\displaystyle \sin (x)\cdot \sin (x),}$ not ${\displaystyle \sin (\sin x).}$ This differs from the (historically later) general functional notation in which ${\displaystyle f^2(x)=(f\circ f)(x)=f(f(x)).}$

However, the exponent ${\displaystyle -1}$ is commonly used to denote the inverse function, not the reciprocal. For example ${\displaystyle {\sin }^{-1}x}$ and ${\displaystyle {\sin }^{-1}(x)}$ denote the inverse trigonometric function alternatively written ${\displaystyle \arcsin x:}$ The equation ${\displaystyle \theta ={\sin }^{-1}x}$ implies ${\displaystyle \sin \theta =x,}$ not ${\displaystyle \theta \cdot \sin x=1.}$ In this case, the superscript could be considered as denoting a composed or iterated function, but negative superscripts other than ${\displaystyle -1}$ are not in common use.

Right-angled triangle definitions

In this right triangle, denoting the measure of angle BAC as A: sin A = a/c; cos A = b/c; tan A = a/b.

Plot of the six trigonometric functions, the unit circle, and a line for the angle θ = 0.7 radians. The points labelled 1, Sec(θ), Csc(θ) represent the length of the line segment from the origin to that point. Sin(θ), Tan(θ), and 1 are the heights to the line starting from the x-axis, while Cos(θ), 1, and Cot(θ) are lengths along the x-axis starting from the origin.

If the acute angle θ is given, then any right triangles that have an angle of θ are similar to each other. This means that the ratio of any two side lengths depends only on θ. Thus these six ratios define six functions of θ, which are the trigonometric functions. In the following definitions, the hypotenuse is the length of the side opposite the right angle, opposite represents the side opposite the given angle θ, and adjacent represents the side between the angle θ and the right angle.

sine ${\displaystyle \sin \theta =\frac{\mathrm{o}\mathrm{p}\mathrm{p}\mathrm{o}\mathrm{s}\mathrm{i}\mathrm{t}\mathrm{e}}{\mathrm{h}\mathrm{y}\mathrm{p}\mathrm{o}\mathrm{t}\mathrm{e}\mathrm{n}\mathrm{u}\mathrm{s}\mathrm{e}}}$	cosecant ${\displaystyle \csc \theta =\frac{\mathrm{h}\mathrm{y}\mathrm{p}\mathrm{o}\mathrm{t}\mathrm{e}\mathrm{n}\mathrm{u}\mathrm{s}\mathrm{e}}{\mathrm{o}\mathrm{p}\mathrm{p}\mathrm{o}\mathrm{s}\mathrm{i}\mathrm{t}\mathrm{e}}}$
cosine ${\displaystyle \cos \theta =\frac{\mathrm{a}\mathrm{d}\mathrm{j}\mathrm{a}\mathrm{c}\mathrm{e}\mathrm{n}\mathrm{t}}{\mathrm{h}\mathrm{y}\mathrm{p}\mathrm{o}\mathrm{t}\mathrm{e}\mathrm{n}\mathrm{u}\mathrm{s}\mathrm{e}}}$	secant ${\displaystyle \sec \theta =\frac{\mathrm{h}\mathrm{y}\mathrm{p}\mathrm{o}\mathrm{t}\mathrm{e}\mathrm{n}\mathrm{u}\mathrm{s}\mathrm{e}}{\mathrm{a}\mathrm{d}\mathrm{j}\mathrm{a}\mathrm{c}\mathrm{e}\mathrm{n}\mathrm{t}}}$
tangent ${\displaystyle \tan \theta =\frac{\mathrm{o}\mathrm{p}\mathrm{p}\mathrm{o}\mathrm{s}\mathrm{i}\mathrm{t}\mathrm{e}}{\mathrm{a}\mathrm{d}\mathrm{j}\mathrm{a}\mathrm{c}\mathrm{e}\mathrm{n}\mathrm{t}}}$	cotangent ${\displaystyle \cot \theta =\frac{\mathrm{a}\mathrm{d}\mathrm{j}\mathrm{a}\mathrm{c}\mathrm{e}\mathrm{n}\mathrm{t}}{\mathrm{o}\mathrm{p}\mathrm{p}\mathrm{o}\mathrm{s}\mathrm{i}\mathrm{t}\mathrm{e}}}$

In a right-angled triangle, the sum of the two acute angles is a right angle, that is, 90° or π/2 radians. Therefore ${\displaystyle \sin (\theta )}$ and ${\displaystyle \cos ({90}^{\circ }-\theta )}$ represent the same ratio, and thus are equal. This identity and analogous relationships between the other trigonometric functions are summarized in the following table.

Top: Trigonometric function sin θ for selected angles θ, π − θ, π + θ, and 2π − θ in the four quadrants.
Bottom: Graph of sine function versus angle. Angles from the top panel are identified.

Summary of relationships between trigonometric functions

Function	Description	Relationship
		using radians	using degrees
sine	opposite/hypotenuse	${\displaystyle \sin \theta =\cos \left(\frac{\pi }{2}-\theta \right)=\frac{1}{\csc \theta }}$	${\displaystyle \sin x=\cos \left({90}^{\circ }-x\right)=\frac{1}{\csc x}}$
cosine	adjacent/hypotenuse	${\displaystyle \cos \theta =\sin \left(\frac{\pi }{2}-\theta \right)=\frac{1}{\sec \theta }}$	${\displaystyle \cos x=\sin \left({90}^{\circ }-x\right)=\frac{1}{\sec x}}$
tangent	opposite/adjacent	${\displaystyle \tan \theta =\frac{\sin \theta }{\cos \theta }=\cot \left(\frac{\pi }{2}-\theta \right)=\frac{1}{\cot \theta }}$	${\displaystyle \tan x=\frac{\sin x}{\cos x}=\cot \left({90}^{\circ }-x\right)=\frac{1}{\cot x}}$
cotangent	adjacent/opposite	${\displaystyle \cot \theta =\frac{\cos \theta }{\sin \theta }=\tan \left(\frac{\pi }{2}-\theta \right)=\frac{1}{\tan \theta }}$	${\displaystyle \cot x=\frac{\cos x}{\sin x}=\tan \left({90}^{\circ }-x\right)=\frac{1}{\tan x}}$
secant	hypotenuse/adjacent	${\displaystyle \sec \theta =\csc \left(\frac{\pi }{2}-\theta \right)=\frac{1}{\cos \theta }}$	${\displaystyle \sec x=\csc \left({90}^{\circ }-x\right)=\frac{1}{\cos x}}$
cosecant	hypotenuse/opposite	${\displaystyle \csc \theta =\sec \left(\frac{\pi }{2}-\theta \right)=\frac{1}{\sin \theta }}$	${\displaystyle \csc x=\sec \left({90}^{\circ }-x\right)=\frac{1}{\sin x}}$

Radians versus degrees

In geometric applications, the argument of a trigonometric function is generally the measure of an angle. For this purpose, any angular unit is convenient. One common unit is degrees, in which a right angle is 90° and a complete turn is 360° (particularly in elementary mathematics).

However, in calculus and mathematical analysis, the trigonometric functions are generally regarded more abstractly as functions of real or complex numbers, rather than angles. In fact, the functions sin and cos can be defined for all complex numbers in terms of the exponential function, via power series, or as solutions to differential equations given particular initial values (see below), without reference to any geometric notions. The other four trigonometric functions (tan, cot, sec, csc) can be defined as quotients and reciprocals of sin and cos, except where zero occurs in the denominator. It can be proved, for real arguments, that these definitions coincide with elementary geometric definitions if the argument is regarded as an angle given in radians. Moreover, these definitions result in simple expressions for the derivatives and indefinite integrals for the trigonometric functions. Thus, in settings beyond elementary geometry, radians are regarded as the mathematically natural unit for describing angle measures.

