Publications
301 results found
EA Brown, 2003, Selection of Dialysis Modality, Horizons in Medicine, Editors: Weber, Publisher: Royal College of Physicians
Stevens P, Brown E, Forni L, et al., 2002, RENAL REPLACEMENT THERAPY IN ACUTE RENAL FAILURE, Acute Renal Failure in Practice, Publisher: PUBLISHED BY IMPERIAL COLLEGE PRESS AND DISTRIBUTED BY WORLD SCIENTIFIC PUBLISHING CO., Pages: 196-255
Parsons DS, Reaveley DA, Pavitt DV, et al., 2002, Relationship of renal function to homocysteine and lipoprotein(a) levels: The frequency of the combination of both risk factors in chronic renal impairment, AMERICAN JOURNAL OF KIDNEY DISEASES, Vol: 40, Pages: 916-923, ISSN: 0272-6386
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- Citations: 22
Preston EC, Parsons DS, Brown EA, et al., 2002, Accurate measurement of GFR using a modified MDRD formula in the United Kingdom Indo-Asian population., JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, Vol: 13, Pages: 262A-262A, ISSN: 1046-6673
Brown EA, Davies SJ, Rutherford P, et al., 2002, European APD outcome study (EAPOS): Ultrafiltration and not solute clearance or solute transport status predicts outcomes at 2 years for APD in anuric patients., JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, Vol: 13, Pages: 1A-1A, ISSN: 1046-6673
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- Citations: 3
Brown EA, 2002, An opportune time to develop new strategies against repeat peritonitis in patients on peritoneal dialysis?, AMERICAN JOURNAL OF KIDNEY DISEASES, Vol: 39, Pages: 1318-1320, ISSN: 0272-6386
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- Citations: 1
EA Brown, 2002, Acute Peritoneal Dialysis, Acute renal failure in practice, Editors: Glynne, Allen, Pusey, Publisher: Imperial College Press
Jones S, Holmes CJ, Krediet RT, et al., 2001, Bicarbonate/lactate-based peritoneal dialysis solution increases cancer antigen 125 and decreases hyaluronic acid levels., Kidney Int, Vol: 59, Pages: 1529-1538, ISSN: 0085-2538
BACKGROUND: In a randomized, controlled trial comparing a pH neutral, bicarbonate/lactate (B/L)-buffered PD solution to conventional acidic, lactate-buffered solution (C), the overnight dialysate levels of markers of inflammation/wound healing [hyaluronic acid (HA)], mesothelial cell mass/membrane integrity [cancer antigen 125 (CA125)], and fibrosis [transforming growth factor-beta1 (TGF-beta1) and procollagen I peptides (PICP)] were assessed over a six-month treatment period. METHODS: One hundred six patients were randomized (2:1) to either the B/L group or C group. Overnight effluents were collected at entry into the study (time = 0 all patients on control solution) and then at three and six months after randomization. Aliquots were filtered, stored frozen, and assayed for HA, CA125, TGF-beta1, and PICP. Differences between groups were assessed by repeated-measures analysis of variance for unbalanced data using the SAS procedure MIXED. RESULTS: In patients treated with B/L, there was a significant (P = 0.03) increase in CA125 after six months compared with time = 0 (19.76 +/- 11.8 vs. 24.4 +/- 13.8 U/mL; mean +/- SD; N = 51). In the same group of patients, HA levels were significantly decreased at both three and six months in the B/L-treated group (time = 0, 336.0 +/- 195.2; time = 3 months, 250.6 +/- 167.6; and time = 6 months, 290.5 +/- 224.6 ng/mL; mean +/- SD; P = 0.006, N = 47 and P = 0.003, N = 48, respectively). No significant changes in CA125 or HA levels were observed in the control group. There were no significant changes observed in the levels of PICP or TGF-beta1 in the B/L or C group over the six-month treatment period. CONCLUSIONS: These results suggest that continuous therapy with the B/L solutions modulates the levels of putative markers of peritoneal membrane integrity and inflammation. In the long term, this may positively impact the peritoneal membrane, increasing its life as a dialyzing organ.
