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Biomedical subjects

P Sharpstone

Publications and source records attributed to P Sharpstone.

46 records · Page 3Linked to original sources
PubMed1969

Nephrotic syndrome due to primary renal disease in adults: II. A controlled trial of prednisolone and azathioprine.

A controlled trial in 20 adult patients with the nephrotic syndrome due to proliferative glomerulonephritis compared the effects of consecutive eight-week courses of treatment with prednisolone in conventional dosage and a low-dose azathioprine-prednisolone combination. Though the azathioprine regimen avoided serious toxicity and produced a statistically significant improvement in creatinine clearance and urine protein excretion, the results were not significantly better than with prednisolone itself and overall were not of great clinical value. Prolongation of the azathioprine-prednisolone treatment to one year was associated with some small improvement in the results.The effectiveness of prednisolone in the nephritic syndrome of adults with minimal renal histological abnormality was confirmed by a complete loss of proteinuria within eight weeks in six out of eight patients and substantial reduction in the other two. These two patients subsequently received azathioprine as well but with equivocal results.

Adolescent↗
PubMedDate not supplied

How reproducible is diurnal blood pressure rhythm in patients with secondary (renal) hypertension?

Abnormalities (reduction in/absence of) in diurnal bp rhythm are much more commonly seen in patients with chronic uremia than in patients with primary hypertension or in normal subjects. Target-organ damage is greater in these patients. However, the extent to which these diurnal bp rhythm changes are consistent or variable is untested. We retrospectively examined 223 ambulatory blood pressure monitoring (ABPM) traces in 92 patients with chronic uremia who had undergone ABPM at least twice (mean 2.3 ABPM traces/patient) over the period 1991-1997. ABPM technique and analysis were constant over this period. We found that for patients with chronic declining renal function but not yet on dialysis therapy, 67% retained the same diurnal rhythm from one ABPM recording to the next; if the known tendency for declining renal function to accompanied by a greater prevalence of "non-dipping" is taken into account, 82% of all patients had a "predictable" diurnal pattern. 79% of transplant patients, 87% of haemodialysis patients and 100% of CAPD patients retained the diurnal rhythmicity from one ABPM session to the next. Non-dipping was much more frequent than dipping (67% vs 33%). We conclude that abnormalities of diurnal BP rhythm are reasonably consistent in patients with renal hypertension, especially as renal function declines and patients enter the renal replacement therapy programme.

Adult↗
PubMedDate not supplied

Drug removal in continuous haemofiltration and haemodialysis.

Although both continuous haemofiltration and continuous haemodialysis are techniques routinely employed in the management of critically ill patients, deciding on a drug dosing regimen is often difficult. This article highlights the factors influencing drug removal by both processes, the difficulties associated with the interpretation of research in this area and offers a number of approaches which can be used when selecting a dosing regimen for a patient receiving one of these therapies.

Creatinine↗