When radians (rad) are employed, the angle is given as the length of the arc of the unit circle subtended by it: the angle that subtends an arc of length 1 on the unit circle is 1 rad (≈ 57.3°), and a complete turn (360°) is an angle of 2π (≈ 6.28) rad. For real number x, the notations sin x, cos x, etc. refer to the value of the trigonometric functions evaluated at an angle of x rad. If units of degrees are intended, the degree sign must be explicitly shown (e.g., sin x°, cos x°, etc.). Using this standard notation, the argument x for the trigonometric functions satisfies the relationship x = (180x/π)°, so that, for example, sin π = sin 180° when we take x = π. In this way, the degree symbol can be regarded as a mathematical constant such that 1° = π/180 ≈ 0.0175.

Unit-circle definitions

In this illustration, the six trigonometric functions of an arbitrary angle θ are represented as Cartesian coordinates of points related to the unit circle. The ordinates of A, B and D are sin θ, tan θ and csc θ, respectively, while the abscissas of A, C and E are cos θ, cot θ and sec θ, respectively.

Signs of trigonometric functions in each quadrant. The mnemonic "all science teachers (are) crazy" lists the functions which are positive from quadrants I to IV. This is a variation on the mnemonic "All Students Take Calculus".

The six trigonometric functions can be defined as coordinate values of points on the Euclidean plane that are related to the unit circle, which is the circle of radius one centered at the origin O of this coordinate system. While right-angled triangle definitions allow for the definition of the trigonometric functions for angles between 0 and $\frac{\pi }{2}$ radians (90°), the unit circle definitions allow the domain of trigonometric functions to be extended to all positive and negative real numbers.

Let ${\displaystyle \mathcal{L}}$ be the ray obtained by rotating by an angle θ the positive half of the x-axis (counterclockwise rotation for ${\displaystyle \theta >0,}$ and clockwise rotation for ${\displaystyle \theta <0}$). This ray intersects the unit circle at the point ${\displaystyle \mathrm{A}=(x_{\mathrm{A}},y_{\mathrm{A}}).}$ The ray ${\displaystyle \mathcal{L},}$ extended to a line if necessary, intersects the line of equation ${\displaystyle x=1}$ at point ${\displaystyle \mathrm{B}=(1,y_{\mathrm{B}}),}$ and the line of equation ${\displaystyle y=1}$ at point ${\displaystyle \mathrm{C}=(x_{\mathrm{C}},1).}$ The tangent line to the unit circle at the point A, is perpendicular to ${\displaystyle \mathcal{L},}$ and intersects the y- and x-axes at points ${\displaystyle \mathrm{D}=(0,y_{\mathrm{D}})}$ and ${\displaystyle \mathrm{E}=(x_{\mathrm{E}},0).}$ The coordinates of these points give the values of all trigonometric functions for any arbitrary real value of θ in the following manner.

The trigonometric functions cos and sin are defined, respectively, as the x- and y-coordinate values of point A. That is,

${\displaystyle \cos \theta =x_{\mathrm{A}}}$ and ${\displaystyle \sin \theta =y_{\mathrm{A}}.}$

In the range ${\displaystyle 0\le \theta \le \pi /2}$, this definition coincides with the right-angled triangle definition, by taking the right-angled triangle to have the unit radius OA as hypotenuse. And since the equation ${\displaystyle x^2+y^2=1}$ holds for all points ${\displaystyle \mathrm{P}=(x,y)}$ on the unit circle, this definition of cosine and sine also satisfies the Pythagorean identity.

${\displaystyle {\cos }^2\theta +{\sin }^2\theta =1.}$

The other trigonometric functions can be found along the unit circle as

${\displaystyle \tan \theta =y_{\mathrm{B}}}$ and ${\displaystyle \cot \theta =x_{\mathrm{C}},}$

${\displaystyle \csc \theta =y_{\mathrm{D}}}$ and ${\displaystyle \sec \theta =x_{\mathrm{E}}.}$

By applying the Pythagorean identity and geometric proof methods, these definitions can readily be shown to coincide with the definitions of tangent, cotangent, secant and cosecant in terms of sine and cosine, that is

${\displaystyle \tan \theta =\frac{\sin \theta }{\cos \theta },\cot \theta =\frac{\cos \theta }{\sin \theta },\sec \theta =\frac{1}{\cos \theta },\csc \theta =\frac{1}{\sin \theta }.}$

Trigonometric functions: Sine, Cosine, Tangent, Cosecant (dotted), Secant (dotted), Cotangent (dotted) – animation

Since a rotation of an angle of ${\displaystyle \pm 2\pi }$ does not change the position or size of a shape, the points A, B, C, D, and E are the same for two angles whose difference is an integer multiple of ${\displaystyle 2\pi }$. Thus trigonometric functions are periodic functions with period ${\displaystyle 2\pi }$. That is, the equalities

${\displaystyle \sin \theta =\sin \left(\theta +2k\pi \right)}$ and ${\displaystyle \cos \theta =\cos \left(\theta +2k\pi \right)}$

hold for any angle θ and any integer k. The same is true for the four other trigonometric functions. By observing the sign and the monotonicity of the functions sine, cosine, cosecant, and secant in the four quadrants, one can show that ${\displaystyle 2\pi }$ is the smallest value for which they are periodic (i.e., ${\displaystyle 2\pi }$ is the fundamental period of these functions). However, after a rotation by an angle ${\displaystyle \pi }$, the points B and C already return to their original position, so that the tangent function and the cotangent function have a fundamental period of ${\displaystyle \pi }$. That is, the equalities

${\displaystyle \tan \theta =\tan (\theta +k\pi )}$ and ${\displaystyle \cot \theta =\cot (\theta +k\pi )}$

hold for any angle θ and any integer k.

Algebraic values

The unit circle, with some points labeled with their cosine and sine (in this order), and the corresponding angles in radians and degrees.

The algebraic expressions for the most important angles are as follows:

${\displaystyle \sin 0=\sin 0^{\circ }=\frac{\sqrt{0}}{2}=0}$ (zero angle)

${\displaystyle \sin \frac{\pi }{6}=\sin {30}^{\circ }=\frac{\sqrt{1}}{2}=\frac{1}{2}}$

${\displaystyle \sin \frac{\pi }{4}=\sin {45}^{\circ }=\frac{\sqrt{2}}{2}=\frac{1}{\sqrt{2}}}$

${\displaystyle \sin \frac{\pi }{3}=\sin {60}^{\circ }=\frac{\sqrt{3}}{2}}$

${\displaystyle \sin \frac{\pi }{2}=\sin {90}^{\circ }=\frac{\sqrt{4}}{2}=1}$ (right angle)

Writing the numerators as square roots of consecutive non-negative integers, with a denominator of 2, provides an easy way to remember the values.

Such simple expressions generally do not exist for other angles which are rational multiples of a right angle.

• For an angle which, measured in degrees, is a multiple of three, the exact trigonometric values of the sine and the cosine may be expressed in terms of square roots. These values of the sine and the cosine may thus be constructed by ruler and compass.
• For an angle of an integer number of degrees, the sine and the cosine may be expressed in terms of square roots and the cube root of a non-real complex number. Galois theory allows a proof that, if the angle is not a multiple of 3°, non-real cube roots are unavoidable.
• For an angle which, expressed in degrees, is a rational number, the sine and the cosine are algebraic numbers, which may be expressed in terms of nth roots. This results from the fact that the Galois groups of the cyclotomic polynomials are cyclic.
• For an angle which, expressed in degrees, is not a rational number, then either the angle or both the sine and the cosine are transcendental numbers. This is a corollary of Baker's theorem, proved in 1966.

