72 results on '"Feest TG"'
Search Results
2. Dialysis decision making in Canada, the United Kingdom, and the United States
- Author
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McKenzie, JK, primary, Moss, AH, additional, Feest, TG, additional, Stocking, CB, additional, and Siegler, M, additional
- Published
- 1998
- Full Text
- View/download PDF
3. The provision of renal replacement therapy for adults in England and Wales: recent trends and future directions.
- Author
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Roderick, PJ, Ferris, G, and Feest, TG
- Published
- 1998
- Full Text
- View/download PDF
4. OSTEOMALACIC DIALYSIS OSTEODYSTROPHY: EVIDENCE FOR A WATER-BORNE ÆTIOLOGICAL AGENT, PROBABLY ALUMINIUM
- Author
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David N.S. Kerr, G.L Goode, H. A. Ellis, Feest Tg, J Herrington, M. K. Ward, and I. S. Parkinson
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Encephalopathy ,chemistry.chemical_element ,Dialysis Encephalopathy ,Gastroenterology ,Renal Dialysis ,Water Supply ,Aluminium ,Internal medicine ,medicine ,Humans ,Water Pollutants ,In patient ,Osteodystrophy ,Child ,Dialysis ,Ions ,Osteomalacia ,business.industry ,Osmolar Concentration ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,England ,chemistry ,Etiology ,Kidney Failure, Chronic ,Female ,business ,Water Pollutants, Chemical ,Aluminum - Abstract
In patients maintained on regular haemodialysis in Newcastle upon Tyne the development of osteomalacia is substantially reduced when water used to prepare dialysate is deionised. After 1-4 years of dialysis, osteomalacia was evident in 15% of patients on deionised water and in 70% of patients on softened water from the same source. The close association of dialysis encephalopathy and osteomalacia suggests a common aetiology. Both diseases occur in centres with a high tap-water aluminium content. Serum-aluminium concentrations were raised in patients undergoing regular haemodialysis in the Northern Region of England. Those using softened water had higher concentrations than those using deionised water. Patients on softened water who had encephalopathy or dementia had serum-aluminium concentrations similar to those of patients using the same water-supplies without symptoms of these diseases, but they had been treated for longer. The evidence that aluminium absorption from dialysate causes osteomalacia and encephalopathy is strong enough to justify the expense of treating water by deionisation, reverse osmosis, or both in centres where tap-water aluminium is high.
- Published
- 1978
- Full Text
- View/download PDF
5. HISTOPATHOLOGY OF RENAL OSTEODYSTROPHY WITH PARTICULAR REFERENCE TO THE EFFECTS OF lα-HYDROXYVITAMIN D3IN PATIENTS TREATED BY LONG-TERM HAEMODIALYSIS
- Author
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Feest Tg, M. K. Ward, David N.S. Kerr, H. A. Ellis, and A. M. Pierides
- Subjects
musculoskeletal diseases ,Osteomalacia ,medicine.medical_specialty ,Bone disease ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,nutritional and metabolic diseases ,Histology ,urologic and male genital diseases ,medicine.disease ,Endocrinology ,Internal medicine ,Medicine ,Alkaline phosphatase ,Renal osteodystrophy ,Histopathology ,Osteitis ,business ,Dialysis - Abstract
(1) The bone histology of 233 non-dialysed and 276 haemodialysed patients with chronic renal failure is reviewed. In non-dialysed patients osteitis fibrosa occurred in 83.7% and osteomalacia in 23.6% of patients. Osteomalacia was not found in the absence of osteitis fibrosa. In haemodialysed patients there was a more variable bone histology, sometimes resembling non-dialysed bone disease, but in general with a greater incidence of osteomalacia, especially with increasing time on dialysis. In some patients there was a predominance of osteomalacia accompanied by no or only mild osteitis fibrosa and the serum alkaline phosphatase was normal. (2) The results of treating twenty-six haemodialysed patients with 1alpha-hydroxyvitamin D3 (1alpha-OHD3) are described. Patients with osteomalacia and minimal or no osteitis fibrosa and a normal serum alkaline phosphatase (Group I) in general failed to respond and it is suggested that 1,25-dihydroxyvitamin D3 deficiency is not the sole factor responsible for the osteomalacia in these patients. In contrast, 1alpha-OHD3 therapy was effective in improving osteitis fibrosa and osteomalacia in some patients with moderate to severe degrees of osteitis fibrosa and osteomalacia (Group IIa) and in improving osteitis fibrosa where this occurred alone (Group IIb).
- Published
- 1977
- Full Text
- View/download PDF
6. The care of patients with diabetic nephropathy: audit, feedback, and improvement
- Author
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Dunn, EJ, Burton, CJ, and Feest, TG
- Abstract
Diabetic nephropathy is the commonest cause of end-stage renal failure in the developed world. The quality of care of 152 patients with diabetic nephropathy was assessed at the time of referral to a single nephrologist. The type 11 diabetics (62%) were older than the type 1 diabetics (38%) (mean 65 years vs. 48 years). The mean duration of diabetes was 17 years. Significant cardiovascular disease was present in 52%. There was diabetic retinopathy in 84% of the type 1 diabetics and 53% of the type 11 diabetics. Overall, 63% had hypertension at referral (St Vincent Declaration criteria), untreated in 25%. ACE inhibitors were not prescribed in 48% when no contraindications to their use were present. Glycosylated haemoglobin was >9.1% in 29%. Twenty were prescribed medications inappropriate to their renal function. Of patients with ischaemic heart disease and serum cholesterol >5.5 mmol/1, 82% were untreated; 82% of patients with secondary hyperparathyroidism were also untreated. At initial referral, many patients' care was sub-optimal. Referral was too late for adequate preparation for renal replacement therapy in 33%. Following a process of education and feedback of the results to referring practitioners, the timing of referral improved. We emphasize the need for closer co-operation between those managing diabetic patients with nephropathy to optimize their care.
- Published
- 1999
7. Can intensive treatment alter the progress of established diabetic nephropathy to end-stage renal failure?
- Author
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Feest, TG, Dunn, EJ, and Burton, CJ
- Abstract
Diabetic nephropathy is now the leading cause of end-stage renal disease in the Western world, and is associated with a higher patient morbidity and mortality than other causes of renal failure, largely because of associated cardiovascular disease. Numerous studies have elucidated the factors which influence its onset and progression. The St Vincent Declaration in 1994 proposed standards for the appropriate management of patients with diabetic nephropathy. We assessed whether referral to a nephrology clinic attempting to apply these standards influenced the progression of diabetic nephropathy. The results show a significant improvement in blood pressure, glycosylated haemoglobin and serum cholesterol following referral. There was a significant reduction in the rate of decline of renal function following referral in 39% of patients. With the possible exception of diabetic control there were no significant differences in the management of those that did and did not show improvement. The results show that with intensive out-patient clinic monitoring it is possible to improve the quality of patient care, and that even in established diabetic nephropathy it is possible to slow the rate of progression to end-stage renal failure.
