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Nephrology Divisional Spotlight – September 2020

Mark D. Okusa, MD

This year has changed and challenged us in ways that none of us could have ever imagined. So what did we do? We rose to the challenge, and we adapted quickly. The practice of nephrology and medicine has changed forever. Always waiting in the wings, telemedicine finally took center stage. ZOOM meetings, face masks, and physical distancing became standard practice, homeschooling was back in fashion.

But more important than all the advanced technology are all the wonderful people in our Division. I could not be prouder of Nephrology/CIIR’s faculty and staff; their dedication and sacrifice deserve endless applause.

Long hours were spent creating new protocols to protect patients and staff alike, we watched the numbers rise everywhere, scrambled for PPOs, volunteered at the COVID-19 clinic, dove into doxy.me, focused heavily on our research, wrote papers, applied for grants, and made a Fellowship Promotional Video. Every army has its foot soldiers. In this particular battle, our nurses, faced with the unknown, showed unbelievable courage. We kept pushing forward, and in doing so pushed back, and always stayed true to our mission. We are grateful to our DOM leaders, especially Mitch Rosner who along with his team, laid the groundwork to navigate the uncharted waters. ~ Mark D. Okusa, MD

CLINICAL UPDATE

On a practical level, while our clinical performance was impacted by COVID-19, the Division recovered quickly and ended the fiscal year above budget. Even with staff shortages, our dialysis unit numbers remained constant.

Led by Kambiz Kalantari, the acute hemodialysis unit had a very strong performance and ensured necessary provisions for COVID-19.

Our transplant unit goes from strength to strength under the direction of Alden Doyle.

Augusta Hospital continues to be a powerhouse under Adam Campbell.

Our Culpepper self-care unit opened; it is geared towards converting suitable patients to home dialysis.

We also have a new facility in Waynesboro that will transition dialysis patients from Augusta to Waynesboro.

With the signing of the Executive Order on July 10, 2019, an alternative payment model through the Centers for Medicare and Medicaid Innovation (CMMI) was created aimed at managing early stages of chronic kidney disease and increasing the number of patients on home dialysis and those receiving preemptive transplants. Through Brendan Bowman’s efforts, we applied and received his letter of acceptance from CMMI into the alternative payment model, Kidney Care First.

Sana Khan is leading a team to create a “High-Risk CKD Clinic” to facilitate late-stage CKD patients to home therapies while incorporating Telehealth as a central component in this program.

Increased faculty meetings led to great ideas, one stands out being a Fellowship Promotional Video. Post-production, our hope is that it increases visibility for Nephrology and the entire organization, provides a quality product that builds engagement, is shareable, and gives us a competitive edge. I won’t use the word “trailblazers” but I think the idea’s caught on.

RESEARCH HIGHLIGHTS

Clinical Research is rapidly developing under the leadership of Julia Scialla, increasing our capacity for complex studies and allowing us to create a database linking the full ESRD experience.

We have maintained continued growth in research funding. Sho Morioka won an NIH K01 and an ASN Transition to Independence Grant; Okusa was awarded 2 NIH R01 grants and along with Rahul Sharma and William Guilford (School of Engineering) (MPI) was awarded an R25 entitled University of Virginia Kidney Technology Development Research Education Program (VA K-TUTOR).  The aim of the VA K-TUTOR is to increase interest and engagement among students from different disciplines to pursue further studies or careers in kidney research.  PI’s have many grant applications in the pipeline, and they are managed expertly by Linda Deeds, Andrea Johnson, Kirsti Moose-McConkey, and Lee McCraw-Leavitt.  We now conduct faculty grant review sessions to use the collective wisdom of our research faculty to improve our grant applications in the hopes of a positive outcome.

An exciting new opportunity and challenge face the Division as we will need to replace our long-standing T32 (as NIH has abandoned the T32, as we know it), and we will apply through a new KUH (Kidney Urology and Hematology) program for a multi-disciplinary multi-institutional training grant (entitled The Integrated Virginia Research Training Centers in Kidney, Urology, and Hematology (IGNITE KUH) to increase the pipeline of early investigators interested in kidney, urologic and hematologic diseases.  We will partner with Virginia Commonwealth University as well as Virginia Tech. A large number of individuals from Nephrology/CIIR are leading this program including Scialla, Portilla, Linden, Brown, Okusa, Sharma, and our pediatric colleagues, Agnieszka (Agnes) Swiatecka-Urban (new chief of Pediatric Nephrology) and Ariel Gomez (Director, Pediatric Center of Excellence in Nephrology).  We believe this program will be important in expanding the pipeline of researchers across the Commonwealth of Virginia.

OTHER NEWS

The much-touted Pinn Hall renovation is complete, with a move-in date scheduled for early September. It is state of the art, beautifully appointed, and encourages scientific collaboration.

COVID-19 created havoc and disrupted lives on a personal and professional level, but we still had much to celebrate. We made three new hires:

Sanja Arandjelovic, PhD, Assistant Professor, joined the Division in July 2020.

Daphne Harrington Knicely, MD, Associate Professor, will officially begin in December 2020. She will be based at Augusta Hospital primarily but will also serve as an attending on the UVA nephrology consult service.

Joel Linden, PhD, Professor Emeritus, joined the Division/CIIR late spring 2020. Joel is one of the world’s leading cardiovascular scientists in inflammation and will contribute to building the Division/CIIR research program.

Sana Khan was promoted to associate professor.

Karen Warburton was awarded tenure.

We have an impressive and talented pool of faculty members as demonstrated by being recipients of the DOM Excellence Awards:

• Swati Rao, MD Excellence in Clinical Care
• Leah Clinic in Wayner, MSN, ACNP Excellence in Clinical Care
• Charles Brooks, MD Excellence in Clinical Care
• Tushar Chopra, MD Excellence in Teaching
• Linda Deeds. Outstanding Staff contributor
• Sho Morioka, PhD Excellence in Research

Danielle Wentworth, MSN, ACNP, CNN-NP, celebrated five years with the Division of Nephrology.

Leah Wayner is leading the way by creating a UVA Nephrology Advanced Practitioner Program to ensure the growth and career advancement of Nephrology APPs. This program will serve as an educational/training platform for current APPs and student APPs in the future.

Rajkumar Venkatadri was the recipient of the Shyr-Te-Ju Immunology Award for “IL-233 Regulates Mitochondrial Function and Canonical WNT Signaling for Lupus Glomerulaonephritis Remission.”

We’re sad to see Sundararaman “Swami” Swaminathan go, he was recruited to head translational research at Mayo Clinic in Arizona.

View the entire September 2020 issue of Medicine Matters featuring the Division of Nephrology here.

Filed Under: Basic Research, Clinical Research, Education, In the Know, News and Notes

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