Imperial College London
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ProfessorEdwinaBrown

Faculty of Medicine, Department of Immunology and Inflammation

Professor of Renal Medicine
 
 
 
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Contact

 

+44 (0)20 3311 7590e.a.brown

 
 
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Location

 

Renal OfficesHammersmith HouseHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

301 results found

Beckwith H, Adwaney A, Appelbe M, Gaffney H, Hill P, Moabi D, Prout V, Salisbury E, Webster P, Tomlinson J, Brown Eet al., 2021, Perceptions of illness severity, treatment goals and life expectancy: the ePISTLE study, Kidney International Reports, Vol: 6, Pages: 1558-1566, ISSN: 2468-0249

IntroductionA better understanding of factors influencing perceived life expectancy (PLE), interactions between patient prognostic beliefs, experiences of illness, and treatment behavior is urgently needed.MethodsCase-notes at 3 hemodialysis units were screened: patients with ≥20% 1-year mortality risk were included. Patients and their health care professionals (HCPs) were invited to complete a structured interview or mixed-methods questionnaire. Four hundred eleven patient notes were screened. Seventy-seven eligible patients were approached and 51 were included.ResultsPatients predicted significantly higher life expectancies than HCPs (P < 0.0001). Documented cognitive impairment, gender, or increasing age did not affect 1- or 5-year PLE. PLE influenced priorities of care: one-fifth of patients who estimated themselves to have >95% 1-year survival preferred “care focusing on relieving pain and discomfort,” compared with nearly three-quarters of those reporting a ≤50% chance of 1-year survival. Twenty of 51 (39%) patients believed transplantation was an option for them, despite only 4 being waitlisted at the time of the interview. Patients who thought they were transplant candidates were significantly more confident they would be alive at 1 and 5 years and to want resuscitation attempted. Cognitive impairment had no effect on perceived transplant candidacy. A high symptom burden was present and underrecognized by HCPs. High symptom burden was associated with significantly lower PLE at both 1 and 5 years, increased anxiety/depression scores, and treatment choices more likely to prioritize relief of suffering.ConclusionThere is a disparity between patient PLE and those of their HCPs. Severity of symptom burden and beliefs regarding PLE or transplant candidacy affect patient treatment preferences.

Journal article

Thind A, Beckwith H, Dattani R, Dhutia A, Gleeson S, Martin P, Ryan L, Shuaib R, Svetitsky S, Dor F, Brown E, Willicombe Met al., 2021, Resuming deceased donor kidney transplantation in the COVID-19 era: what do patients want?, Transplantation Direct, Vol: 7, Pages: 1-6, ISSN: 2373-8731

Background: The rapidly evolving novel coronavirus 2019 (COVID-19) pandemic bought many kidney transplant (KT) programmes to a halt. Integral to resuming KT activity is understanding the perspectives of potential transplant candidates during this highly dynamic time. Methods: From June 1st to July 7th 2020, a telephone survey of KT candidates on the deceased donor waiting list at Imperial College Renal and Transplant Centre in West London was conducted. The survey captured ongoing COVID-19 exposure risks and patients’ views on wait list (WL) reactivation and undergoing transplantation. Results: 207 responses were received. Of the respondents 180 patients (87%) were happy to be reactivated onto the WL; with 141 patients (68%) willing to give consent to transplantation currently, whilst 53 patients (26%) felt unsure, and 13 patients (6%) would decline a KT. The vast majority of patients had no concerns. In the responses from those who were uncertain or who would decline a KT, concerns about COVID-19 infection and the need for reassurance from transplant units dominated. Universally patients wanted more information about COVID-19 infection risk with KT and the precautions being taken to reduce this risk. Conclusions: The majority of surveyed patients are in favour of reactivation and receiving a KT despite the ongoing COVID-19 pandemic. Reactivation of candidates cannot be assumed and should take an individualised approach, incorporating clinical risk with patient perspectives. Improved communication with KT candidates is highly requested.

