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Biomedical subjects

V Parsons

Publications and source records attributed to V Parsons.

161 records · Page 9Linked to original sources
PubMedDate not supplied

Vascular calcification, autonomic neuropathy, and peripheral blood flow in patients with diabetic nephropathy.

The possibility that digital gangrene in patients with diabetic nephropathy might be due to abnormalities of peripheral blood flow secondary to vascular calcification has been investigated. Twenty patients with renal failure due to diabetic nephropathy were studied. Peripheral blood flow was measured using venous occlusion plethysmography, together with an assessment of medial arterial calcification on plain radiographs of the hands and feet, and transcutaneous oxygen tension (TcPO2). Hallux blood flow was markedly raised (median 22.5, range 11.5-56.5, ml min-1 100-ml-1) compared with non-diabetic control subjects (4.7, 1.1-10.5, ml min-1 100-ml-1; p less than 0.01) and similar to that in diabetic patients with autonomic neuropathy (29.5, 16.7-49.6, ml min-1 100-ml-1). Although vascular calcification was common and extensive in the patients with diabetic nephropathy, TcPO2 measurements in the supine foot were normal and did not indicate tissue ischaemia. We conclude that despite extensive vascular calcification high peripheral blood flow occurs in the feet of these patients at rest together with normal transcutaneous oxygen tension.

Adult↗
PubMedDate not supplied

Renal replacement for diabetic patients: experience at King's College Hospital 1980-1989.

Renal failure is an important cause of morbidity and mortality in diabetic patients, who account for up to 25 per cent of new patients entering renal replacement therapy. Between 1980 and 1989, 651 patients with renal failure were treated at King's College Hospital, of whom 177 (27 per cent) had diabetes. Of these 177 patients 148 had diabetic nephropathy (65 non-insulin-dependent), while the rest had other renal diseases. Of the non-insulin-dependent diabetics, 45 per cent (29 of 65) were Asian or Afro-Caribbean compared to only 12 per cent (10/83) of the insulin-dependent diabetics. Ninety-two patients (62 per cent) have received a renal transplant with actuarial patient survival of 82 per cent at 1 year and 61 per cent at 4 years. Both patient and graft survival have been improved by the introduction of cyclosporin A. Continuous ambulatory peritoneal dialysis is the main form of dialysis and has allowed increasing numbers of patients to be dialysed, especially older individuals with non-insulin-dependent diabetes. Rehabilitation is best in those with functioning transplants: 21 patients (19 with functioning grafts) have survived for longer than 5 years. Diabetic complications before and after renal replacement therapy are described. Cardiovascular disease is especially common and may limit the success of renal replacement therapy.

Adolescent↗