- Published
- 1999
8. Osteomalacic dialysis osteodystrophy: a trial of phosphate-enriched dialysis fluid
- Author
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David N.S. Kerr, M. K. Ward, Aljama P, H. A. Ellis, and Feest Tg
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Iliac crest ,Phosphates ,Renal Dialysis ,Humans ,Medicine ,Renal osteodystrophy ,Prospective Studies ,Osteodystrophy ,Myopathy ,Prospective cohort study ,Dialysis ,General Environmental Science ,Chronic Kidney Disease-Mineral and Bone Disorder ,Osteomalacia ,Hydroxycholecalciferols ,business.industry ,General Engineering ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,General Earth and Planetary Sciences ,Female ,Osteitis ,medicine.symptom ,business ,Research Article - Abstract
To assess whether phosphate depletion is an aetiological factor in osteomalacic dialysis osteodystrophy we undertook a prospective trial of phosphate-enriched dialysis fluid, in association with oral 1alpha-hydroxycholecalciferol, for this condition. Thirty patients started the trial; of the 27 who completed more than 6 months' treatment, 14 had iliac crest bone biopsies at the beginning and end of the treatment period. Side effects included pruritus, stiffness, and increase in corneal and vascular calcification. Only one patient showed histological improvement of osteomalacia, and eight deteriorated; in seven the osteitis fibrosa worsened. Myopathy showed some improvement in four patients, but became worse in four. This treatment does not seem to have a place in the routine management of non-hypophosphataemic patients on dialysis.
- Published
- 1978
- Full Text
- View/download PDF
9. Renal Tubular Acidosis
- Author
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Wrong Om and Feest Tg
- Subjects
Adult ,Male ,medicine.medical_specialty ,business.industry ,030232 urology & nephrology ,Urology ,Infant ,Acidosis, Renal Tubular ,General Medicine ,medicine.disease ,Renal tubular acidosis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Female ,030212 general & internal medicine ,business - Published
- 1981
- Full Text
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10. In memoriam: Oliver M. Wrong.
- Author
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Scheinman SJ, Feehally J, Feest TG, Norden AG, Thakker RV, and Unwin RJ
- Subjects
- Acid-Base Equilibrium, Acidosis, Renal Tubular history, Fanconi Syndrome history, History, 20th Century, History, 21st Century, Kidney Diseases genetics, Kidney Diseases physiopathology, Renal Tubular Transport, Inborn Errors history, United Kingdom, Biomedical Research history, Kidney Diseases history, Nephrology history
- Published
- 2012
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11. Exploring the differences in epidemiology of treated ESRD between Germany and England and Wales.
- Author
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Caskey FJ, Schober-Halstenberg HJ, Roderick PJ, Edenharter G, Ansell D, Frei U, and Feest TG
- Subjects
- Adolescent, Adult, Aged, England epidemiology, Female, Germany epidemiology, Humans, Incidence, Kidney Failure, Chronic therapy, Male, Middle Aged, Registries, Renal Replacement Therapy, Wales epidemiology, Kidney Failure, Chronic epidemiology
- Abstract
Background: The aim of this study is to investigate reasons for the large reported differences in renal replacement therapy (RRT) incidence between Germany and England and Wales (E&W)., Methods: Age- and sex-standardized incidence rates were calculated at day 0, day 90, and day 180 by using registry data, and early RRT mortality was studied as an indicator of ascertainment differences. Nationally representative health survey data were analyzed to provide general population prevalence data for major chronic kidney disease risk factors: hypertension, diabetes, vascular disease, obesity, and smoking. Resource data were collected from routine sources and national surveys, and literature searches were performed to explore variation in chronic kidney disease prevalence, late referral, early start, and nondialytic therapy., Results: The gap in RRT incidence between Germany and E&W increased after adjusting for differences in early mortality. The standardized day-90 incidence rate ratio was 1.79 (193.0 per million of the adult population [pmap] in Germany and 107.5 pmap in E&W) diabetes and vascular disease explained 79% of this difference. Diabetes, ischemic heart disease, and hypertension were 1.85-, 1.24-, and 1.18-fold more prevalent in Germany, whereas rates of hypertension control were 0.54-fold lower (20% versus 37% in England). Ischemic heart disease mortality rates were lower in Germany., Conclusion: Much of the difference in RRT incidence between Germany and E&W is explained by a greater prevalence of diabetes, hypertension, and vascular disease in the German general population, particularly those older than 65 years, and lower competing mortality risk.
- Published
- 2006
- Full Text
- View/download PDF
12. Renal replacement therapy for diabetic end-stage renal disease: data from 10 registries in Europe (1991-2000).
- Author
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Van Dijk PC, Jager KJ, Stengel B, Grönhagen-Riska C, Feest TG, and Briggs JD
- Subjects
- Age Distribution, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 epidemiology, Diabetic Nephropathies epidemiology, Europe epidemiology, Female, Humans, Incidence, Kidney Failure, Chronic epidemiology, Male, Registries, Diabetic Nephropathies therapy, Kidney Failure, Chronic therapy, Renal Replacement Therapy statistics & numerical data
- Abstract
Background: There is concern about the rising prevalence of type 2 diabetes mellitus and of the resultant nephropathy. This study uses data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry to provide information on the epidemiology and outcome of renal replacement therapy (RRT) for end-stage renal disease (ESRD) due to diabetic nephropathy (DN)., Methods: Data from the following 10 registries: Austria, French-speaking Belgium, Denmark, Finland, Greece, Norway, Scotland (UK), Catalonia (Spain), Sweden, and The Netherlands were combined. Average annual changes (%) were estimated by Poisson regression. Analyses of mortality were performed by Cox regression., Results: An increase in patients with type 2 DN entering RRT has been observed (+11.9% annually, P < 0.05), while large differences in RRT incidence in this disease continue to exist between countries in Europe. There was a reduction in mortality during the first 2 years on dialysis therapy among patients with type 2 DN (AHR 0.96, 95%CI 0.94-0.97 annually). The mortality among transplant recipients decreased for both type 1 DN and nondiabetic ESRD (non DN) within the 1995-1998 cohort (type 1 DN: AHR 0.49, 95% CI 0.35-0.68; non DN: AHR 0.79, 95% CI 0.69-0.90) compared to the 1991-1994 cohort., Conclusion: This report has shown that during the last decade there has been a marked increase in the incidence of RRT for type 2 DN. Survival analysis showed that over the period 1991-1999 the mortality rates of all dialysis patients and of type 1 diabetic and nondiabetic renal transplant recipients have fallen.