Simple algebraic values

Main article: Exact trigonometric values § Common angles

The following table lists the sines, cosines, and tangents of multiples of 15 degrees from 0 to 90 degrees.

Angle, θ, in		${\displaystyle \sin (\theta )}$	${\displaystyle \cos (\theta )}$	${\displaystyle \tan (\theta )}$
radians	degrees
${\displaystyle 0}$	${\displaystyle 0^{\circ }}$	${\displaystyle 0}$	${\displaystyle 1}$	${\displaystyle 0}$
${\displaystyle \frac{\pi }{12}}$	${\displaystyle {15}^{\circ }}$	${\displaystyle \frac{\sqrt{6}-\sqrt{2}}{4}}$	${\displaystyle \frac{\sqrt{6}+\sqrt{2}}{4}}$	${\displaystyle 2-\sqrt{3}}$
${\displaystyle \frac{\pi }{6}}$	${\displaystyle {30}^{\circ }}$	${\displaystyle \frac{1}{2}}$	${\displaystyle \frac{\sqrt{3}}{2}}$	${\displaystyle \frac{\sqrt{3}}{3}}$
${\displaystyle \frac{\pi }{4}}$	${\displaystyle {45}^{\circ }}$	${\displaystyle \frac{\sqrt{2}}{2}}$	${\displaystyle \frac{\sqrt{2}}{2}}$	${\displaystyle 1}$
${\displaystyle \frac{\pi }{3}}$	${\displaystyle {60}^{\circ }}$	${\displaystyle \frac{\sqrt{3}}{2}}$	${\displaystyle \frac{1}{2}}$	${\displaystyle \sqrt{3}}$
${\displaystyle \frac{5\pi }{12}}$	${\displaystyle {75}^{\circ }}$	${\displaystyle \frac{\sqrt{6}+\sqrt{2}}{4}}$	${\displaystyle \frac{\sqrt{6}-\sqrt{2}}{4}}$	${\displaystyle 2+\sqrt{3}}$
${\displaystyle \frac{\pi }{2}}$	${\displaystyle {90}^{\circ }}$	${\displaystyle 1}$	${\displaystyle 0}$	Undefined

In calculus

Graphs of sine, cosine and tangent

 

The sine function (blue) is closely approximated by its Taylor polynomial of degree 7 (pink) for a full cycle centered on the origin.

Animation for the approximation of cosine via Taylor polynomials.

${\displaystyle \cos (x)}$ together with the first Taylor polynomials ${\displaystyle p_n(x)=\sum _{k=0}^n(-1{)}^k\frac{x^{2k}}{(2k)!}}$

The modern trend in mathematics is to build geometry from calculus rather than the converse. Therefore, except at a very elementary level, trigonometric functions are defined using the methods of calculus.

Trigonometric functions are differentiable and analytic at every point where they are defined; that is, everywhere for the sine and the cosine, and, for the tangent, everywhere except at π/2 + kπ for every integer k.

The trigonometric function are periodic functions, and their primitive period is 2π for the sine and the cosine, and π for the tangent, which is increasing in each open interval (π/2 + kπ, π/2 + (k + 1)π). At each end point of these intervals, the tangent function has a vertical asymptote.

In calculus, there are two equivalent definitions of trigonometric functions, either using power series or differential equations. These definitions are equivalent, as starting from one of them, it is easy to retrieve the other as a property. However the definition through differential equations is somehow more natural, since, for example, the choice of the coefficients of the power series may appear as quite arbitrary, and the Pythagorean identity is much easier to deduce from the differential equations.

Definition by differential equations

Sine and cosine can be defined as the unique solution to the initial value problem:

${\displaystyle \frac{d}{dx}\sin x=\cos x,\frac{d}{dx}\cos x=-\sin x,\sin (0)=0,\cos (0)=1.}$

Differentiating again, $\frac{d^2}{d{x}^2}\sin x=\frac{d}{dx}\cos x=-\sin x$ and $\frac{d^2}{d{x}^2}\cos x=-\frac{d}{dx}\sin x=-\cos x$, so both sine and cosine are solutions of the ordinary differential equation

${\displaystyle y^{″}+y=0.}$

Applying the quotient rule to the tangent ${\displaystyle \tan x=\sin x/\cos x}$, we derive

${\displaystyle \frac{d}{dx}\tan x=\frac{{\cos }^{2}x+{\sin }^{2}x}{{\cos }^{2}x}=1+{\tan }^{2}x={\sec }^{2}x.}$

Power series expansion

Applying the differential equations to power series with indeterminate coefficients, one may deduce recurrence relations for the coefficients of the Taylor series of the sine and cosine functions. These recurrence relations are easy to solve, and give the series expansions^[12]

${\displaystyle \begin{array}{rl}\sin x& =x-\frac{x^3}{3!}+\frac{x^5}{5!}-\frac{x^7}{7!}+\cdots \\ & =\sum _{n=0}^{\mathrm{\infty }}\frac{(-1{)}^n}{(2n+1)!}{x}^{2n+1}\\ \cos x& =1-\frac{x^2}{2!}+\frac{x^4}{4!}-\frac{x^6}{6!}+\cdots \\ & =\sum _{n=0}^{\mathrm{\infty }}\frac{(-1{)}^n}{(2n)!}{x}^{2n}.\end{array}}$

The radius of convergence of these series is infinite. Therefore, the sine and the cosine can be extended to entire functions (also called "sine" and "cosine"), which are (by definition) complex-valued functions that are defined and holomorphic on the whole complex plane.

Being defined as fractions of entire functions, the other trigonometric functions may be extended to meromorphic functions, that is functions that are holomorphic in the whole complex plane, except some isolated points called poles. Here, the poles are the numbers of the form $(2k+1)\frac{\pi }{2}$ for the tangent and the secant, or ${\displaystyle k\pi }$ for the cotangent and the cosecant, where k is an arbitrary integer.

Recurrences relations may also be computed for the coefficients of the Taylor series of the other trigonometric functions. These series have a finite radius of convergence. Their coefficients have a combinatorial interpretation: they enumerate alternating permutations of finite sets.

More precisely, defining

U_n, the nth up/down number,

B_n, the nth Bernoulli number, and

E_n, is the nth Euler number,

one has the following series expansions:

${\displaystyle \begin{array}{rl}\tan x& =\sum _{n=0}^{\mathrm{\infty }}\frac{U_{2n+1}}{(2n+1)!}{x}^{2n+1}\\ & =\sum _{n=1}^{\mathrm{\infty }}\frac{(-1{)}^{n-1}{2}^{2n}\left(2^{2n}-1\right)B_{2n}}{(2n)!}{x}^{2n-1}\\ & =x+\frac{1}{3}{x}^3+\frac{2}{15}{x}^5+\frac{17}{315}{x}^7+\cdots ,\text{for }|x|<\frac{\pi }{2}.\end{array}}$

${\displaystyle \begin{array}{rl}\csc x& =\sum _{n=0}^{\mathrm{\infty }}\frac{(-1{)}^{n+1}2\left(2^{2n-1}-1\right)B_{2n}}{(2n)!}{x}^{2n-1}\\ & =x^{-1}+\frac{1}{6}x+\frac{7}{360}{x}^3+\frac{31}{15120}{x}^5+\cdots ,\text{for }0<|x|<\pi .\end{array}}$

${\displaystyle \begin{array}{rl}\sec x& =\sum _{n=0}^{\mathrm{\infty }}\frac{U_{2n}}{(2n)!}{x}^{2n}=\sum _{n=0}^{\mathrm{\infty }}\frac{(-1{)}^n{E}_{2n}}{(2n)!}{x}^{2n}\\ & =1+\frac{1}{2}{x}^2+\frac{5}{24}{x}^4+\frac{61}{720}{x}^6+\cdots ,\text{for }|x|<\frac{\pi }{2}.\end{array}}$

