Clinical and Research Experience and Interests
Clinical Experience and Interests
In Guy’s I see general nephrology, dialysis and transplantation patients regularly in outpatients. I am responsible for CAPD quality review. I have 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 have 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).
The Guy’s renal unit has 600 dialysis and over 1000 renal transplant follow-ups.
My main clinical interests are HYPERTENSION, CARDIOVASCULAR DISEASE, INFLAMMATION AND CALCIFICATION SYNDROMES IN RENAL PATIENTS.
- Professor David Goldsmith 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 use non-invasive measures of arterial 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 are 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.
Reseach Trials :
I have participated as 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.