- Published
- 2005
- Full Text
- View/download PDF
13. Regional differences in the provision of adult renal dialysis services in the UK.
- Author
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Blank L, Peters J, Lumsdon A, O'donoghue DJ, Feest TG, Scoble J, Wight JP, and Bradley J
- Subjects
- Adult, Arteriovenous Shunt, Surgical statistics & numerical data, Erythropoietin administration & dosage, Health Care Surveys, Health Services Research, Humans, Recombinant Proteins, Renal Dialysis methods, Surveys and Questionnaires, United Kingdom, Waiting Lists, Health Services Accessibility statistics & numerical data, Kidney Failure, Chronic therapy, Renal Dialysis statistics & numerical data
- Abstract
Background: Provision of renal dialysis varies between UK regions., Aim: To analyse these differences in provision and investigate their causes., Design: Questionnaire-based survey., Methods: A questionnaire was posted to all renal provider units and renal commissioning groups in the UK. Questions covered issues such as dialysis modalities and patient choice. Data were collected by telephone interview (or post in some cases) and analysed using SPSS., Results: All renal provider units in the UK responded. A full range of modalities was provided by the majority of units. Clear variations in the level and quality of dialysis provision were seen between the UK regions. These included variation in choice of dialysis modality, provision of high-cost drugs, vascular access waiting times, number of support staff and availability of spare dialysis slots., Discussion: The considerable variation between UK regions in the provision of adult renal dialysis services cannot be entirely explained by age or ethnic variation, and is in part due to limited bed space, dialysis machines and support staff, as well as changes in commissioning arrangements. To meet the requirements of the renal national service framework in most regions, changes to policy and funding will be required, such that the relatively new commissioning groups implement more appropriate funding structures in closer dialogue with their provider units.
- Published
- 2005
- Full Text
- View/download PDF
14. Trends in adult renal replacement therapy in the UK: 1982-2002.
- Author
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Feest TG, Rajamahesh J, Byrne C, Ahmad A, Ansell D, Burden R, and Roderick PJ
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Child, Child, Preschool, Cross-Sectional Studies, Diabetic Nephropathies therapy, Health Services Needs and Demand, Hospital Units supply & distribution, Humans, Infant, Infant, Newborn, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic etiology, Middle Aged, Needs Assessment, Prevalence, Registries, Renal Replacement Therapy methods, Renal Replacement Therapy statistics & numerical data, Sex Distribution, United Kingdom epidemiology, Kidney Failure, Chronic therapy, Renal Replacement Therapy trends
- Abstract
Background: Following the introduction of dialysis and transplantation for the treatment of established renal failure (ERF) 40 years ago, the UK failed to match the achievements of many other countries., Aim: To review progress with treatment for ERF in the UK in the past 20 years., Design: Review of four cross-sectional national studies, and 1997-2002 annual UK Renal Registry data., Methods: Data on UK patients on renal replacement treatment (RRT) were collated from three sources: European Registry reports for 1982-1990, surveys carried out within the UK in 1993, 1996, 1998 and 2002, and the UK Renal Registry database (1997-2002). Trends in acceptance and prevalence rates, median age, cause of ERF, and treatment modality were analysed and compared with current data from other countries., Results: The UK annual acceptance rate for RRT increased from 20 per million population (pmp) in 1982 to 101 pmp in 2002. This growth was largely in those aged over 65 years, and in those with co-morbidity. Annual acceptance rates for ERF due to diabetes rose from 1.6 to 18 pmp. The prevalence of RRT increased from 157 pmp in 1982 to 626 pmp in 2002. Hospital haemodialysis has become the main modality, and is increasingly being provided in satellite units. Although rising, UK acceptance and prevalence rates are still lower than in many developed countries., Discussion: Despite significant expansion in RRT services for adults in the UK over the last 20 years, there is evidence of unmet need, and need is expected to rise, due to demographic changes and trends in type 2 diabetes. Continuing growth in the already substantial investment in RRT will be needed, unless efforts to prevent the occurrence of ERF are successful.
- Published
- 2005
- Full Text
- View/download PDF
15. The care of patients with diabetic nephropathy: audit, feedback, and improvement.
- Author
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Dunn EJ, Burton CJ, and Feest TG
- Subjects
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 drug therapy, Diabetic Retinopathy prevention & control, Disease Progression, Female, Humans, Hyperlipidemias drug therapy, Hyperparathyroidism, Secondary therapy, Male, Middle Aged, Outpatient Clinics, Hospital, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Diabetic Nephropathies drug therapy, Medical Audit
- Abstract
Diabetic nephropathy is the commonest cause of end-stage renal failure in the developed world. The quality of care of 152 patients with diabetic nephropathy was assessed at the time of referral to a single nephrologist. The type II diabetics (62%) were older than the type I diabetics (38%) (mean 65 years vs. 48 years). The mean duration of diabetes was 17 years. Significant cardiovascular disease was present in 52%. There was diabetic retinopathy in 84% of the type I diabetics and 53% of the type II diabetics. Overall, 63% had hypertension at referral (St Vincent Declaration criteria), untreated in 25%. ACE inhibitors were not prescribed in 48% when no contraindications to their use were present. Glycosylated haemoglobin was > 9.1% in 29%. Twenty were prescribed medications inappropriate to their renal function. Of patients with ischaemic heart disease and serum cholesterol > 5.5 mmol/l, 82% were untreated; 82% of patients with secondary hyperparathyroidism were also untreated. At initial referral, many patients' care was sub-optimal. Referral was too late for adequate preparation for renal replacement therapy in 33%. Following a process of education and feedback of the results to referring practitioners, the timing of referral improved. We emphasize the need for closer co-operation between those managing diabetic patients with nephropathy to optimize their care.
- Published
- 1999
- Full Text
- View/download PDF
16. Can intensive treatment alter the progress of established diabetic nephropathy to end-stage renal failure?
- Author
-
Feest TG, Dunn EJ, and Burton CJ
- Subjects
- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases complications, Cohort Studies, Diabetic Nephropathies blood, Diabetic Nephropathies therapy, Female, Glycated Hemoglobin metabolism, Humans, Hypertension complications, Kidney Failure, Chronic blood, Kidney Failure, Chronic etiology, Male, Middle Aged, Diabetic Nephropathies complications, Kidney Failure, Chronic prevention & control
- Abstract
Diabetic nephropathy is now the leading cause of end-stage renal disease in the Western world, and is associated with a higher patient morbidity and mortality than other causes of renal failure, largely because of associated cardiovascular disease. Numerous studies have elucidated the factors which influence its onset and progression. The St Vincent Declaration in 1994 proposed standards for the appropriate management of patients with diabetic nephropathy. We assessed whether referral to a nephrology clinic attempting to apply these standards influenced the progression of diabetic nephropathy. The results show a significant improvement in blood pressure, glycosylated haemoglobin and serum cholesterol following referral. There was a significant reduction in the rate of decline of renal function following referral in 39% of patients. With the possible exception of diabetic control there were no significant differences in the management of those that did and did not show improvement. The results show that with intensive out-patient clinic monitoring it is possible to improve the quality of patient care, and that even in established diabetic nephropathy it is possible to slow the rate of progression to end-stage renal failure.