${\displaystyle \begin{array}{rl}\cot x& =\sum _{n=0}^{\mathrm{\infty }}\frac{(-1{)}^n{2}^{2n}{B}_{2n}}{(2n)!}{x}^{2n-1}\\ & =x^{-1}-\frac{1}{3}x-\frac{1}{45}{x}^3-\frac{2}{945}{x}^5-\cdots ,\text{for }0<|x|<\pi .\end{array}}$

Continued fraction expansion

The following expansions are valid in the whole complex plane:

${\displaystyle \sin x=\frac{x}{1+\frac{x^2}{2\cdot 3-x^2+\frac{2\cdot 3x^2}{4\cdot 5-x^2+\frac{4\cdot 5x^2}{6\cdot 7-x^2+\ddots }}}}}$

${\displaystyle \cos x=\frac{1}{1+\frac{x^2}{1\cdot 2-x^2+\frac{1\cdot 2x^2}{3\cdot 4-x^2+\frac{3\cdot 4x^2}{5\cdot 6-x^2+\ddots }}}}}$

${\displaystyle \tan x=\frac{x}{1-\frac{x^2}{3-\frac{x^2}{5-\frac{x^2}{7-\ddots }}}}=\frac{1}{\frac{1}{x}-\frac{1}{\frac{3}{x}-\frac{1}{\frac{5}{x}-\frac{1}{\frac{7}{x}-\ddots }}}}}$

The last one was used in the historically first proof that π is irrational.

Partial fraction expansion

There is a series representation as partial fraction expansion where just translated reciprocal functions are summed up, such that the poles of the cotangent function and the reciprocal functions match:

${\displaystyle \pi \cot \pi x=\underset{N\to \mathrm{\infty }}{lim}\sum _{n=-N}^N\frac{1}{x+n}.}$

This identity can be proved with the Herglotz trick. Combining the (–n)th with the nth term lead to absolutely convergent series:

${\displaystyle \pi \cot \pi x=\frac{1}{x}+2x\sum _{n=1}^{\mathrm{\infty }}\frac{1}{x^2-n^2}.}$

Similarly, one can find a partial fraction expansion for the secant, cosecant and tangent functions:

${\displaystyle \pi \csc \pi x=\sum _{n=-\mathrm{\infty }}^{\mathrm{\infty }}\frac{(-1{)}^n}{x+n}=\frac{1}{x}+2x\sum _{n=1}^{\mathrm{\infty }}\frac{(-1{)}^n}{x^2-n^2},}$

${\displaystyle {\pi }^2{\csc }^2\pi x=\sum _{n=-\mathrm{\infty }}^{\mathrm{\infty }}\frac{1}{(x+n{)}^2},}$

${\displaystyle \pi \sec \pi x=\sum _{n=0}^{\mathrm{\infty }}(-1{)}^n\frac{(2n+1)}{(n+\frac{1}{2}{)}^2-x^2},}$

${\displaystyle \pi \tan \pi x=2x\sum _{n=0}^{\mathrm{\infty }}\frac{1}{(n+\frac{1}{2}{)}^2-x^2}.}$

Infinite product expansion

The following infinite product for the sine is of great importance in complex analysis:

${\displaystyle \sin z=z\prod _{n=1}^{\mathrm{\infty }}\left(1-\frac{z^2}{n^2{\pi }^2}\right),z\in \mathbb{C}.}$

For the proof of this expansion, see Sine. From this, it can be deduced that

${\displaystyle \cos z=\prod _{n=1}^{\mathrm{\infty }}\left(1-\frac{z^2}{(n-1/2{)}^2{\pi }^2}\right),z\in \mathbb{C}.}$

Relationship to exponential function (Euler's formula)

${\displaystyle \cos (\theta )}$ and ${\displaystyle \sin (\theta )}$ are the real and imaginary part of ${\displaystyle e^{i\theta }}$ respectively.

Euler's formula relates sine and cosine to the exponential function:

${\displaystyle e^{ix}=\cos x+i\sin x.}$

This formula is commonly considered for real values of x, but it remains true for all complex values.

Proof: Let ${\displaystyle f_1(x)=\cos x+i\sin x,}$ and ${\displaystyle f_2(x)=e^{ix}.}$ One has ${\displaystyle d{f}_j(x)/dx=i{f}_j(x)}$ for j = 1, 2. The quotient rule implies thus that ${\displaystyle d/dx(f_1(x)/f_2(x))=0}$. Therefore, ${\displaystyle f_1(x)/f_2(x)}$ is a constant function, which equals 1, as ${\displaystyle f_1(0)=f_2(0)=1.}$ This proves the formula.

One has

${\displaystyle \begin{array}{rl}{e}^{ix}& =\cos x+i\sin x\\ e^{-ix}& =\cos x-i\sin x.\end{array}}$

Solving this linear system in sine and cosine, one can express them in terms of the exponential function:

${\displaystyle \begin{array}{rl}\sin x& =\frac{e^{ix}-e^{-ix}}{2i}\\ \cos x& =\frac{e^{ix}+e^{-ix}}{2}.\end{array}}$

When x is real, this may be rewritten as

${\displaystyle \cos x=\mathrm{Re}\left(e^{ix}\right),\sin x=\mathrm{Im}\left(e^{ix}\right).}$

Most trigonometric identities can be proved by expressing trigonometric functions in terms of the complex exponential function by using above formulas, and then using the identity ${\displaystyle e^{a+b}=e^a{e}^b}$ for simplifying the result.

Definitions using functional equations

One can also define the trigonometric functions using various functional equations.

For example, the sine and the cosine form the unique pair of continuous functions that satisfy the difference formula

${\displaystyle \cos (x-y)=\cos x\cos y+\sin x\sin y}$

and the added condition

${\displaystyle 0<x\cos x<\sin x<x\text{ for }0<x<1.}$

In the complex plane

The sine and cosine of a complex number ${\displaystyle z=x+iy}$ can be expressed in terms of real sines, cosines, and hyperbolic functions as follows:

${\displaystyle \begin{array}{rl}\sin z& =\sin x\cosh y+i\cos x\sinh y\\ \cos z& =\cos x\cosh y-i\sin x\sinh y\end{array}}$

By taking advantage of domain coloring, it is possible to graph the trigonometric functions as complex-valued functions. Various features unique to the complex functions can be seen from the graph; for example, the sine and cosine functions can be seen to be unbounded as the imaginary part of ${\displaystyle z}$ becomes larger (since the color white represents infinity), and the fact that the functions contain simple zeros or poles is apparent from the fact that the hue cycles around each zero or pole exactly once. Comparing these graphs with those of the corresponding Hyperbolic functions highlights the relationships between the two.

Trigonometric functions in the complex plane

${\displaystyle \sin z}$ ${\displaystyle \cos z}$

${\displaystyle \tan z}$ ${\displaystyle \cot z}$

${\displaystyle \sec z}$ ${\displaystyle \csc z}$

Basic identities

Many identities interrelate the trigonometric functions. This section contains the most basic ones; for more identities, see List of trigonometric identities. These identities may be proved geometrically from the unit-circle definitions or the right-angled-triangle definitions (although, for the latter definitions, care must be taken for angles that are not in the interval [0, π/2], see Proofs of trigonometric identities). For non-geometrical proofs using only tools of calculus, one may use directly the differential equations, in a way that is similar to that of the above proof of Euler's identity. One can also use Euler's identity for expressing all trigonometric functions in terms of complex exponentials and using properties of the exponential function.

