Clinical and Research Experience and Interests
Clinical Experience and Interests
In Guy’s I saw general nephrology, dialysis and transplantation patients regularly in outpatients. I was responsible for CAPD quality review. I guided and developed a robust cardiovascular risk factor screening programme for newly / recently transplanted patients. I developed a joint Diabetic Renal clinic at Guy’s with the Guy’s diabetic team (1999 - 2009). I looked after patients with von-Hippel Lindau syndrome (from 2000 - 2008), in one of the UK’s largest multi-professional VHL combined clinics. I also helped start a combined haem-oncology renal clinic for patients with PTLD (2008). I also provide nephrological input for the Nationally Commissioned Bardet-Biedl Syndrome Clinic (one adult site for which is Guy’s Genetics Centre) from 2010-2017.
The Guy’s renal unit has 700 dialysis and over 1200 renal transplant follow-ups.
My main clinical interests are HYPERTENSION, CARDIOVASCULAR DISEASE, INFLAMMATION AND CALCIFICATION SYNDROMES IN RENAL PATIENTS.
- Professor David Goldsmith Emeritus Consultant Nephrologist
MA, MB BChir, FRCP(Lond),FRCP (Edin), FASN, FERA
I am now pursuing the following lines of research:
Cardiac and arterial structural and functional changes seen in uraemia, specificially arterial distensibility (pulse wave velocity), left ventricular hypertrophy, and arterial wall structure (calcification, plaques and intima-media thickness). We have used non-invasive measures of arterial function, endothelial function, and plain Xrays and CT scans for arterial calcification
The relationship between calcium and phosphate balance, chronic kidney disease, and bone and mineral metabolism – and how the integrity and normal physiology of bone prevents ectopic calcification. We have used using 18-F PET imaging, CT scanning, and bone biopsies to examine skeletal structure and function.
The effect of vitamin D treatment on human endothelial function, and left ventricular morphology and function (as an RCT).
Reseach Trials :
I was the Guy’s lead in numerous multi-centre drug trials in dialysis patients – Lanthanum as a phosphate binder in CAPD (Shire), Atorvastatin to reduce cholesterol in dyslipidaemic CAPD pts (Parke-Davies), Cyclosporin-Tacrolimus switching to improve cardiovascular risk factors (Fujisawa), Sevelamer carbonate versus sevelamer hydrochloride (Genzyme). I have been co-investigator for trials involving everolimus, FTY720, and other immunosuppresants.