Wight J, Payne N, 2001, North Thames Dialysis Study., Lancet, Vol: 357, Pages: 719-720, ISSN: 0140-6736
Goldberg L, Clemenger M, Azadian B, et al., 2001, Initial treatment of peritoneal dialysis peritonitis without vancomycin with a once-daily cefazolin-based regimen, AMERICAN JOURNAL OF KIDNEY DISEASES, Vol: 37, Pages: 49-55, ISSN: 0272-6386
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- Citations: 25
Cooker LA, Luneburg P, Holmes CJ, et al., 2001, Interleukin-6 levels decrease in effluent from patients dialyzed with bicarbonate/lactate-based peritoneal dialysis solutions., Perit Dial Int, Vol: 21 Suppl 3, Pages: S102-S107, ISSN: 0896-8608
OBJECTIVE: Conventional lactate-buffered peritoneal dialysis (PD) solutions have several bioincompatible characteristics, including acidic pH, lactate buffer, and the presence of glucose degradation products (GDPs). These characteristics, along with inflammation, are believed to contribute to membrane dysfunction in peritoneal dialysis patients. A new PD solution containing a bicarbonate/lactate buffer system with physiologic pH and low GDPs has shown improved biocompatibility in both in vitro and ex vivo studies. In the present study, the concentrations of cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNFalpha), and vascular endothelial growth factor (VEGF), were measured in timed overnight effluents from PD patients continuously dialyzed with either lactate-based control solution (C) or bicarbonate/lactate-based solution (B/L) for 6 months. METHODS: Effluents from 92 continuous ambulatory peritoneal dialysis (CAPD) patients were collected when the patients were entered into the study (baseline, all patients on C for more than 3 months), and at 3 and 6 months following randomization to C (n = 31) or to B/L (n = 61). Effluent samples were filtered, stored frozen, and then assayed for IL-6, TNFalpha, and VEGF by ELISA. RESULTS: A significant decrease in effluent IL-6 was seen at 3 months and at 6 months in the B/L-treated patients. Levels of VEGF were significantly reduced at 3 months. No changes in the levels of IL-6 or VEGF were seen in the C-treated patients, and no changes in TNFalpha were seen in either group over time. CONCLUSIONS: Treatment with B/L is associated with decreased IL-6 synthesis and decreased VEGF secretion. The data suggest that the use of B/L solution is associated with reduced intraperitoneal inflammation and potential for angiogenesis. The use of B/L solution may, over time, help to restore peritoneal homeostasis and therefore preserve the function of the membrane in peritoneal dialysis.
Brown EA, Davies SJ, Heimbürger O, et al., 2001, Adequacy targets can be met in anuric patients by automated peritoneal dialysis:: Baseline data from EAPOS, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 21, Pages: S133-S137, ISSN: 0896-8608
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- Citations: 27
Lamping DL, Constantinovici N, Roderick P, et al., 2000, Clinical outcomes, quality of life, and costs in the North Thames Dialysis Study of elderly people on dialysis: a prospective cohort study., Lancet, Vol: 356, Pages: 1543-1550, ISSN: 0140-6736
BACKGROUND: Evidence-based health policy is urgently needed to meet the increasing demand for health services among elderly people, particularly for expensive technologies such as renal-replacement therapy. Age has been used to ration dialysis, although not always explicitly, despite the lack of rigorous empirical evidence about how elderly people fare on dialysis. We undertook a comprehensive assessment of outcomes in patients 70 years or over. METHODS: We did a 12-month prospective cohort study of outcomes in 221 patients with end-stage renal failure aged 70 years or over recruited from four hospital-based renal units. We assessed 1-year survival in 125 incident patients (70-86 years) and disease burden (hospital admissions, quality of life, costs) in 174 prevalent patients (70-93 years). FINDINGS: 1-year survival rates were: 71% overall; 80%, 69%, and 