Parity

The cosine and the secant are even functions; the other trigonometric functions are odd functions. That is:

${\displaystyle \begin{array}{rl}\sin (-x)& =-\sin x\\ \cos (-x)& =\cos x\\ \tan (-x)& =-\tan x\\ \cot (-x)& =-\cot x\\ \csc (-x)& =-\csc x\\ \sec (-x)& =\sec x.\end{array}}$

Periods

All trigonometric functions are periodic functions of period 2π. This is the smallest period, except for the tangent and the cotangent, which have π as smallest period. This means that, for every integer k, one has

${\displaystyle \begin{array}{lrl}\sin (x+& 2k\pi )& =\sin x\\ \cos (x+& 2k\pi )& =\cos x\\ \tan (x+& k\pi )& =\tan x\\ \cot (x+& k\pi )& =\cot x\\ \csc (x+& 2k\pi )& =\csc x\\ \sec (x+& 2k\pi )& =\sec x.\end{array}}$

Pythagorean identity

The Pythagorean identity, is the expression of the Pythagorean theorem in terms of trigonometric functions. It is

${\displaystyle {\sin }^{2}x+{\cos }^{2}x=1}$.

Dividing through by either ${\displaystyle {\cos }^{2}x}$ or ${\displaystyle {\sin }^{2}x}$ gives

${\displaystyle {\tan }^{2}x+1={\sec }^{2}x}$

and

${\displaystyle 1+{\cot }^{2}x={\csc }^{2}x}$.

Sum and difference formulas

The sum and difference formulas allow expanding the sine, the cosine, and the tangent of a sum or a difference of two angles in terms of sines and cosines and tangents of the angles themselves. These can be derived geometrically, using arguments that date to Ptolemy. One can also produce them algebraically using Euler's formula.

Sum

${\displaystyle \begin{array}{rl}\sin \left(x+y\right)& =\sin x\cos y+\cos x\sin y,\\ \cos \left(x+y\right)& =\cos x\cos y-\sin x\sin y,\\ \tan (x+y)& =\frac{\tan x+\tan y}{1-\tan x\tan y}.\end{array}}$

Difference

${\displaystyle \begin{array}{rl}\sin \left(x-y\right)& =\sin x\cos y-\cos x\sin y,\\ \cos \left(x-y\right)& =\cos x\cos y+\sin x\sin y,\\ \tan (x-y)& =\frac{\tan x-\tan y}{1+\tan x\tan y}.\end{array}}$

When the two angles are equal, the sum formulas reduce to simpler equations known as the double-angle formulae.

${\displaystyle \begin{array}{rl}\sin 2x& =2\sin x\cos x=\frac{2\tan x}{1+{\tan }^{2}x},\\ \cos 2x& ={\cos }^{2}x-{\sin }^{2}x=2{\cos }^{2}x-1=1-2{\sin }^{2}x=\frac{1-{\tan }^{2}x}{1+{\tan }^{2}x},\\ \tan 2x& =\frac{2\tan x}{1-{\tan }^{2}x}.\end{array}}$

These identities can be used to derive the product-to-sum identities.

By setting ${\displaystyle t=\tan \frac{1}{2}\theta ,}$ all trigonometric functions of ${\displaystyle \theta }$ can be expressed as rational fractions of ${\displaystyle t}$:

${\displaystyle \begin{array}{rl}\sin \theta & =\frac{2t}{1+t^2},\\ \cos \theta & =\frac{1-t^2}{1+t^2},\\ \tan \theta & =\frac{2t}{1-t^2}.\end{array}}$

Together with

${\displaystyle d\theta =\frac{2}{1+t^2}dt,}$

this is the tangent half-angle substitution, which reduces the computation of integrals and antiderivatives of trigonometric functions to that of rational fractions.

Derivatives and antiderivatives

The derivatives of trigonometric functions result from those of sine and cosine by applying quotient rule. The values given for the antiderivatives in the following table can be verified by differentiating them. The number C is a constant of integration.

${\displaystyle f(x)}$	${\displaystyle f^{\prime }(x)}$	$\int f(x)dx$
${\displaystyle \sin x}$	${\displaystyle \cos x}$	${\displaystyle -\cos x+C}$
${\displaystyle \cos x}$	${\displaystyle -\sin x}$	${\displaystyle \sin x+C}$
${\displaystyle \tan x}$	${\displaystyle {\sec }^{2}x}$	${\displaystyle \ln \left|\sec x\right|+C}$
${\displaystyle \csc x}$	${\displaystyle -\csc x\cot x}$	${\displaystyle \ln \left|\csc x-\cot x\right|+C}$
${\displaystyle \sec x}$	${\displaystyle \sec x\tan x}$	${\displaystyle \ln \left|\sec x+\tan x\right|+C}$
${\displaystyle \cot x}$	${\displaystyle -{\csc }^{2}x}$	${\displaystyle \ln \left|\sin x\right|+C}$

Note: For ${\displaystyle 0<x<\pi }$ the integral of ${\displaystyle \csc x}$ can also be written as ${\displaystyle -\mathrm{arsinh}(\cot x),}$ and for the integral of ${\displaystyle \sec x}$ for ${\displaystyle -\pi /2<x<\pi /2}$ as ${\displaystyle \mathrm{arsinh}(\tan x),}$ where ${\displaystyle \mathrm{arsinh}}$ is the inverse hyperbolic sine.

Alternatively, the derivatives of the 'co-functions' can be obtained using trigonometric identities and the chain rule:

${\displaystyle \begin{array}{rl}\frac{d\cos x}{dx}& =\frac{d}{dx}\sin (\pi /2-x)=-\cos (\pi /2-x)=-\sin x,\\ \frac{d\csc x}{dx}& =\frac{d}{dx}\sec (\pi /2-x)=-\sec (\pi /2-x)\tan (\pi /2-x)=-\csc x\cot x,\\ \frac{d\cot x}{dx}& =\frac{d}{dx}\tan (\pi /2-x)=-{\sec }^2(\pi /2-x)=-{\csc }^{2}x.\end{array}}$

Inverse functions

Main article: Inverse trigonometric functions

The trigonometric functions are periodic, and hence not injective, so strictly speaking, they do not have an inverse function. However, on each interval on which a trigonometric function is monotonic, one can define an inverse function, and this defines inverse trigonometric functions as multivalued functions. To define a true inverse function, one must restrict the domain to an interval where the function is monotonic, and is thus bijective from this interval to its image by the function. The common choice for this interval, called the set of principal values, is given in the following table. As usual, the inverse trigonometric functions are denoted with the prefix "arc" before the name or its abbreviation of the function.

Function	Definition	Domain	Set of principal values
${\displaystyle y=\arcsin x}$	${\displaystyle \sin y=x}$	${\displaystyle -1\le x\le 1}$	$-\frac{\pi }{2}\le y\le \frac{\pi }{2}$
${\displaystyle y=\arccos x}$	${\displaystyle \cos y=x}$	${\displaystyle -1\le x\le 1}$	$0\le y\le \pi$
${\displaystyle y=\arctan x}$	${\displaystyle \tan y=x}$	${\displaystyle -\mathrm{\infty }<x<\mathrm{\infty }}$	$-\frac{\pi }{2}<y<\frac{\pi }{2}$
${\displaystyle y=\mathrm{arccot}x}$	${\displaystyle \cot y=x}$	${\displaystyle -\mathrm{\infty }<x<\mathrm{\infty }}$	$0<y<\pi$
${\displaystyle y=\mathrm{arcsec}x}$	${\displaystyle \sec y=x}$	${\displaystyle x<-1\text{ or }x>1}$	$0\le y\le \pi ,y\ne \frac{\pi }{2}$
${\displaystyle y=\mathrm{arccsc}x}$	${\displaystyle \csc y=x}$	${\displaystyle x<-1\text{ or }x>1}$	$-\frac{\pi }{2}\le y\le \frac{\pi }{2},y\ne 0$

The notations sin⁻¹, cos⁻¹, etc. are often used for arcsin and arccos, etc. When this notation is used, inverse functions could be confused with multiplicative inverses. The notation with the "arc" prefix avoids such a confusion, though "arcsec" for arcsecant can be confused with "arcsecond".