- Published
- 1999
- Full Text
- View/download PDF
17. The provision of renal replacement therapy for adults in England and Wales: recent trends and future directions.
- Author
-
Roderick PJ, Ferris G, and Feest TG
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, England epidemiology, Hemodialysis Units, Hospital organization & administration, Humans, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic etiology, Middle Aged, Patient Selection, Renal Replacement Therapy standards, Sex Distribution, Surveys and Questionnaires, Utilization Review statistics & numerical data, Wales epidemiology, Health Care Surveys, Health Services Needs and Demand trends, Hemodialysis Units, Hospital statistics & numerical data, Kidney Failure, Chronic therapy, Renal Replacement Therapy statistics & numerical data
- Abstract
We assessed the level of provision of renal replacement therapy for adults in England and Wales. All autonomous main renal units in England (n = 52) and Wales (n = 5) were surveyed in 1996. Data for England were compared to the 1993 National Renal Review. The acceptance rate in England 1995 was 82 (80-85) per million population (p.m.p.) compared with 67 (65-70) p.m.p. in 1991-2. The rate in 1995 in Wales was 109 (98-122) p.m.p. The prevalence rate in England was 476 p.m.p. at end-1995 compared to 393 p.m.p. in 1993, in Wales it was 487 p.m.p. The number of main renal units in England did not rise between 1993 and 1995; capacity was increased by use of more treatment shifts and temporary haemodialysis stations, and by opening more satellite units. The main growth was in hospital haemodialysis. There was an uneven geographical distribution of services. Patients accepted were older with more comorbidity. The use of better-quality processes of dialysis increased. The steady-state position for RRT will not be reached for over a decade. Health authorities will face continued pressure to fund increases in quantity and quality improvements. A stronger evidence base of the effectiveness of therapies, and a national registry to monitor the equity and cost-effectiveness of services are needed.
- Published
- 1998
- Full Text
- View/download PDF
18. Vancomycin-resistant Staphylococcus aureus.
- Author
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Howe RA, Bowker KE, Walsh TR, Feest TG, and MacGowan AP
- Subjects
- Aged, Aged, 80 and over, Drug Resistance, Microbial, Humans, Male, Methicillin Resistance, Staphylococcal Infections drug therapy, Staphylococcal Infections microbiology, Staphylococcus aureus drug effects, Vancomycin pharmacology
- Published
- 1998
- Full Text
- View/download PDF
19. Thoracic aortic dissection complicating autosomal dominant polycystic kidney disease.
- Author
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Paynter HE, Parnham A, Feest TG, and Dudley CR
- Subjects
- Adult, Aortic Dissection diagnostic imaging, Aortic Dissection surgery, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic surgery, Female, Humans, Postoperative Complications surgery, Reoperation, Tomography, X-Ray Computed, Aortic Dissection etiology, Aortic Aneurysm, Thoracic etiology, Polycystic Kidney, Autosomal Dominant complications
- Published
- 1997
- Full Text
- View/download PDF
20. Carbamylated hemoglobin: a potential marker for the adequacy of hemodialysis therapy in end-stage renal failure.
- Author
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Davenport A, Jones S, Goel S, Astley JP, and Feest TG
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Carbamates, Diabetes Mellitus metabolism, Erythropoietin therapeutic use, Female, Hemoglobin A analysis, Hemoglobins metabolism, Humans, Male, Middle Aged, Prospective Studies, Sex Factors, Biomarkers blood, Hemoglobin A analogs & derivatives, Hemoglobins chemistry, Kidney Failure, Chronic therapy, Renal Dialysis, Uremia diagnosis
- Abstract
Urea can dissociate in vivo to form isocyanic acid which can react with hemoglobin to form carbamylated hemoglobin. Previous work has shown that formation of carbamylated hemoglobin depends upon both the severity and the duration of renal failure. To determine whether carbamylated hemoglobin can be used as an assessment of the adequacy of hemodialysis treatment, we prospectively studied 55 stable patients who regularly attended our hospital dialysis program. Carbamylated hemoglobin was greater in those patients with a Kt/V of < or = 1.1 compared to those with a Kt/V of > 1.1 (120 +/- 8 micrograms VH/gHb versus 99 +/- 7, P < 0.01), and there was a negative correlation with Kt/V (r = -0.37, P = 0.007). There were positive correlations between carbamylated hemoglobin and the time-averaged urea concentration (r = 0.4, P = 0.004), and a negative correlation with the urea reduction ratio (r = -0.37, P = 0.01). Carbamylated hemoglobin may therefore be a useful marker of the degree of uremia, just as glycosylated hemoglobin is used in the assessment of patients with diabetes mellitus.
- Published
- 1996
- Full Text
- View/download PDF
21. c-ANCA as a marker of Wegener's disease.
- Author
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Unsworth DJ, Tomson CR, Lock RJ, Wallington TB, and Feest TG
- Subjects
- Aged, Antibodies, Antineutrophil Cytoplasmic, Biomarkers blood, Diagnosis, Differential, Humans, Kidney Papillary Necrosis blood, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Autoantibodies blood, Granulomatosis with Polyangiitis immunology
- Published
- 1996
22. Dent's disease; a familial proximal renal tubular syndrome with low-molecular-weight proteinuria, hypercalciuria, nephrocalcinosis, metabolic bone disease, progressive renal failure and a marked male predominance.
- Author
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Wrong OM, Norden AG, and Feest TG
- Subjects
- Adolescent, Adult, Female, Humans, Kidney Calculi genetics, Kidney Tubules, Proximal physiopathology, Male, Middle Aged, Pedigree, Phosphates blood, Phosphates urine, Sex Factors, Calcium urine, Fanconi Syndrome genetics, Kidney Failure, Chronic genetics, Nephrocalcinosis genetics, Proteinuria genetics, Rickets genetics
- Abstract
We describe a familial form of renal Fanconi syndrome characterized by hypercalciuria, low-molecular-weight proteinuria, nephrocalcinosis and slowly progressive renal failure. Males are much more severely affected than females. The patients studied included 15 males and 10 females, and five families with up to three generations involved. Studies of the two largest families described here have already shown that their disease is inherited on the X-chromosome. The series contains the two unrelated patients originally described by Dent and Friedman in 1964 as 'hypercalcuric rickets'.