Journal article

Hurst H, Jones E, Ormandy P, Brettle A, Nixon AC, Young H, Mooney A, Winterbottom A, Bekker H, Brown E, Murtagh FE, Da Silva-Gane M, Coyle D, Finnigan Ret al., 2021, Outcomes and care priorities for older people living with frailty and advanced chronic kidney disease: a multiprofessional scoping review protocol., BMJ Open, Vol: 11

INTRODUCTION: Reported outcomes for older people with advanced chronic kidney disease (CKD) often focus on survival and mortality and little attention is paid to symptom burden and health-related quality of life. Recognising frailty and providing interventions that may improve outcomes have been studied in the general population with a growing research interest within CKD. METHODS AND ANALYSIS: A scoping review will be undertaken following a recommended process to understand relevant research and priorities for older people living with frailty and advanced CKD. Databases will be searched and following a systematic process by a core team, a final list of included studies will be analysed. Focus groups will then be conducted with older people with advanced CKD to incorporate stakeholder views. ETHICS AND DISSEMINATION: Our scoping review will use robust methodology to identify relevant literature focused on outcomes and care priorities for older people with advanced CKD. Ethical approval will be sought to conduct the focus groups. The result of this review will be disseminated through patient networks and national conferences. The interdisciplinary team collaborating plan to continue work in this area to improve the care and management of older people with advanced CKD.

Journal article

Lunney M, Bello AK, Levin A, Tam-Tham H, Thomas C, Osman MA, Ye F, Bellorin-Font E, Benghanem Gharbi M, Ghnaimat M, Htay H, Cho Y, Jha V, Ossareh S, Rondeau E, Sola L, Tchokhonelidze I, Tesar V, Tungsanga K, Kazancioglu RT, Wang AY-M, Yang C-W, Zemchenkov A, Zhao M-H, Jager KJ, Jindal KK, Okpechi IG, Brown EA, Brown M, Tonelli M, Harris DC, Johnson DW, Caskey FJ, Davison SNet al., 2021, Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide, CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, Vol: 16, Pages: 79-87, ISSN: 1555-9041

Journal article

Beadle J, Brown EA, 2021, Quality of Life in Peritoneal Dialysis, Applied Peritoneal Dialysis: Improving Patient Outcomes, Pages: 301-316, ISBN: 9783030708962

End-stage kidney disease (ESKD) is a chronic medical condition with a significant symptom burden. Treatment with kidney replacement therapies, including peritoneal dialysis (PD), can improve survival and ameliorate the complications and consequences of ESKD but do not provide a ‘cure’. For many patients, some of whom may be on dialysis for life, the quality, rather than duration of life, is increasingly important. Health-related quality of life (HRQOL) is a concept that relates to the impact of both the disease and its treatment on a patient’s physical, functional, social and psychological well-being. HRQOL is an important outcome measure in patients on PD – it correlates with outcomes such as mortality and hospitalisation, but it also reflects the patient’s perspective and experience of dialysis. Whilst HRQOL is often overlooked as an outcome measure in favour of assessment of mortality, infection rates or dialysis adequacy, it more closely reflects the subjective patient experience of PD and offers opportunities to optimise an individual patient’s care. This chapter will focus on definitions of quality of life and measurement tools to assess this, compare quality of life in haemodialysis and peritoneal dialysis and identify a selection of factors that influence HRQOL in PD.

Book chapter

Clarke C, Lucisano G, Prendecki M, Gleeson S, Martin P, Ali M, McAdoo SP, Lightstone L, Ashby D, Charif R, Griffith M, McLean A, Dor F, Willicombe M, ICHNT Renal COVID Groupet al., 2021, Informing the risk of kidney transplantation versus remaining on the wait list in the COVID-19 era, Kidney International Reports, Vol: 6, Pages: 46-55, ISSN: 2468-0249