54% in patients 70-74 years, 75-79 years, and 80 years and older, respectively (p=0.008); and 88%, 71%, and 64% in patients with no, one, or two or more comorbid conditions, respectively (p=0.056). Cox regression analyses showed that mortality was significantly associated with age 80 years and older (relative risk 2.79 [95% CI 1.28-6.93]) and peripheral vascular disease (2.83 [1.29-6.17]), but not with diabetes, ischaemic heart disease, cerebrovascular disease, chronic obstructive airways disease, sex, or treatment method. In terms of disease burden, hospital admissions represent a low proportion of costs and was not required by a third of patients, mental quality of life in elderly dialysis patients was similar to that of elderly people in the general population, and the average annual cost per patient of 20802 (US$31200) (68% dialysis treatment, 1% transport, 19% inpatient hospital admissions, 12% medications) was within the range of other life-extending interventions. INTERPRETATION: Our results suggest that age alone should not be used as a barrier to referral and treatment and emphasise the need to consider the
Ahmed W, Harris S, Brown E, 1999, Attitudes to organ donation among South Asians in an English high street., J R Soc Med, Vol: 92, Pages: 626-627, ISSN: 0141-0768
In the UK, people of South Asian origin are at more than twice the risk of end-stage renal failure encountered in the Caucasian population but are under-represented among organ donors. Difficulties with matching mean that few donated kidneys are suitable for transplantation to South Asian recipients. A survey of attitudes in 100 South Asian adults was conducted in the main street of Southall, Middlesex. 90 of those questioned were aware of organ transplantation and 69 had heard about donor cards. However, the 16% who carried a donor card was lower than the 28% reported in the general population. The main reason for the low organ donation rate by South Asians seemed to be lack of knowledge, and this could be remedied by more targeting of information in the Asian media.
Harris SAC, Constantinovici N, Brown EA, et al., 1999, Effect of dialysis adequacy on morbidity and mortality in elderly dialysis patients., KIDNEY INTERNATIONAL, Vol: 55, Pages: 2576-2576, ISSN: 0085-2538
Tan SY, Baillod R, Brown E, et al., 1999, Clinical, radiological and serum amyloid P component scintigraphic features of beta2-microglobulin amyloidosis associated with continuous ambulatory peritoneal dialysis., Nephrol Dial Transplant, Vol: 14, Pages: 1467-1471, ISSN: 0931-0509
BACKGROUND: Beta2-Microglobulin (beta2M) amyloidosis occurs in patients with end-stage renal failure (ESRF) who undergo long-term continuous ambulatory peritoneal dialysis (CAPD), but its prevalence in patients treated exclusively by CAPD is unknown. In addition, its features may differ from those of haemodialysis-associated beta2M amyloidosis because CAPD is more biocompatible. METHODS: We performed serum amyloid P component (SAP) scintigraphy, a specific technique for imaging amyloid deposits, in 13 consecutive patients with ESRF who had been dialysed for >5 years, at least 80% of the time by CAPD. Clinical and radiological features of beta2M amyloidosis were sought and compared with the results of SAP scintigraphy. RESULTS: SAP scans showed articular amyloid deposits in seven patients, all of whom had evidence of carpal tunnel syndrome and four of whom had arthralgia characteristic of dialysis amyloidosis. Typical radiographic bone cysts were present in only one case who had been dialysed for >17 years. The remaining six patients had no clinical, radiological or scintigraphic evidence of beta2M amyloidosis. CONCLUSIONS: The prevalence of beta2M amyloidosis in this study was comparable with that in reported haemodialysis populations. Many of the amyloid deposits demonstrated by SAP scintigraphy were not associated with symptoms, but larger and longer term studies are required to determine whether CAPD favourably influences their clinical expression.