Just like the sine and cosine, the inverse trigonometric functions can also be expressed in terms of infinite series. They can also be expressed in terms of complex logarithms.

Applications

Main article: Uses of trigonometry

Angles and sides of a triangle

In this section A, B, C denote the three (interior) angles of a triangle, and a, b, c denote the lengths of the respective opposite edges. They are related by various formulas, which are named by the trigonometric functions they involve.

Law of sines

Main article: Law of sines

The law of sines states that for an arbitrary triangle with sides a, b, and c and angles opposite those sides A, B and C:

$${\displaystyle \frac{\sin A}{a}=\frac{\sin B}{b}=\frac{\sin C}{c}=\frac{2\mathrm{\Delta }}{abc},}$$

where Δ is the area of the triangle, or, equivalently,

$${\displaystyle \frac{a}{\sin A}=\frac{b}{\sin B}=\frac{c}{\sin C}=2R,}$$

where R is the triangle's circumradius.

It can be proved by dividing the triangle into two right ones and using the above definition of sine. The law of sines is useful for computing the lengths of the unknown sides in a triangle if two angles and one side are known. This is a common situation occurring in triangulation, a technique to determine unknown distances by measuring two angles and an accessible enclosed distance.

Law of cosines

Main article: Law of cosines

The law of cosines (also known as the cosine formula or cosine rule) is an extension of the Pythagorean theorem:

$${\displaystyle c^2=a^2+b^2-2ab\cos C,}$$

or equivalently,

$${\displaystyle \cos C=\frac{a^2+b^2-c^2}{2ab}.}$$

In this formula the angle at C is opposite to the side c. This theorem can be proved by dividing the triangle into two right ones and using the Pythagorean theorem.

The law of cosines can be used to determine a side of a triangle if two sides and the angle between them are known. It can also be used to find the cosines of an angle (and consequently the angles themselves) if the lengths of all the sides are known.

Law of tangents

Main article: Law of tangents

The law of tangents says that:

${\displaystyle \frac{\tan \frac{A-B}{2}}{\tan \frac{A+B}{2}}=\frac{a-b}{a+b}}$.

Law of cotangents

Main article: Law of cotangents

If s is the triangle's semiperimeter, (a + b + c)/2, and r is the radius of the triangle's incircle, then rs is the triangle's area. Therefore Heron's formula implies that:

${\displaystyle r=\sqrt{\frac{1}{s}(s-a)(s-b)(s-c)}}$.

The law of cotangents says that:

${\displaystyle \cot \frac{A}{2}=\frac{s-a}{r}}$

It follows that

${\displaystyle \frac{\cot {\displaystyle \frac{A}{2}}}{s-a}=\frac{\cot {\displaystyle \frac{B}{2}}}{s-b}=\frac{\cot {\displaystyle \frac{C}{2}}}{s-c}=\frac{1}{r}.}$

Periodic functions

A Lissajous curve, a figure formed with a trigonometry-based function.

An animation of the additive synthesis of a square wave with an increasing number of harmonics

Sinusoidal basis functions (bottom) can form a sawtooth wave (top) when added. All the basis functions have nodes at the nodes of the sawtooth, and all but the fundamental (k = 1) have additional nodes. The oscillation seen about the sawtooth when k is large is called the Gibbs phenomenon

The trigonometric functions are also important in physics. The sine and the cosine functions, for example, are used to describe simple harmonic motion, which models many natural phenomena, such as the movement of a mass attached to a spring and, for small angles, the pendular motion of a mass hanging by a string. The sine and cosine functions are one-dimensional projections of uniform circular motion.

Trigonometric functions also prove to be useful in the study of general periodic functions. The characteristic wave patterns of periodic functions are useful for modeling recurring phenomena such as sound or light waves.

Under rather general conditions, a periodic function f (x) can be expressed as a sum of sine waves or cosine waves in a Fourier series. Denoting the sine or cosine basis functions by φ_k, the expansion of the periodic function f (t) takes the form:

$${\displaystyle f(t)=\sum _{k=1}^{\mathrm{\infty }}{c}_k{\phi }_k(t).}$$

For example, the square wave can be written as the Fourier series

$${\displaystyle f_{\text{square}}(t)=\frac{4}{\pi }\sum _{k=1}^{\mathrm{\infty }}\frac{\sin ((2k-1)t)}{2k-1}.}$$

In the animation of a square wave at top right it can be seen that just a few terms already produce a fairly good approximation. The superposition of several terms in the expansion of a sawtooth wave are shown underneath.

History

Main article: History of trigonometry

While the early study of trigonometry can be traced to antiquity, the trigonometric functions as they are in use today were developed in the medieval period. The chord function was discovered by Hipparchus of Nicaea (180–125 BCE) and Ptolemy of Roman Egypt (90–165 CE). The functions of sine and versine (1 – cosine) can be traced back to the jyā and koti-jyā functions used in Gupta period Indian astronomy (Aryabhatiya, Surya Siddhanta), via translation from Sanskrit to Arabic and then from Arabic to Latin. (See Aryabhata's sine table.)

All six trigonometric functions in current use were known in Islamic mathematics by the 9th century, as was the law of sines, used in solving triangles. With the exception of the sine (which was adopted from Indian mathematics), the other five modern trigonometric functions were discovered by Persian and Arab mathematicians, including the cosine, tangent, cotangent, secant and cosecant. Al-Khwārizmī (c. 780–850) produced tables of sines, cosines and tangents. Circa 830, Habash al-Hasib al-Marwazi discovered the cotangent, and produced tables of tangents and cotangents. Muhammad ibn Jābir al-Harrānī al-Battānī (853–929) discovered the reciprocal functions of secant and cosecant, and produced the first table of cosecants for each degree from 1° to 90°. The trigonometric functions were later studied by mathematicians including Omar Khayyám, Bhāskara II, Nasir al-Din al-Tusi, Jamshīd al-Kāshī (14th century), Ulugh Beg (14th century), Regiomontanus (1464), Rheticus, and Rheticus' student Valentinus Otho.

Madhava of Sangamagrama (c. 1400) made early strides in the analysis of trigonometric functions in terms of infinite series. (See Madhava series and Madhava's sine table.)

The tangent function was brought to Europe by Giovanni Bianchini in 1467 in trigonometry tables he created to support the calculation of stellar coordinates.

The terms tangent and secant were first introduced by the Danish mathematician Thomas Fincke in his book Geometria rotundi (1583).

The 17th century French mathematician Albert Girard made the first published use of the abbreviations sin, cos, and tan in his book Trigonométrie.

In a paper published in 1682, Gottfried Leibniz proved that sin x is not an algebraic function of x. Though introduced as ratios of sides of a right triangle, and thus appearing to be rational functions, Leibnitz result established that they are actually transcendental functions of their argument. The task of assimilating circular functions into algebraic expressions was accomplished by Euler in his Introduction to the Analysis of the Infinite (1748). His method was to show that the sine and cosine functions are alternating series formed from the even and odd terms respectively of the exponential series. He presented "Euler's formula", as well as near-modern abbreviations (sin., cos., tang., cot., sec., and cosec.).

A few functions were common historically, but are now seldom used, such as the chord, the versine (which appeared in the earliest tables), the coversine, the haversine, the exsecant and the excosecant. The list of trigonometric identities shows more relations between these functions.