Introduction: There is limited data pertaining to comparative outcomes of remaining on dialysis versus kidney transplantation as the threat of COVID-19 remains. This study aims to delineate the differential risks involved using serological methods to help define exposure rates. Methods: From a cohort of 1433 patients with ESKD, we analysed COVID-19 infection rates and outcomes in 299 wait list patients compared with 237 transplant recipients within their first year post-transplant. Patients were followed over a 68-day period from the time our transplant programme closed due to COVID-19. Results: The overall mortality rate in wait list and transplant populations were equivalent, p=0.69. However, COVID-19 infection was more commonly diagnosed in the wait list patients, p=0.001, who were more likely to be tested by RT-PCR, p=0.0004. Once infection was confirmed, mortality risk was higher in the transplant patients, p=0.015. The seroprevalence in dialysis and transplant patients with undetected infection was 18.3% and 4.6% respectively, p=0.0001. After adjusting for a potential screening bias, the relative risk of death following a diagnosis of COVID-19 remained higher in transplant recipients, HR: 3.36 (1.19-9.50), p=0.022. Conclusions: In conclusion, whilst COVID-19 infection was more common in the wait list patients, a higher COVID-19 associated mortality rate was seen in transplant recipients, resulting in comparable overall mortality rates.

Journal article

Navaratnarajah A, Clemenger M, McGrory J, Hisole N, Chelapurath T, Corbett RW, Brown EAet al., 2021, Flexibility in peritoneal dialysis prescription: Impact on technique survival, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 41, Pages: 49-56, ISSN: 0896-8608

Journal article

Baumgart A, Manera KE, Johnson DW, Craig JC, Shen J, Ruiz L, Wang AY-M, Yip T, Fung SKS, Tong M, Lee A, Cho Y, Viecelli AK, Sautenet B, Teixeira-Pinto A, Brown EA, Brunier G, Dong J, Scholes-Robertson N, Dunning T, Mehrotra R, Naicker S, Pecoits-Filho R, Perl J, Wilkie M, Tong Aet al., 2020, Meaning of empowerment in peritoneal dialysis: focus groups with patients and caregivers, NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol: 35, Pages: 1949-1958, ISSN: 0931-0509

Journal article

Harris DCH, Davies SJ, Finkelstein FO, Jha V, Bello AK, Brown M, Caskey FJ, Donner J-A, Liew A, Muller E, Naicker S, O'Connell PJ, Pecoits Filho R, Vachharajani Tet al., 2020, Strategic plan for integrated care of patients with kidney failure, KIDNEY INTERNATIONAL, Vol: 98, Pages: S117-S134, ISSN: 0085-2538

Journal article

Navaratnarajah A, Brown EA, Kemp P, 2020, Why do people waste differently on dialysis? Important insights from other chronic diseases with a focus on microRNAs., Clin Nephrol, Vol: 94, Pages: 105-115, ISSN: 0301-0430

Premature muscle tiring (fatigue) is an important complication of advanced kidney disease, and results in a reduced ability to walk and exercise. As patients move from pre-dialysis care to dialysis, they begin to lose their residual kidney function and experience muscle wasting. Not all patients on dialysis are affected equally by the loss of muscle mass, and the effect of dialysis mode (peritoneal dialysis and hemodialysis) on muscle wasting is not known. This review will explore molecular mechanisms relevant to muscle wasting in end-stage kidney disease and in particular address some important insights into the emerging role of microRNAs in regulating the wasting response in individuals with chronic disease.

Journal article

Brown EA, Perl J, 2020, Increasing Peritoneal Dialysis Use in Response to the COVID-19 Pandemic: Will It Go Viral?, J Am Soc Nephrol, Vol: 31, Pages: 1928-1930

Journal article

Navaratnarajah A, El-Sherbini N, Brown EA, 2020, Long-term outcomes in patients with encapsulating peritoneal sclerosis managed with nutritional support, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 487-495, ISSN: 0896-8608

Journal article

Ronco C, Manani SM, Giuliani A, Tantillo I, Reis T, Brown EAet al., 2020, Remote patient management of peritoneal dialysis during COVID-19 pandemic, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 363-367, ISSN: 0896-8608