- Published
- 1994
23. Clinical significance of anti-neutrophil cytoplasm antibodies detected by a standardized indirect immunofluorescence assay.
- Author
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Davenport A, Lock RJ, Wallington TB, and Feest TG
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Antineutrophil Cytoplasmic, Arteritis blood, Biomarkers blood, Child, Child, Preschool, Female, Granulomatosis with Polyangiitis blood, Humans, Infant, Infant, Newborn, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Vasculitis blood, Arteritis diagnosis, Autoantibodies blood, Fluorescent Antibody Technique, Granulomatosis with Polyangiitis diagnosis, Immunoglobulin G blood, Vasculitis diagnosis
- Abstract
We assessed the use of a standardized antineutrophil cytoplasm antibody (ANCA) test in diagnosing Wegener's granulomatosis (WG), microscopic polyarteritis (mPA) and systemic vasculitis (SV). All samples (n = 779) tested for ANCA at our laboratory were identified, and clinical information was obtained for 783/779 patients by questionnaire, and by visits where necessary. The combined prevalence of WG/mPA/SV was 123/738 (17%). The ANCA test was positive in 48/68 WG patients (71%; 38 cANCA, 10 pANCA), 22/43 mPA patients (51%; 12 cANCA, 10 pANCA) and 3/12 SV patients (25%). WG and mPA patients in remission had similar frequencies of positive ANCA to those with active disease. The sensitivity and specificity for WG (71% and 80%) and mPA (51% and 80%) were lower than previously reported. In this high-prevalence population, the overall (WG/mPA/SV) positive predictive value was only 40%, and the sensitivity 59%. Only 29% of positive tests were from patients with active disease. Overall, 78% of test results gave a 'true' prediction. On this basis, a diagnosis of necrotizing vasculitis (WG/mPA/SV) can be neither made nor refuted by ANCA test alone.
- Published
- 1994
24. Dent's disease, a renal Fanconi syndrome with nephrocalcinosis and kidney stones, is associated with a microdeletion involving DXS255 and maps to Xp11.22.
- Author
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Pook MA, Wrong O, Wooding C, Norden AG, Feest TG, and Thakker RV
- Subjects
- Calcinosis genetics, Chromosome Mapping, DNA, Satellite genetics, Female, Genetic Linkage, Genetic Markers, Humans, Kidney Calculi genetics, Lymphocytes pathology, Male, Pedigree, Software, Fanconi Syndrome genetics, Polymorphism, Genetic, Sequence Deletion, X Chromosome
- Abstract
Dent's disease is a familial proximal renal tubular disorder which is associated with low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, kidney stones and renal failure. The mode of inheritance and the primary defect for this disorder are unknown. An analysis of 5 unrelated British families revealed a greater disease severity in males and an absence of male to male transmission. This suggested an X-linked inheritance and we investigated this further by linkage studies in 33 members (12 affected, 21 unaffected) from two 3-generation families. Twenty X-linked polymorphic markers were used and linkage was established with the Xp11 loci ARAFI, DXS426, DXS255 and DXS988 with peak LOD scores and recombination fractions (theta) of 5.42 (theta = 0.000), 3.61 (theta = 0.000), 5.48 (theta = 0.000) and 4.25 (theta = 0.045) respectively. In addition, DXS255 revealed a microdeletion in the affected members of one family, thereby further localising Dent's disease to Xp11.22. Combined multilocus linkage analysis and deletion mapping studies defined the locus order Xpter-MAOB-(ARAFI, DXS426)-SYP-TFE3-(DXS255, DENT'S)-DXS988-Xcen, thereby mapping the microdeletion associated with Dent's disease to a 4 centiMorgan interval flanked by TFE3 and DXS988. Thus, Dent's disease is an X-linked disorder which is associated with a microdeletion of Xp11.22, and a further characterisation of this gene will help to elucidate the factors controlling proximal renal tubular function and the development of kidney stones.
- Published
- 1993
- Full Text
- View/download PDF
25. Immune-related potassium-losing interstitial nephritis: a comparison with distal renal tubular acidosis.
- Author
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Wrong OM, Feest TG, and MacIver AG
- Subjects
- Acidosis, Renal Tubular genetics, Acidosis, Renal Tubular immunology, Adolescent, Adult, Aged, Autoimmune Diseases genetics, Autoimmune Diseases immunology, Female, Humans, Hypokalemia metabolism, Kidney metabolism, Kidney pathology, Male, Middle Aged, Nephritis, Interstitial genetics, Nephritis, Interstitial immunology, Osmolar Concentration, Potassium metabolism, Acidosis, Renal Tubular metabolism, Autoimmune Diseases metabolism, Hypokalemia etiology, Nephritis, Interstitial metabolism
- Abstract
Six patients with immune-related potassium-losing interstitial nephritis (IRPLIN) are described, and compared with 34 patients with immune-related distal renal tubular acidosis (IRdRTA) and 24 with familial distal renal tubular acidosis (FdRTA). Close similarities were found between IRPLIN and IRdRTA. In our experience, both syndromes are confined to postpubertal women, and are characterized by systemic features of autoimmune disease and a chronic interstitial nephritis which is probably immune-mediated and responsible for the functional tubular defects of the two syndromes. In IRPLIN, a renal potassium-losing state is the main consequence (probably mediated at least in part by renin and aldosterone hypersecretion secondary to renal sodium-losing), and urinary acidification is normal or minimally disturbed; consequently there is no systemic acidosis, and the syndrome is not complicated by nephrocalcinosis or renal bone disease. In IRdRTA, the renal tubular lesion also usually causes potassium depletion, but the most prominent tubular fault is a defect in urinary acidification, which commonly causes metabolic acidosis and often leads to nephrocalcinosis and bone disease. Familial dRTA, in contrast, is equally prevalent in the two sexes and presents at an earlier age than IRPLIN and IRdRTA. Patients with FdRTA and IRdRTA have a similar urinary acidification defect and propensity to acidosis, nephrocalcinosis and bone disease. FdRTA is frequently complicated by renal potassium-losing, but hypokalaemia is less common and less profound than in IRdRTA and IRPLIN, suggesting that immune-related interstitial nephritis has a particular tendency to cause renal potassium-losing.