• crd(θ) = 2 sin(θ/2)
• versin(θ) = 1 − cos(θ) = 2 sin²(θ/2)
• coversin(θ) = 1 − sin(θ) = versin(π/2 − θ)
• haversin(θ) = 1/2versin(θ) = sin²(θ/2)
• exsec(θ) = sec(θ) − 1
• excsc(θ) = exsec(π/2 − θ) = csc(θ) − 1

Etymology

Main article: History of trigonometry § Etymology

The word sine derives from Latin sinus, meaning "bend; bay", and more specifically "the hanging fold of the upper part of a toga", "the bosom of a garment", which was chosen as the translation of what was interpreted as the Arabic word jaib, meaning "pocket" or "fold" in the twelfth-century translations of works by Al-Battani and al-Khwārizmī into Medieval Latin. The choice was based on a misreading of the Arabic written form j-y-b (جيب), which itself originated as a transliteration from Sanskrit jīvā, which along with its synonym jyā (the standard Sanskrit term for the sine) translates to "bowstring", being in turn adopted from Ancient Greek χορδή "string".

The word tangent comes from Latin tangens meaning "touching", since the line touches the circle of unit radius, whereas secant stems from Latin secans—"cutting"—since the line cuts the circle.

The prefix "co-" (in "cosine", "cotangent", "cosecant") is found in Edmund Gunter's Canon triangulorum (1620), which defines the cosinus as an abbreviation for the sinus complementi (sine of the complementary angle) and proceeds to define the cotangens similarly.

Nephrology

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Nephrology

Nephrology

A human kidney
System	Urinary
Significant diseases	Hypertension, Kidney cancer
Significant tests	Kidney biopsy, Urinalysis
Specialist	Nephrologist
Glossary	Glossary of medicine

Nephrologist

Occupation
Names	Physician
Occupation type	Specialty
Activity sectors	Medicine
Description
Education required	Doctor of Medicine (M.D.) Doctor of Osteopathic medicine (D.O.) Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) Bachelor of Medicine, Bachelor of Surgery (MBChB)
Fields of employment	Hospitals, Clinics

Nephrology (from Greek nephros "kidney", combined with the suffix -logy, "the study of") is a specialty of adult internal medicine and pediatric medicine that concerns the study of the kidneys, specifically normal kidney function (renal physiology) and kidney disease (renal pathophysiology), the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy (dialysis and kidney transplantation). The word "renal" is an adjective meaning "relating to the kidneys", and its roots are French or late Latin. Whereas according to some opinions, "renal" and "nephro" should be replaced with "kidney" in scientific writings such as "kidney medicine" (instead of nephrology) or "kidney replacement therapy", other experts have advocated preserving the use of renal and nephro as appropriate including in "nephrology" and "renal replacement therapy", respectively.

Nephrology also studies systemic conditions that affect the kidneys, such as diabetes and autoimmune disease; and systemic diseases that occur as a result of kidney disease, such as renal osteodystrophy and hypertension. A physician who has undertaken additional training and become certified in nephrology is called a nephrologist.

The term "nephrology" was first used in about 1960, according to the French "néphrologie" proposed by Pr. Jean Hamburger in 1953, from the Greek νεφρός / nephrós (kidney). Before then, the specialty was usually referred to as "kidney medicine".

Scope

Nephrology concerns the diagnosis and treatment of kidney diseases, including electrolyte disturbances and hypertension, and the care of those requiring renal replacement therapy, including dialysis and renal transplant patients. The word 'dialysis' is from the mid-19th century: via Latin from the Greek word 'dialusis'; from 'dialuein' (split, separate), from 'dia' (apart) and 'luein' (set free). In other words, dialysis replaces the primary (excretory) function of the kidney, which separates (and removes) excess toxins and water from the blood, placing them in the urine.

Many diseases affecting the kidney are systemic disorders not limited to the organ itself, and may require special treatment. Examples include acquired conditions such as systemic vasculitides (e.g. ANCA vasculitis) and autoimmune diseases (e.g. lupus), as well as congenital or genetic conditions such as polycystic kidney disease.

Patients are referred to nephrology specialists after a urinalysis, for various reasons, such as acute kidney injury, chronic kidney disease, hematuria, proteinuria, kidney stones, hypertension, and disorders of acid/base or electrolytes.

Nephrologist

A nephrologist is a physician who specializes in the care and treatment of kidney disease. Nephrology requires additional training to become an expert with advanced skills. Nephrologists may provide care to people without kidney problems and may work in general/internal medicine, transplant medicine, immunosuppression management, intensive care medicine, clinical pharmacology, perioperative medicine, or pediatric nephrology.

Nephrologists may further sub-specialise in dialysis, kidney transplantation, home therapies (home dialysis), cancer-related kidney diseases (onco-nephrology), structural kidney diseases (uro-nephrology), procedural nephrology or other non-nephrology areas as described above.

Procedures a nephrologist may perform include native kidney and transplant kidney biopsy, dialysis access insertion (temporary vascular access lines, tunnelled vascular access lines, peritoneal dialysis access lines), fistula management (angiographic or surgical fistulogram and plasty), and bone biopsy. Bone biopsies are now unusual.

Training

India

To become a nephrologist in India, one has to complete an MBBS (5 and 1/2 years) degree, followed by an MD/DNB (3 years) either in medicine or paediatrics, followed by a DM/DNB (3 years) course in either nephrology or paediatric nephrology.

Australia and New Zealand

Nephrology training in Australia and New Zealand typically includes completion of a medical degree (Bachelor of Medicine, Bachelor of Surgery: 4–6 years), internship (1 year), Basic Physician Training (3 years minimum), successful completion of the Royal Australasian College of Physicians written and clinical examinations, and Advanced Physician Training in Nephrology (3 years). The training pathway is overseen and accredited by the Royal Australasian College of Physicians, though the application process varies across states. Completion of a post-graduate degree (usually a PhD) in a nephrology research interest (3–4 years) is optional but increasingly common. Finally, many Australian and New Zealand nephrologists participate in career-long professional and personal development through bodies such as the Australian and New Zealand Society of Nephrology and the Transplant Society of Australia and New Zealand.

United Kingdom

In the United Kingdom, nephrology (often called renal medicine) is a subspecialty of general medicine. A nephrologist has completed medical school, foundation year posts (FY1 and FY2) and core medical training (CMT), specialist training (ST) and passed the Membership of the Royal College of Physicians (MRCP) exam before competing for a National Training Number (NTN) in renal medicine. The typical Specialty Training (when they are called a registrar, or an ST) is five years and leads to a Certificate of Completion of Training (CCT) in both renal medicine and general (internal) medicine. In those five years, they usually rotate yearly between hospitals in a region (known as a deanery). They are then accepted on to the Specialist Register of the General Medical Council (GMC). Specialty trainees often interrupt their clinical training to obtain research degrees (MD/PhD). After achieving CCT, the registrar (ST) may apply for a permanent post as Consultant in Renal Medicine. Subsequently, some Consultants practice nephrology alone. Others work in this area, and in Intensive Care (ICU), or General (Internal) or Acute Medicine.

United States

Nephrology training can be accomplished through one of two routes. The first path way is through an internal medicine pathway leading to an Internal Medicine/Nephrology specialty, and sometimes known as "adult nephrology". The second pathway is through Pediatrics leading to a speciality in Pediatric Nephrology. In the United States, after medical school adult nephrologists complete a three-year residency in internal medicine followed by a two-year (or longer) fellowship in nephrology. Complementary to an adult nephrologist, a pediatric nephrologist will complete a three-year pediatric residency after medical school or a four-year Combined Internal Medicine and Pediatrics residency. This is followed by a three-year fellowship in Pediatric Nephrology. Once training is satisfactorily completed, the physician is eligible to take the American Board of Internal Medicine (ABIM) or American Osteopathic Board of Internal Medicine (AOBIM) nephrology examination. Nephrologists must be approved by one of these boards. To be approved, the physician must fulfill the requirements for education and training in nephrology in order to qualify to take the board's examination. If a physician passes the examination, then he or she can become a nephrology specialist. Typically, nephrologists also need two to three years of training in an ACGME or AOA accredited fellowship in nephrology. Nearly all programs train nephrologists in continuous renal replacement therapy; fewer than half in the United States train in the provision of plasmapheresis. Only pediatric trained physicians are able to train in pediatric nephrology, and internal medicine (adult) trained physicians may enter general (adult) nephrology fellowships.

