Imperial College London

DrDamienAshby

Faculty of MedicineDepartment of Immunology and Inflammation

Honorary Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3313 2718d.ashby

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

11 results found

Adwaney A, Lim C, Blakey S, Duncan N, Ashby DRet al., 2019, Central Venous Stenosis, Access Outcome and Survival in Patients undergoing Maintenance Hemodialysis., Clin J Am Soc Nephrol, Vol: 14, Pages: 378-384

BACKGROUND AND OBJECTIVES: Central venous catheters have traditionally provided access for urgent hemodialysis, but are also sometimes advocated as an option for older or more comorbid patients. Adverse effects of this type of dialysis access include central venous stenosis, for which the risk factors and consequences are incompletely understood. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted two studies within the same population cohort, comprising all patients starting hemodialysis in a single center from January 2006 to December 2013. First, patients were retrospectively analyzed for the presence of central venous stenosis; their access outcomes are described and survival compared with matched controls drawn from the same population. Second, a subset of patients with a history of catheter access within this cohort was analyzed to determine risk factors for central venous stenosis. RESULTS: Among 2811 patients, central venous stenosis was diagnosed in 120 (4.3%), at a median dialysis vintage of 2.9 (interquartile range, 1.8-4.6) years. Compared with matched controls, patients with central venous stenosis had similar survival (median 5.1 versus 5.2 years; P=0.54). Among a subset of 500 patients, all with a history of catheter use, 34 (6.8%) developed central venous stenosis, at a rate of 2.2 per 100 patient-years. The incidence of central venous stenosis was higher with larger number of previous catheters (relative risk [RR], 2.2; 95% confidence interval [95% CI]. 1.6 to 2.9), pacemaker insertion (RR, 3.9; 95% CI, 1.7 to 8.9), and was lower with older age (RR, 0.7 per decade; 95% CI, 0.6 to 0.8). In a Cox proportional hazards model, the catheter number, pacemaker, and younger age at dialysis initiation were all significant independent risk factors for central venous stenosis. CONCLUSIONS: Central venous stenosis occurred in a minority of patients on hemodialysis, and was associated with compromised future access, but unchanged survival. Among patie

Journal article

Ashby DR, Duncan ND, 2013, Effect of initial dialysis access on post-transplant outcome, CLINICAL TRANSPLANTATION, Vol: 27, Pages: 649-649, ISSN: 0902-0063

Journal article

Tan TM, Field BCT, Minnion JS, Cuenco Shillito J, Chambers ES, Zac-Varghese S, Brindley CJ, Mt-Isa S, Fiorentino F, Ashby D, Ward I, Ghatei MA, Bloom SRet al., 2012, Pharmacokinetics, adverse effects and tolerability of a novel analogue of human pancreatic polypeptide, PP 1420., British Journal of Clinical Pharmacology, Vol: 73, Pages: 232-239

AIMS: The objectives of this phase 1 study were to confirm the tolerability ofsingle ascending subcutaneous doses of PP 1420 in healthy subjects, to assess itsadverse effects and to investigate the drug's pharmacokinetics and doseproportionality.METHODS: This was a double-blind, placebo-controlled, randomized study. Therewere three dosing periods. Each subject (n= 12) was randomized to receive onedose of placebo and two ascending doses of PP 1420, given as a subcutaneousinjection. Blood samples were taken over 24 h to assess pharmacokinetics.Standard safety and laboratory data were collected. The primary endpoint was the tolerability of PP 1420. The secondary endpoint was exposure to PP 1420 asassessed by C(max) and AUC(0,∞).RESULTS: PP 1420 was well tolerated by all subjects with no serious adverseeffects. Following single subcutaneous doses of PP 1420 at 2, 4 and 8 mg to male subjects, C(max) was reached at a median t(max) of approximately 1 h post dose(range 0.32-2.00 h). Thereafter, plasma concentrations of PP 1420 declined withgeometric mean apparent terminal elimination t(1/2) ranging from 2.42-2.61 h(range 1.64-3.95 h) across all dose levels.CONCLUSIONS: Subcutaneous PP 1420 was well tolerated in healthy human subjects atsingle doses between 2-8 mg, with no tolerability issues arising. Where observed,adverse events were not serious, and there was no evidence of a dose-relationshipto frequency of adverse events. The results therefore support the conduct ofclinical trials to investigate efficacy, tolerability and pharmacokinetics duringrepeated dosing.

Journal article

Rhodes CJ, Howard LS, Busbridge M, Ashby D, Kondili E, Gibbs JSR, Wharton J, Wilkins MRet al., 2011, Iron Deficiency and Raised Hepcidin in Idiopathic Pulmonary Arterial Hypertension Clinical Prevalence, Outcomes, and Mechanistic Insights, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 58, Pages: 300-309, ISSN: 0735-1097

Journal article

Ashby DR, Gale DP, Busbridge M, Murphy KG, Duncan ND, Cairns TD, Taube DH, Bloom SR, Tam FWK, Chapman R, Maxwell PH, Choi Pet al., 2010, Erythropoietin administration in humans causes a marked and prolonged reduction in circulating hepcidin, HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, Vol: 95, Pages: 505-508, ISSN: 0390-6078

Journal article

Ashby DR, Power A, Singh S, Choi P, Taube DH, Duncan ND, Cairns TDet al., 2009, Bacteremia Associated with Tunneled Hemodialysis Catheters: Outcome after Attempted Salvage, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, Vol: 4, Pages: 1601-1605, ISSN: 1555-9041

Journal article

Ashby DR, Gale DP, Busbridge M, Murphy KG, Duncan ND, Cairns TD, Taube DH, Bloom SR, Tam FWK, Chapman RS, Maxwell PH, Choi Pet al., 2009, Plasma hepcidin levels are elevated but responsive to erythropoietin therapy in renal disease, KIDNEY INTERNATIONAL, Vol: 75, Pages: 976-981, ISSN: 0085-2538

Journal article

Ashby D, Ford H, Wynne K, Wren A, Murphy K, Busbridge M, Brown E, Taube D, Ghatei M, Tam F, Bloom SR, Choi Pet al., 2009, Sustained appetite improvement in malnourished dialysis patients with daily subctanous ghrelin, Kidney International, Vol: 2, Pages: 199-206

Journal article

Busbridge M, Griffiths C, Ashby D, Gale D, Jayantha A, Sanwaiya A, Chapman RSet al., 2009, Development of a novel immunoassay for the iron regulatory peptide hepcidin, BRITISH JOURNAL OF BIOMEDICAL SCIENCE, Vol: 66, Pages: 150-157, ISSN: 0967-4845

Journal article

Ashby D, Choi P, Bloom S, 2008, Gut hormones and the treatment of disease cachexia, Annual Meeting of the Nutrition-Society/British-Association-for-Parenteral-and-Enteral-Nutrition, Publisher: CAMBRIDGE UNIV PRESS, Pages: 263-269, ISSN: 0029-6651

Conference paper

Ashby D, Smith C, Hurril R, Maxwell P, Brown Eet al., 2008, Dialysis survivors: Clinical status of patients on treatment for more than 10 years, NEPHRON CLINICAL PRACTICE, Vol: 108, Pages: C207-C212, ISSN: 1660-2110

Journal article

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