- Published
- 1993
- Full Text
- View/download PDF
26. Incidence of severe acute renal failure in adults: results of a community based study.
- Author
-
Feest TG, Round A, and Hamad S
- Subjects
- Acute Kidney Injury diagnosis, Acute Kidney Injury etiology, Acute Kidney Injury mortality, Acute Kidney Injury therapy, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, England epidemiology, Female, Hemofiltration, Humans, Incidence, Male, Middle Aged, Prognosis, Prospective Studies, Referral and Consultation, Renal Dialysis, Sex Factors, Acute Kidney Injury epidemiology
- Abstract
Objective: To determine the age related incidence of severe acute renal failure in adults in two health districts in England., Design: Prospective study of patients identified as having severe acute renal failure within a two year period; subsequent monitoring of outcome for a further two years., Setting: Two health districts in Devon., Subjects: Those adults in a population of 444,971 who developed severe acute renal failure (serum creatinine concentration > 500 mumol/l) for the first time during two years, with subsequent fall of the serum creatinine concentration below the index value., Main Outcome Measures and Results: 125 adults (140 per million total population yearly, 172 per million adults) developed severe acute renal failure, of whom 90 (72%) were over 70. Age related incidence rose from 17 per million yearly in adults under 50 to 949 per million yearly in the 80-89 age groups. In 31 patients (25%) the cause was prostatic disease, which was related to a good prognosis (84% (26) alive at three months). Overall survival was 54% (67) at three months and 34% (42) at two years and was not significantly age related. 18 per million total population yearly (22 per million adult population) received acute dialysis. Referral rate for specialised opinion was 51 per million total population yearly with an estimated appropriate referral rate of 70 per million per year., Conclusions: The incidence of severe acute renal failure in the community is at least twice as high as the incidence reported from renal unit based studies. Prostatic disease, a preventable and treatable problem, is the most common cause. Survival figures indicate that age alone should not be a bar to specialist referral or treatment.
- Published
- 1993
- Full Text
- View/download PDF
27. Simulation model for planning renal services.
- Author
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Feest TG and Harrison P
- Subjects
- Decision Making, Computer-Assisted, England, Health Care Costs, Humans, Peritoneal Dialysis, Continuous Ambulatory, Regional Health Planning, Computer Simulation, Renal Dialysis economics
- Published
- 1992
- Full Text
- View/download PDF
28. Apolipoprotein AI mutation Arg-60 causes autosomal dominant amyloidosis.
- Author
-
Soutar AK, Hawkins PN, Vigushin DM, Tennent GA, Booth SE, Hutton T, Nguyen O, Totty NF, Feest TG, and Hsuan JJ
- Subjects
- Amino Acid Sequence, Base Sequence, DNA blood, DNA genetics, DNA isolation & purification, Female, Humans, Macromolecular Substances, Male, Molecular Sequence Data, Pedigree, Amyloid genetics, Amyloidosis genetics, Apolipoprotein A-I genetics, Arginine, Genes, Dominant, Mutation
- Abstract
A mutation in the gene for apolipoprotein AI (apoAI) was identified in an English family with autosomal dominant non-neuropathic systemic amyloidosis. The plasma of all affected individuals contained a variant apoAI with one additional charge, as well as normal apoAI. The propositus was heterozygous; the coding region of his apoAI gene contained both the normal sequence and a single-base substitution changing the codon for residue 60 of the mature protein from CTG (leucine) to CGG (arginine). Allele-specific oligonucleotide hybridization showed that the other affected individuals were also heterozygotes and that there was concordance of the mutant allele with the presence of variant plasma apoAI. Amyloid fibrils isolated from the spleen of the propositus consisted of proteins that ran as a doublet with an apparent mass of approximately 10 kDa in SDS/PAGE and a trace band at 28 kDa. Electrospray mass spectrometry of the purified 10-kDa material revealed components with mass corresponding to the N-terminal 88, 92, 93, and 94 residues of apoAI each with substitution of arginine for leucine. These observations were confirmed by direct protein sequencing and laser desorption time-of-flight mass analysis. No material with the normal apoAI sequence was detected. The trace band at 28 kDa yielded the N-terminal sequence of mature apoAI, indicating that intact or minimally degraded apoAI was also present in the fibril preparation. Discovery of this mutation and the detailed characterization of the apoAI fragments that form the amyloid fibrils open additional avenues for investigation of amyloidogenesis.
- Published
- 1992
- Full Text
- View/download PDF
29. X-linked recessive nephrolithiasis with renal failure.
- Author
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Wrong O, Norden AG, and Feest TG
- Subjects
- Alpha-Globulins urine, Female, Genetic Linkage, Humans, Kidney Calculi complications, Kidney Diseases complications, Male, X Chromosome, beta 2-Microglobulin urine, Kidney Calculi genetics, Kidney Diseases genetics
- Published
- 1992
- Full Text
- View/download PDF
30. Erythrocytosis and nephrocalcinosis.
- Author
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Feest TG and Wrong O
- Subjects
- Humans, Nephrocalcinosis complications, Polycythemia etiology
- Published
- 1992
31. Potassium deficiency and sudden unexplained nocturnal death.
- Author
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Feest TG and Wrong O
- Subjects
- Adult, Aged, Female, Humans, Kidney Calculi etiology, Male, Middle Aged, Thailand, Death, Sudden etiology, Potassium Deficiency complications
- Published
- 1991
- Full Text
- View/download PDF
32. High organ retrieval rate: a disincentive to organ sharing?
- Author
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Riad HN, Nicholls AJ, Feest TG, and Golby MG
- Subjects
- ABO Blood-Group System, Blood Grouping and Crossmatching, Graft Survival, Humans, United Kingdom, Kidney Transplantation physiology, Tissue and Organ Procurement organization & administration
- Published
- 1991
33. Incidence of advanced chronic renal failure and the need for end stage renal replacement treatment.
- Author
-
Feest TG, Mistry CD, Grimes DS, and Mallick NP
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, England epidemiology, Humans, Incidence, Kidney Failure, Chronic mortality, Kidney Failure, Chronic therapy, Middle Aged, Prospective Studies, Referral and Consultation, Renal Dialysis statistics & numerical data, Health Services Needs and Demand, Hemodialysis Units, Hospital statistics & numerical data, Kidney Failure, Chronic epidemiology, Patient Selection, Resource Allocation
- Abstract
Objective: To determine the age related incidence of advanced chronic renal failure in two areas of England., Design: Prospective study of patients newly identified as having advanced chronic renal failure within a two year period; subsequent monitoring of patients' clinical course for a further 26 months., Setting: Devon and Blackburn., Subjects: Those patients in a population of 708,997 who developed advanced chronic renal failure (serum creatinine concentration greater than 500 mumol/l) for the first time during a two year period., Main Outcome Measures and Results: 210 Patients (148 per million population per year) developed advanced chronic renal failure, 117 (51%) of whom were over 70. The age related incidence rose from 58 per million per year in those aged 20-49 to 588 per million per year in those aged 80 or over. Only 54% (113) of patients were referred to a nephrologist; 120 patients (57%) needed dialysis or died within three months of presenting without receiving dialysis, and 187 (89%) died or needed dialysis within three years. After those unsuitable for further treatment had been excluded, 78 patients per million population per year aged under 80 needed to start long term renal replacement treatment., Conclusions: Many patients suitable for renal replacement treatment are still not referred for nephrological opinion and are denied treatment. If the treatment rate in the United Kingdom rose from the 1988 rate of 55.1 per million per year to 78 per million per year then the number of patients receiving treatment would rise to about 800 per million. This is double the present number and has considerable but predictable resource implications for the NHS.