Diagnosis

History and physical examination are central to the diagnostic workup in nephrology. The history typically includes the present illness, family history, general medical history, diet, medication use, drug use and occupation. The physical examination typically includes an assessment of volume state, blood pressure, heart, lungs, peripheral arteries, joints, abdomen and flank. A rash may be relevant too, especially as an indicator of autoimmune disease.

Examination of the urine (urinalysis) allows a direct assessment for possible kidney problems, which may be suggested by appearance of blood in the urine (hematuria), protein in the urine (proteinuria), pus cells in the urine (pyuria) or cancer cells in the urine. A 24-hour urine collection used to be used to quantify daily protein loss (see proteinuria), urine output, creatinine clearance or electrolyte handling by the renal tubules. It is now more common to measure protein loss from a small random sample of urine.

Basic blood tests can be used to check the concentration of hemoglobin, white count, platelets, sodium, potassium, chloride, bicarbonate, urea, creatinine, albumin, calcium, magnesium, phosphate, alkaline phosphatase and parathyroid hormone (PTH) in the blood. All of these may be affected by kidney problems. The serum creatinine concentration is the most important blood test as it is used to estimate the function of the kidney, called the creatinine clearance or estimated glomerular filtration rate (GFR).

It is a good idea for patients with longterm kidney disease to know an up-to-date list of medications, and their latest blood tests, especially the blood creatinine level. In the United Kingdom, blood tests can monitored online by the patient, through a website called RenalPatientView.

More specialized tests can be ordered to discover or link certain systemic diseases to kidney failure such as infections (hepatitis B, hepatitis C), autoimmune conditions (systemic lupus erythematosus, ANCA vasculitis), paraproteinemias (amyloidosis, multiple myeloma) and metabolic diseases (diabetes, cystinosis).

Structural abnormalities of the kidneys are identified with imaging tests. These may include Medical ultrasonography/ultrasound, computed axial tomography (CT), scintigraphy (nuclear medicine), angiography or magnetic resonance imaging (MRI).

In certain circumstances, less invasive testing may not provide a certain diagnosis. Where definitive diagnosis is required, a biopsy of the kidney (renal biopsy) may be performed. This typically involves the insertion, under local anaesthetic and ultrasound or CT guidance, of a core biopsy needle into the kidney to obtain a small sample of kidney tissue. The kidney tissue is then examined under a microscope, allowing direct visualization of the changes occurring within the kidney. Additionally, the pathology may also stage a problem affecting the kidney, allowing some degree of prognostication. In some circumstances, kidney biopsy will also be used to monitor response to treatment and identify early relapse. A transplant kidney biopsy may also be performed to look for rejection of the kidney.

Treatment

Treatments in nephrology can include medications, blood products, surgical interventions (urology, vascular or surgical procedures), renal replacement therapy (dialysis or kidney transplantation) and plasma exchange. Kidney problems can have significant impact on quality and length of life, and so psychological support, health education and advanced care planning play key roles in nephrology.

Chronic kidney disease is typically managed with treatment of causative conditions (such as diabetes), avoidance of substances toxic to the kidneys (nephrotoxins like radiologic contrast and non-steroidal anti-inflammatory drugs), antihypertensives, diet and weight modification and planning for end-stage kidney failure. Impaired kidney function has systemic effects on the body. An erythropoetin stimulating agent (ESA) may be required to ensure adequate production of red blood cells, activated vitamin D supplements and phosphate binders may be required to counteract the effects of kidney failure on bone metabolism, and blood volume and electrolyte disturbance may need correction. Diuretics (such as furosemide) may be used to correct fluid overload, and alkalis (such as sodium bicarbonate) can be used to treat metabolic acidosis.

Auto-immune and inflammatory kidney disease, such as vasculitis or transplant rejection, may be treated with immunosuppression. Commonly used agents are prednisone, mycophenolate, cyclophosphamide, ciclosporin, tacrolimus, everolimus, thymoglobulin and sirolimus. Newer, so-called "biologic drugs" or monoclonal antibodies, are also used in these conditions and include rituximab, basiliximab and eculizumab. Blood products including intravenous immunoglobulin and a process known as plasma exchange can also be employed.

When the kidneys are no longer able to sustain the demands of the body, end-stage kidney failure is said to have occurred. Without renal replacement therapy, death from kidney failure will eventually result. Dialysis is an artificial method of replacing some kidney function to prolong life. Renal transplantation replaces kidney function by inserting into the body a healthier kidney from an organ donor and inducing immunologic tolerance of that organ with immunosuppression. At present, renal transplantation is the most effective treatment for end-stage kidney failure although its worldwide availability is limited by lack of availability of donor organs. Generally speaking, kidneys from living donors are 'better' than those from deceased donors, as they last longer.

Most kidney conditions are chronic conditions and so long term followup with a nephrologist is usually necessary. In the United Kingdom, care may be shared with the patient's primary care physician, called a General Practitioner (GP).

Organizations

The world's first society of nephrology was the French 'Societe de Pathologie Renale'. Its first president was Jean Hamburger, and its first meeting was in Paris in February 1949. In 1959, Hamburger also founded the 'Société de Néphrologie', as a continuation of the older society. The UK's Renal Association was founded in 1950; the second society of nephrologists. Its first president was Arthur Osman and met for the first time, in London, on the 30th of March 1950. The Società di Nefrologia Italiana was founded in 1957 and was the first national society to incorporate the phrase nephrologia (or nephrology) into its name.

The word 'nephrology' appeared for the first time in a conference, on 1–4 September 1960 at the "Premier Congrès International de Néphrologie" in Evian and Geneva, the first meeting of the International Society of Nephrology (ISN, International Society of Nephrology). The first day (1.9.60) was in Geneva and the next three (2–4.9.60) were in Evian, France. The early history of the ISN is described by Robinson and Richet in 2005 and the later history by Barsoum in 2011. The ISN is the largest global society representing medical professionals engaged in advancing kidney care worldwide.

In the US, founded in 1964, the National Kidney Foundation is a national organization representing patients and professionals who treat kidney diseases. Founded in 1966, the American Society of Nephrology (ASN) is the world's largest professional society devoted to the study of kidney disease. The American Nephrology Nurses' Association (ANNA), founded in 1969, promotes excellence in and appreciation of nephrology nursing to make a positive difference for patients with kidney disease. The American Association of Kidney Patients (AAKP) is a non-profit, patient-centric group focused on improving the health and well-being of CKD and dialysis patients. The National Renal Administrators Association (NRAA), founded in 1977, is a national organization that represents and supports the independent and community-based dialysis providers. The American Kidney Fund directly provides financial support to patients in need, as well as participating in health education and prevention efforts. ASDIN (American Society of Diagnostic and Interventional Nephrology) is the main organization of interventional nephrologists. Other organizations include CIDA, VASA etc. which deal with dialysis vascular access. The Renal Support Network (RSN) is a nonprofit, patient-focused, patient-run organization that provides non-medical services to those affected by chronic kidney disease (CKD).

In the United Kingdom, UK National Kidney Federation and Kidney Care UK (previously known as British Kidney Patient Association, BKPA) represent patients, and the Renal Association represents renal physicians and works closely with the National Service Framework for kidney disease.

There is an international office in Brussels, Belgium.