Journal article

Brown EA, Boudville N, Finkelstein F, Johnson D, Liew A, Moraes T, Teitelbaum I, Warady Bet al., 2020, Response to: International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis Reply, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 427-428, ISSN: 0896-8608

Journal article

Gleeson S, Navaratnarajah A, Hisole N, McGrory J, Chelapurath T, Galima F, Zanovello V, Bartholomew C, Punzalan S, Brown E, Corbett Ret al., 2020, TREATMENT OUTCOMES IN PERITONEAL DIALYSIS PERITONITIS ARE NOT AFFECTED BY DEGREE OF RESIDUAL RENAL FUNCTION, 57th ERA-EDTA Congress, Publisher: OXFORD UNIV PRESS, Pages: 1533-1533, ISSN: 0931-0509

Conference paper

Brown EA, Hurst H, 2020, Delivering peritoneal dialysis for the multimorbid, frail and palliative patient, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 327-332, ISSN: 0896-8608

Journal article

Corbett RW, Goodlet G, MacLaren B, Jolliffe A, Joseph A, Lu C, da Silva CCF, Soni B, Wicks M, Brown EA, Blake PGet al., 2020, International Society for Peritoneal Dialysis Practice Recommendations: The view of the person who is doing or who has done peritoneal dialysis, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 349-352, ISSN: 0896-8608

Journal article

Brown EA, Blake PG, Boudville N, Davies S, de Arteaga J, Dong J, Finkelstein F, Foo M, Hurst H, Johnson DW, Johnson M, Liew A, Moraes T, Perl J, Shroff R, Teitelbaum I, Wang AY-M, Warady Bet al., 2020, International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 244-253, ISSN: 0896-8608

Journal article

Blake PG, Brown EA, 2020, Person-centered peritoneal dialysis prescription and the role of shared decision-making, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 40, Pages: 302-309, ISSN: 0896-8608

Journal article

Manera KE, Johnson DW, Craig JC, Shen JI, Gutman T, Cho Y, Wang AY-M, Brown EA, Brunier G, Dong J, Dunning T, Mehrotra R, Naicker S, Pecoits-Filho R, Perl J, Wilkie M, Tong A, Levin A, Liew A, Cueto Manzano A, Abu Alfa A, Neu A, Baumgartf A, Bernier-Jean A, Kelly A, Figueiredo A, Matus A, Viecelli A, Ju A, Saxena A, Sharma A, Nadeau-Fredette A-C, Teixeira-Pinto A, Mendelson A, Kelly A, Goh BL, Sautenet B, Manns B, Hemmelgarn B, Robinson B, Hanson C, Cheung C, Guha C, Logeman C, Szeto C-C, Rutherford C, Schwartz D, Sumpton D, Johnson D, Wheeler D, Brown E, O'Lone E, Au E, Goffin E, Finkelstein F, Abraham G, Brunier G, Germino G, Hurst H, Kawanishi H, Htay H, Yap HK, Teitelbaum I, Perl J, Chen J, Shen J, Dong J, Neumann J, Bargman J, Morelle J, Craig J, Kilonzo KG, Yeates K, Maner K, Azukaitis K, Van KL, Dunn L, Krishnan M, Lambie M, Howell M, Schreiber M, Wilkie M, Oliver M, Sanabria MR, Nataatmadja M, Lichodziejewska-Niemierko M, Verdin N, Mann N, Boudville N, Evangelidis N, Scholes-Robertson N, Blake P, Nourse P, Tugwell P, Li PK-T, Mehrotra R, McGee R, Quinn R, Crowe S, Anumudu S, Bernays S, Naicker S, Wilson S, Nessim S, Teo S, Carter SA, Davies S, Sweety SA, Gutman T, Toffelmire T, Jassal V, Jha V, da Silva VC, Van Biesen W, Winkelmayer W, Ito Y, Cho Y, Kim Y-L, Butt Zet al., 2020, Establishing a core outcome set for peritoneal dialysis: report of the SONG-PD (Standardized Outcomes in Nephrology-Peritoneal Dialysis) consensus workshop, American Journal of Kidney Diseases, Vol: 75, Pages: 404-412, ISSN: 0272-6386

Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology–Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD.