- Published
- 1990
- Full Text
- View/download PDF
34. Protocol for increasing organ donation after cerebrovascular deaths in a district general hospital.
- Author
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Feest TG, Riad HN, Collins CH, Golby MG, Nicholls AJ, and Hamad SN
- Subjects
- Adult, Aged, Brain Death diagnosis, Cerebrovascular Disorders therapy, Evaluation Studies as Topic, Female, Humans, Intensive Care Units, Male, Middle Aged, Patient Transfer, Prognosis, Retrospective Studies, Time Factors, United Kingdom, Cerebrovascular Disorders mortality, Hospitals, District, Hospitals, General, Hospitals, Public, Tissue and Organ Procurement methods
- Abstract
In a district general hospital serving 303,000 people, deaths from cerebrovascular incidents over 12 months were analysed retrospectively. 8 patients who died in general wards were identified as potential organ donors. A working party then devised a protocol for managing such donors by transfer to the intensive care unit for support until organ retrieval could be arranged. In the first 19 months with the protocol, organs (1 heart, 2 sets of heart valves, 2 livers, and 16 kidneys) were retrieved from 8 patients who would not otherwise have become donors. If these results were replicated nationally a further 16.7 donors per million per year would be added to the current annual UK rate of 14.6 donors per million.
- Published
- 1990
- Full Text
- View/download PDF
35. Ulcerative colitis and glomerulonephritis: is there an association?
- Author
-
Thomas DM, Nicholls AJ, and Feest TG
- Subjects
- Child, Colitis, Ulcerative epidemiology, Glomerulonephritis epidemiology, Humans, Incidence, Male, Middle Aged, Prevalence, Colitis, Ulcerative complications, Glomerulonephritis complications
- Abstract
Over a 10-year period in one hospital four patients with pre-existing ulcerative colitis presented with biopsy-proven glomerulonephritis. Statistical comparison with epidemiological data suggests that this is a true association.
- Published
- 1990
- Full Text
- View/download PDF
36. Familial nephropathic amyloidosis associated with indomethacin responsive fever.
- Author
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Feest TG and Wallis JP
- Subjects
- Female, Fever drug therapy, Genes, Dominant, Humans, Indomethacin therapeutic use, Middle Aged, Amyloidosis genetics, Fever genetics, Kidney Diseases genetics
- Published
- 1985
37. Nephrocalcinosis: another cause of renal erythrocytosis.
- Author
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Feest TG, Proctor S, Brown R, and Wrong OM
- Subjects
- Adult, Aged, Erythropoietin urine, Female, Humans, Male, Middle Aged, Nephrocalcinosis complications, Polycythemia etiology
- Published
- 1978
- Full Text
- View/download PDF
38. Successful treatment of myeloma kidney by diuresis and plasmaphoresis.
- Author
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Feest TG, Burge PS, and Cohen SL
- Subjects
- Acute Kidney Injury drug therapy, Adult, Diuresis drug effects, Humans, Male, Melphalan therapeutic use, Kidney Neoplasms therapy, Multiple Myeloma therapy, Peritoneal Dialysis, Plasmapheresis
- Published
- 1976
- Full Text
- View/download PDF
39. Low molecular weight dextran: a continuing cause of acute renal failure.
- Author
-
Feest TG
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Molecular Weight, Acute Kidney Injury chemically induced, Dextrans adverse effects
- Published
- 1976
- Full Text
- View/download PDF
40. Clonazepam: effective treatment for restless legs syndrome in uraemia.
- Author
-
Read DJ, Feest TG, and Nassim MA
- Subjects
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Restless Legs Syndrome etiology, Benzodiazepinones therapeutic use, Clonazepam therapeutic use, Restless Legs Syndrome drug therapy, Uremia complications
- Published
- 1981
- Full Text
- View/download PDF
41. Aluminium: removal from water supplies.
- Author
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Parkinson IS, Beckett A, Ward MK, Feest TG, Hoenich N, Strong A, and Kerr DN
- Subjects
- Brain Diseases etiology, Humans, Osteomalacia etiology, Aluminum adverse effects, Aluminum analysis, Renal Dialysis adverse effects, Water Supply analysis
- Published
- 1978
42. Idiopathic hypercalcaemia of chronic dialysis.
- Author
-
Feest TG, Newrick P, and Read DJ
- Subjects
- Adult, Aluminum adverse effects, Aluminum blood, Calcium metabolism, Female, Humans, Kidney Transplantation, Menopause, Middle Aged, Osteomalacia etiology, Peritoneal Dialysis adverse effects, Peritoneal Dialysis, Continuous Ambulatory adverse effects, Renal Dialysis adverse effects, Time Factors, Dialysis, Hypercalcemia etiology
- Abstract
Three women on different forms of maintenance dialysis developed persistent steroid-responsive idiopathic hypercalcaemia, with low calcium absorption, severe skeletal decalcification, multiple fractures, and severe clinical problems. Bone histology showed osteomalacia with suppression of osteoblast activity and no hyperparathyroidism. The disease persists at least six months after transplantation. The features are compatible with poisoning by a toxin with many similar properties to aluminium: we only found significant aluminium overload in one of these cases.
- Published
- 1983
43. Hypercalcemia following renal transplantation: causes and consequences.
- Author
-
Conceicao SC, Wilkinson R, Feest TG, Owen JP, Dewar J, and Kerr DN
- Subjects
- Adolescent, Adult, Biopsy, Bone and Bones diagnostic imaging, Bone and Bones pathology, Child, Creatinine blood, Female, Humans, Hypercalcemia immunology, Hypercalcemia metabolism, Kidney Diseases therapy, Male, Middle Aged, Parathyroid Hormone immunology, Phosphates blood, Postoperative Complications, Radiography, Renal Dialysis, Hypercalcemia etiology, Kidney Transplantation
- Published
- 1981
44. Renal histology and immunopathology in distal renal tubular acidosis.
- Author
-
Feest TG, Lockwood CM, Morley AR, and Uff JS
- Subjects
- Acidosis, Renal Tubular immunology, Adult, Child, Preschool, Complement C3 metabolism, Female, Fibrin metabolism, Fluorescent Antibody Technique, Humans, Immunoglobulin G metabolism, Kidney immunology, Kidney Glomerulus immunology, Kidney Glomerulus metabolism, Kidney Tubules immunology, Kidney Tubules metabolism, Middle Aged, Acidosis, Renal Tubular pathology, Kidney pathology
- Abstract
Renal biospy studies are reported from 10 patients with distal renal tubular acidosis (DRTA). On the biopsies from 6 patients who had associated immunological abnormalities immunofluorescent studies for immunoglobulins, complement, and fibrin were performed. Interstitial cellular infiltration and fibrosis were common findings in patients with and without immunological abnormalities, and were usually associated with nephrocalcinosis and/or recurrent urinary infection. No immune deposits were demonstrated in association with the renal tubules. This study shows that DRTA in immunologically abnormal patients is not caused by tubular deposition of antibody or immune complexes. The possibility of cell mediated immune damage is discussed.