Harris SAC, Brown EA, Lamping DL, et al., 1999, Effect of late referral to a nephrologist on quality of life of elderly dialysis patients., KIDNEY INTERNATIONAL, Vol: 55, Pages: 2115-2115, ISSN: 0085-2538
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- Citations: 1
Whitaker G, Brown EA, Moss J, et al., 1998, Fibrillary glomerulonephritis occurring in association with hereditary angioneurotic oedema, pernicious anaemia and hypothyroidism, NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol: 13, Pages: 1822-1824, ISSN: 0931-0509
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- Citations: 5
Harris SAC, Brown EA, 1998, Patients surviving more than 10 years on haemodialysis. The natural history of the complications of treatment, NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol: 13, Pages: 1226-1233, ISSN: 0931-0509
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- Citations: 36
Brown EA, 1998, Complications of long term dialysis, Oxford, Publisher: Oxford University Press
Brown EA, 1998, Current trends in the treatment of hypertension in renal disease., Przegl Lek, Vol: 55 Suppl 1, ISSN: 0033-2240
Misra M, Reaveley DA, Cooper C, et al., 1998, Mechanism for elevated plasma lipoprotein(a) concentrations in patients on dialysis: turnover studies., Adv Perit Dial, Vol: 14, Pages: 223-227, ISSN: 1197-8554
Plasma concentrations of lipoprotein (a) [Lp(a)] are increased in patients on renal replacement therapy. Lipoprotein (a) is increasingly being recognized as an independent cardiovascular risk factor. In an effort to explore the mechanism for elevation of Lp(a) in patients on dialysis we have performed turnover studies of Lp(a) with radioactive iodine. Lp(a) was isolated from 1 patient on hemodialysis (HD) and 1 patient on continuous ambulatory peritoneal dialysis (CAPD); the protein was labeled with 125I and returned to each patient. Lipoprotein (a) was subsequently isolated from the patients over a 15-day period and the decay of the specific radioactivity of Lp(a) was used to determine the fractional catabolic rate (FCR), which was 0.27 (pool/day) for the HD patient and 0.28 (pool/day) for the CAPD patient. These rates are indistinguishable from those measured in 4 patients with hypercholesterolemia (0.29, SEM = 0.01) and in 4 other familial hypercholesterolemic patients (0.29, SEM = 0.02) studied previously using the same method by Knight et al. (7). We found no difference in the FCR of patients on dialysis when compared to patients with hyperlipidemia and normal renal function. Increased plasma concentration of Lp(a) in our patients on renal replacement therapy is not due to decreased catabolism, but is caused by increased synthesis.
Bell SP, Frankel A, Brown EA, 1997, Cholesterol emboli syndrome - uncommon or unrecognized?, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 90, Pages: 543-546, ISSN: 0141-0768
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- Citations: 8
Harris SAC, Brown EA, 1997, Long-term complications of dialysis., KIDNEY INTERNATIONAL, Vol: 52, Pages: 1129-1129, ISSN: 0085-2538
Misra M, Reaveley DA, Seed M, et al., 1997, Cardiovascular events on dialysis: A prospective analysis of lipoprotein (a) [Lp(a)] and other risk factors, KIDNEY INTERNATIONAL, Vol: 52, Pages: 267-268, ISSN: 0085-2538
Misra M, Webb AT, Reaveley DA, et al., 1997, The effect of change of renal replacement therapy on serum lipoprotein (a) concentration, ADVANCES IN PERITONEAL DIALYSIS/1997, VOL 13, Vol: 13, Pages: 168-173, ISSN: 1197-8554
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- Citations: 4
Tan SY, Irish A, Winearls CG, et al., 1996, Long term effect of renal transplantation on dialysis-related amyloid deposits and symptomatology, KIDNEY INTERNATIONAL, Vol: 50, Pages: 282-289, ISSN: 0085-2538
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- Citations: 73
Misra M, Ashworth J, Reaveley DA, et al., 1996, Nutritional effects of amino acid dialysate (Nutrineal(TM)) in CAPD patients, ADVANCES IN PERITONEAL DIALYSIS/1996, VOL 12, Vol: 12, Pages: 311-314, ISSN: 1197-8554
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- Citations: 24
BARNES E, FRANKEL A, BROWN EA, et al., 1995, GLOMERULONEPHRITIS ASSOCIATED WITH PERMANENT PACEMAKER ENDOCARDITIS, AMERICAN JOURNAL OF NEPHROLOGY, Vol: 15, Pages: 436-438, ISSN: 0250-8095
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- Citations: 1
WEBB AT, REAVELEY DA, ODONNELL M, et al., 1995, LIPIDS AND LIPOPROTEIN(A) AS RISK-FACTORS FOR VASCULAR-DISEASE IN PATIENTS ON RENAL REPLACEMENT THERAPY, NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol: 10, Pages: 354-357, ISSN: 0931-0509
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- Citations: 46
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