Journal article

Ryan L, Brown E, 2020, Supporting and maintaining the frail patient on long-term renal replacement therapy., Clin Med (Lond), Vol: 20, Pages: 139-141

The number of frail patients reaching end-stage kidney disease is increasing. They have a high level of comorbidity and symptom burden which need to be considered when making management plans. For those who choose renal replacement therapy, it is important to establish goals and ceilings of care and to provide holistic care focusing on optimising quality of life. Advance care planning is the process of documenting the patient's preferences for their treatment in the event they lose capacity to make decisions about their treatment.

Journal article

Van Biesen W, Jha V, Abu-Alfa AK, Andreoli SP, Ashuntantang G, Bernieh B, Brown E, Chen Y, Coppo R, Couchoud C, Cullis B, Douthat W, Eke FU, Hemmelgarn B, Hou FF, Levin NW, Luyckx VA, Morton RL, Moosa MR, Murtagh FEM, Richards M, Rondeau E, Schneditz D, Shah KD, Tesar V, Yeatesand K, Garcia GGet al., 2020, Considerations on equity in management of end -stage kidney disease in low- and middle -income countries, KIDNEY INTERNATIONAL SUPPLEMENTS, Vol: 10, Pages: E63-E71, ISSN: 2157-1724

Journal article

Hole B, Hemmelgarn B, Brown E, Brown M, McCulloch MI, Zuniga C, Andreoli SP, Blake PG, Couchoud C, Cueto-Manzano AM, Dreyer G, Garcia G, Jager KJ, McKnight M, Morton RL, Murtagh FEM, Naicker S, Obrador GT, Perl J, Rahman M, Shah KD, Van Biesen W, Walker RC, Yeates K, Zemchenkov A, Zhao M-H, Davies SJ, Caskey FJet al., 2020, Supportive care for end -stage kidney disease: an integral part of kidney services across a range of income settings around the world, KIDNEY INTERNATIONAL SUPPLEMENTS, Vol: 10, Pages: E86-E94, ISSN: 2157-1724

Journal article

Brown EA, 2020, Peritoneal dialysis versus hemodialysis in the elderly, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 19, Pages: 311-312, ISSN: 0896-8608

Journal article

Fielding RE, Clemenger M, Goldberg L, Brown EAet al., 2020, Treatment and outcome of peritonitis in automated peritoneal dialysis, using a once-daily cefazolin-based regimen, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 22, Pages: 345-349, ISSN: 0896-8608

Journal article

Misra M, Reaveley DA, Ashworth J, Muller B, Seed M, Brown EAet al., 2020, Six-month prospective cross-over study to determine the effects of 1.1% amino acid dialysate on lipid metabolism in patients on continuous ambulatory peritoneal dialysis, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 17, Pages: 279-286, ISSN: 0896-8608

Journal article

Harris SAC, Lamping DL, Brown EA, Constantinovici Net al., 2020, Clinical outcomes and quality of life in elderly patients on peritoneal dialysis versus hemodialysis, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 22, Pages: 463-470, ISSN: 0896-8608

Journal article

Davies SJ, Brown EA, 2020, EAPOS: What have we learned?, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 27, Pages: 131-135, ISSN: 0896-8608

Journal article

Tarzi RM, Frank JW, Ahmad S, Levy JB, Brown EAet al., 2020, Fluorodeoxyglucose positron emission tomography detects the inflammatory phase of sclerosing peritonitis, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 26, Pages: 224-230, ISSN: 0896-8608

Journal article

Brown EA, 2020, Erythropoietin dose: Determined by the genes?, PERITONEAL DIALYSIS INTERNATIONAL, Vol: 26, Pages: 38-40, ISSN: 0896-8608

Journal article

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