- Published
- 1978
45. Vibration sensory threshold: a guide to adequacy of dialysis?
- Author
-
Read DJ, Feest TG, and Holman RH
- Subjects
- Female, Humans, Kidney Failure, Chronic therapy, Kidney Transplantation, Male, Middle Aged, Neural Conduction, Peritoneal Dialysis, Vibration, Kidney Failure, Chronic physiopathology, Peripheral Nerves physiopathology, Renal Dialysis, Sensory Thresholds
- Abstract
The vibration sensory threshold (VST) is an easy non-invasive reproducible and sensitive bedside test of peripheral nerve function. It is impaired in pre-dialysis uraemic patients with no clinical evidence of peripheral neuropathy; tends to deteriorate during the first year of dialysis after which it remains relatively constant, and returns towards normal within one week of kidney allograft function. It is unrelated to type of dialysis, acetylator status, average serum creatinine values or serum aluminium. VST may be a valuable monitor of the adequacy of dialysis.
- Published
- 1983
46. Medullary sponge kidney: abnormalities of renal tubular and glomerular function, and their relationship to clinical features.
- Author
-
Feest TG
- Subjects
- Calcium metabolism, Female, Glomerular Filtration Rate, Humans, Kidney Concentrating Ability, Kidney Medulla pathology, Male, Medullary Sponge Kidney complications, Medullary Sponge Kidney metabolism, Nephrocalcinosis etiology, Prognosis, Urinary Tract Infections etiology, Kidney Glomerulus physiopathology, Kidney Tubules physiopathology, Medullary Sponge Kidney physiopathology
- Abstract
This study confirms that medullary sponge kidney (MSK) has a good prognosis, but there is a considerable morbidity in patients with renal calcification; they suffer renal colic, ureteric obstruction, and frequently need operation. There is a high incidence of urinary infection in women. On follow-up, glomerular function is well maintained, although careful testing shows a mild depression of glomerular filtration rate in at least 40%. Proximal tubular function is normal, but abnormalities of distal tubular function are often seen: acidification defects occur in 24% and are associated with nephrocalcinosis, poor urine concentrating ability, and diminished glomerular function. Urine concentration defects occur in 73% and are probably secondary to nephrocalcinosis. Hypercalciuria was present in 19% and was not related to other defects.
- Published
- 1977
47. Fatal streptococcal septicaemia.
- Author
-
Cruickshank JG, Hart RJ, George M, and Feest TG
- Subjects
- Acute Disease, Adult, Female, Hemolysis, Humans, Male, Sepsis mortality, Streptococcal Infections mortality
- Published
- 1981
- Full Text
- View/download PDF
48. Effect of sodium chenodeoxycholate on oxalate absorption from the excluded human colon--a mechanism for 'enteric' hyperoxaluria.
- Author
-
Fairclough PD, Feest TG, Chadwick VS, and Clark ML
- Subjects
- Adult, Aged, Chronic Disease, Colon drug effects, Humans, Liver Diseases metabolism, Oxalates urine, Perfusion, Time Factors, Water metabolism, Chenodeoxycholic Acid pharmacology, Colon metabolism, Intestinal Absorption drug effects, Oxalates metabolism
- Abstract
A perfusion technique has been used to study the effect of sodium chenodeoxycholate (5 mmol 1-1) on absorption of oxalate (2 mmol 1-1) from the surgically excluded colon in two patients with chronic liver disease. Colonic absorption of oxalate increased at least fivefold when sodium chenodeoxycholate was incorporated in the perfusion solutions. This observation may explain enteric hyperoxaluria after ileal resection and in some other gastrointestinal disorders.
- Published
- 1977
- Full Text
- View/download PDF
49. Hemodialysis bone disease: correlation between clinical, histologic, and other findings.
- Author
-
Alvarez-Ude F, Feest TG, Ward MK, Pierides AM, Ellis HA, Peart M, Simpson W, Weightman D, and Kerr DN
- Subjects
- Adolescent, Adult, Alkaline Phosphatase blood, Bone and Bones pathology, Calcium blood, Chronic Kidney Disease-Mineral and Bone Disorder pathology, Female, Humans, Male, Middle Aged, Osteomalacia pathology, Osteoporosis etiology, Osteoporosis pathology, Phosphates blood, Chronic Kidney Disease-Mineral and Bone Disorder etiology, Osteomalacia etiology, Renal Dialysis adverse effects
- Abstract
This paper explores in patients with dialysis osteodystrophy the relationship between clinical features and histological, radiological, and biochemical findings. Eighty-five patients treated by hemodialysis for more than 6 months were studied. The following conclusions were drawn: 1) Bone pain in patients on regular hemodialysis is usually a symptom of developing osteomalacia but not of hyperparathyroidism or osteoporosis. 2) Many patients with histological osteomalacia and radiological features of osteomalacia, such as fractures or Looser zones, have no symptoms. 3)In dialysis patients, biochemical and radiological abnormalities are not a reliable means of predicting the presence of osteomalacia, but a raised serum alkaline phosphatase is a good indicator of the presence of osteitis fibrosa. For early detection of osteomalacia, bone biopsy in necessary. 4)A number of our dialysis patients develop an unusual form of osteomalacia characterized by absent or minimal histological osteitis fibrosa, a normal serum alkaline phosphatase, and a high incidence of myopathy and fractures.
- Published
- 1978
- Full Text
- View/download PDF
50. Streptococcus bovis endocarditis and colorectal disease.
- Author
-
Dunham WR, Simpson JH, Feest TG, and Cruikshank JG
- Subjects
- Aged, Female, Humans, Intestines microbiology, Male, Streptococcus isolation & purification, Colonic Diseases complications, Endocarditis, Bacterial etiology, Rectal Diseases complications, Streptococcal Infections complications
- Published
- 1980
- Full Text
- View/download PDF
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