London & Essex Kidney Clinic
Dr Ibrahim Fahal

MBBS, MD, FRCP (London), FRCP (Glasgow)
Consultant Nephrologist & Senior Lecturer

Request An Appointment
020 7993 5352

Request An Appointment

020 7993 5352

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Welcome to London & Essex Kidney Clinic

Dr Ibrahim Fahal is both a clinician and a teacher. He did his undergraduate training at Khartoum University Medical School, where he learned not only how to be a doctor but also a compassionate physician. Since his consultant appointment in 1997, he has been continuously involved in patient care and teaching. He serves as an instructor for medical students from Queen Mary University of London and the American University of the Caribbean. He has published numerous scientific articles, contributed chapters to medical textbooks, and given hundreds of lectures at both national and international meetings. He offers private consultations in London and Brentwood.


About Dr Fahal

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Dr Fahal Practices in the Following Hospitals

London Independent Hospital
London E1 4NL
Appointments: 020 7780 2400


Spire Hartswood Hospital
Brentwood Essex CM13 3LE
Appointments 01277 266 766


Nuffield Health Brentwood Hospital
Brentwood Essex CM15 8EH
Appointments: 01277 695 695


Spire Roding Hospital
Ilford IG4 5PZ
Appointments: 020 8709 7878

Are Potatoes Linked to High Blood Pressure?

Whether you like your potatoes boiled, baked, mashed or as chips, new US research has linked them to an increased risk of developing high blood pressure.

However, other experts argue that no direct cause-and-effect has yet been proven and studying dietary patterns is more useful than concentrating on individual foods.

Researchers based at Brigham and Women's Hospital and Harvard Medical School decided to look at whether higher long-term intake of potatoes could be associated with an increased risk of high blood pressure (hypertension). To their knowledge, no one has previously examined a link between potatoes and high blood pressure. Their study is published in The BMJ.

The researchers combined the results of three large US studies that followed over 187,000 men and women for more than 20 years. A questionnaire was used to look at people's diets intake, including how often the participants ate potatoes and in which form. They included baked, boiled and mashed potatoes as one category, as well as potato chips and potato crisps as two separate categories. Reports of high blood pressure were based on diagnoses made by healthcare professionals.

After considering other risk factors in their analysis, the researchers found:

· When compared with less than one serving a month, consuming four or more servings a week of baked, boiled or mashed potatoes could be linked to an increased risk of high blood pressure in women, but not in men.

· Higher consumption of potato chips could be linked to an increase risk of high blood pressure in both men and women.

· Potato crisps could not be linked to an increased risk of high blood pressure in either men or women.

Because potatoes have a high glycaemic index when compared to other vegetables, the researchers have suggested that the raised blood sugar following eating them might trigger mechanisms that are associated with hypertension, and also mention that a diet high in carbohydrates such as potatoes may result in obesity, another risk factor for raised blood pressure. They recommend replacing a serving a day of boiled, baked or mashed potatoes with a serving of a non-starch vegetable - such as peas, butter beans, sweetcorn or sweet potatoes - to decrease the risk of high blood pressure.

Air Pollution Not Just Bad for Your Lungs

Exposure to air pollution for just a month or two may still be enough to increase the risk of developing diabetes, especially for obese people, a recent U.S. study suggests.

Researchers studied more than 1,000 Mexican-Americans living in southern California and found short-term exposure to air pollutants adversely affects glucose tolerance and insulin sensitivity, as well as blood lipid levels.

It's possible that air pollution causes inflammation in the body, which triggers a chain reaction that makes it harder for people to process blood sugar, said senior study author Dr. Frank Gilliland, director of the Southern California Environmental Health Sciences Center and researcher at the Keck School of Medicine at the University of Southern California in Los Angeles.

For the study, Gilliland and colleagues examined concentrations of ozone, an unstable form of oxygen produced when various types of traffic and industrial pollution react with sunlight; nitrogen dioxide, a byproduct of fossil fuel combustion that can contribute to smog; and PM 2.5, a mixture of solid particles and liquid droplets smaller than 2.5 micrometers in diameter that can include dust, dirt, soot and smoke.

All of these pollutants have been found to damage lungs and some PM 2.5 particles are small enough to enter the bloodstream, where they have been linked to increased risk of heart disease and stroke.

The participants in the current study completed questionnaires on their dietary and exercise habits, and they also had tests to measure cholesterol and blood sugar. They were around 35 years old on average and typically overweight or obese.

Short-term (up to 58 days cumulative lagged averages) exposure to PM 2.5 was associated with lower insulin sensitivity and HDL-to-LDL cholesterol ratio and higher fasting glucose and insulin, HOMA-IR, total cholesterol, and LDL cholesterol (LDL-C) (all p≤0.036), the authors report.

In addition, annual average PM 2.5 was associated with higher fasting glucose, HOMA-IR, and LDL-C (p≤0.043).

The effects of short-term PM 2.5 exposure on insulin sensitivity were largest among obese participants.

Among the study's limitations is that researchers lacked data on how long people lived at their current address, which made it impossible to assess lifetime exposure to air pollution.

Even so, the findings suggest people who live in cities and other areas with poor air quality should take precautions, said Michael Jerrett, director of the Center for Occupational and Environmental Health at the University of California, Los Angeles.

Among other things, people could try to limit outdoor exercise during peak commute hours to lower exposure to traffic fumes and try not to run or ride a bike along a major highway, said Jerrett, who wasn't involved in the study.

Indoors, people should use a high-efficiency particulate air (HEPA) filter on furnaces or air conditioning units, or buy stand-alone units for bedrooms, Jerrett said. These mechanical filters force air through a fine mesh that can trap harmful pollutants, but there's a limit to how much individuals can do, he said.

"Air pollution is an involuntary risk factor," Jerrett said. "We all breathe the air, and this should create a stronger incentive for government to take action to reduce emissions that lead to air pollution."


Diabetes Care 2016.

Antihypertensive therapy for the prevention of nephropathy in diabetic hypertensive patients

There was no literature evaluating antihypertensive therapies in preventing nephropathy in type 1 hypertensive diabetics. However, in patients with type 2 diabetes and hypertension, multiple studies demonstrate the benefit of an ACEI or ARB in preventing or delaying the onset of nephropathy, while no study demonstrated the benefit of a CCB over an ACEI or ARB.

Due to the lack of literature, hypertension management in type 1 diabetics with normoalbuminuria should be guided by the treatment of comorbidities. To prevent diabetic nephropathy, an ACEI or ARB should be first-line monotherapy over a CCB for the management of hypertension in patients with type 2 diabetes mellitus, hypertension and normoalbuminuria.

Journal of Clinical Pharmacy and Therapeutics. DOI: 10.1111/jcpt.12361