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Biomedical subjects

D C Dukes

Publications and source records attributed to D C Dukes.

At least 19 recordsLinked to original sources
PubMed1994

Cyclosporin A in refractory idiopathic nephrotic syndrome: 5 years clinical experience.

The use of cyclosporin A (Cy A) in idiopathic nephrotic syndrome, particularly lesions of focal segmental glomerular sclerosis, is controversial. A retrospective study of 10 adult patients with nephrotic syndrome treated with Cy A was performed. Histological diagnosis was established in all patients: focal segmental glomerular sclerosis (n = 6), focal global sclerosis (n = 1), mesangial proliferative glomerulonephritis (n = 1), focal proliferative glomerulonephritis (n = 1) and minimal change disease (n = 1). All patients had previously received immunosuppressive therapy (duration of steroids 1-76 months; 35.0 +/- 12.1, mean +/- SEM). Cy A in a dose of 3-5 mg/kg/day, reduced proteinuria from 16.85 +/- 6.67 to 3.37 +/- 1.48 g/24 hours (P = 0.008), with an associated increase in serum albumin from 15.2 +/- 2.6 to 34.3 +/- 2.5 g/l (P < 0.001). In six patients steroid therapy was discontinued. Cy A was well tolerated for up to 5 years. There was no significant nephrotoxicity. In conclusion, Cy A was effective treatment of refractory idiopathic nephrotic syndrome, including those cases with focal segmental glomerular sclerosis.

Adult↗
PubMed1992

Regulation of iron absorption in iron loaded subjects with end stage renal disease: effects of treatment with recombinant human erythropoietin and reduction of iron stores.

The effects on iron absorption of variation in erythroid activity, haemoglobin and iron stores were studied in six anaemic dialysis-dependent subjects in whom iron stores were increased from previous red cell transfusions. Gastrointestinal mucosal uptake and whole body retention of oral iron were measured at the beginning of the study, after starting treatment with recombinant erythropoietin (but before significant increase in haemoglobin), after partial correction of anaemia, after further reduction of iron stores by repeated phlebotomy, and when erythropoiesis decreased from the discontinuation of treatment with erythropoietin. Between successive measurements, valid comparisons were made in five subjects. Correction of anaemia decreased whole body retention of iron through decreased mucosal uptake (P = 0.032). Further reduction in iron stores through repeated phlebotomy whilst the increase in haemoglobin was maintained by treatment with erythropoietin, tended to increase whole body retention of iron through an increase in mucosal transfer (P = 0.010). With initial enhancement of erythropoiesis in anaemic iron-loaded subjects there was no change in any measured component of iron absorption. However, after correction of anaemia and reduction of iron stores, a decrease in erythropoiesis was associated with decreased whole body iron retention in all subjects through decreased mucosal transfer (P = 0.028). The data suggest that anaemia upregulates mucosal iron uptake, and that erythroid activity upregulates mucosal transfer but that this latter effect may be counter-balanced by iron overload which downregulates mucosal transfer.

Adult↗
PubMed1983

Do beta-adrenoceptor blocking drugs cause retroperitoneal fibrosis?

The aetiology of retroperitoneal fibrosis is unknown. From time to time different drugs have been suggested as a cause, including beta adrenoceptor blocking agents. The notes of 100 hospital inpatients in whom retroperitoneal fibrosis had been diagnosed were surveyed to identify the date of onset of symptoms, the drugs prescribed before then, and the blood pressures on admission. Seventy one patients had diastolic pressures on admission of 90 mm Hg or more and 53 of these had pressures of at least 100 mm Hg despite 14 of the patients taking anti-hypertensive drugs at the time. Six patients had received beta-adrenoceptor blocking agents before the onset of symptoms and a further 24 received them subsequently. In particular, three patients continued treatment for at least six years after the diagnosis was made and surgery performed, without suffering a recurrence of retroperitoneal fibrosis. Besides beta-adrenoceptor drugs, diuretics and other hypotensive drugs were taken in amounts reflecting the pattern of drug use among hypertensive patients generally. Rather than being causal agents, the antihypertensive drugs were probably being used to treat hypertension associated with the retroperitoneal fibrosis, and our findings suggest that beta-adrenoceptor blocking agents do not cause retroperitoneal fibrosis.

Adolescent↗
PubMed1976

Dialysis procedures in acute liver coma.

9 haemodialyses against fluids designed to reduce plasma abnormality were used in four patients with acute liver failure in an attempt to maintain consciousness and buy time for liver regeneration. Dialysis had little effect in two patients. In the third patient spontaneous movements and response to commands were seen during the second dialysis. Arousal occurred during both dialyses in the fourth patient who eventually recovered.

Acute Disease↗