Simply put, we have a phenomenal Nephrology team! As we cautiously ride the unpredictable wake of COVID-19, our remarkable team continues to be incredibly productive. This year we would like to highlight a number of faculty, fellows, researchers, and staff, for award-winning activities, national recognition, new grants, papers, and achievements. We have also been experiencing a refreshing return to in-person normalcy. Hybrid seminars and conferences; in-person meetings are becoming more frequent. We welcomed Renal Grand Round speakers back to UVA and hosted two successful endowed lectureships. Dr. Anupam Agarwal, the Executive Vice Dean of the University of Alabama, Birmingham, was our Philip C. Liverman Distinguished Lecturer. We had the bonus of his wife, Dr. Lisa Curtis as our Renal Grand Rounds speaker. The Phillip C. Liverman Distinguished Lectureship at Medical Grand Rounds was held on April 29, 2022. This lectureship was named after one of our fellows who died in 1984. His family established this lectureship which has been running since 1986. This year we had our inaugural W. Kline Bolton Distinguished Lectureship, and our guest speaker was the eminent nephrologist Dr. Richard Glassock, from the University of California, Los Angeles. Travel to international and national meetings has returned as another signal that we are returning to where we were pre-COVID.
We were pleased to finally host the W. Kline Bolton Distinguished Lectureship on May 13, 2022. Although initially planned for the year before, we decided that we could not possibly have a virtual inaugural lectureship; hence we postponed the event for a year. As many of you know, Dr. Bolton was the Division Chief of Nephrology from 1998 for 20 years, and made many contributions to the University of Virginia and the field of Nephrology. An endowment was established to host renowned nephrologists to the University of Virginia as visiting professors. This year Dr. Richard Glassock was our distinguished lecturer. He was past president of the American Society of Nephrology, and former Chair of the Departments of Medicine at the University of Kentucky and Harbor-UCLA Medical Center.
The Division continues to have a thriving clinical practice, from patient activities to outreach clinics. Clinical performance continues to remain strong post-COVID-19. Our sub-subspecialty clinics continue to grow. Although we previously highlighted Dr. Amanda Renaghan, our onconephrologist, who staffs an Onconephrology Clinic, as well as Corey Cavanaugh, who heads up our glomerulonephritis clinic, we would also like to recognize Dr. Anubhav Kumar, who is newly appointed Director of the Acute Hemodialysis Unit. Dr. Kumar was appointed interim director last year, and because he has done an excellent job, he was unanimously appointed full-time medical director of the unit. Dr. Kumar was a nephrology and ultrasound fellow at the University of Pennsylvania before his recruitment to the University of Virginia in 2019. Dr. Kumar is an expert in ultrasound as he is shown here instructing one of our former fellows in the technique of point of care ultrasound. In his role as acute HD Unit Director, Dr. Kumar has established new protocols, and refined existing ones for using CRRT in the operating room.
The Kidney and Pancreas transplant programs at UVA continue to thrive under the direction of Dr. Alden Doyle. The volumes of referrals, evaluations, and transplants have approximately doubled over the last seven years, projecting an additional 25% increase this fiscal year. The transplant team, leading some of the Health System’s efforts, has set up outreach clinics across the Commonwealth, with approximately 100 full-day clinics set up at five distal sites, to provide greater access to lifesaving organ transplantation. Notable accomplishments have recently included the early adoption of hepatitis C + donors, COVID + donors; ABO mismatched donors, living donor chains, robotic transplants for obese recipients, multimodal strategies to protect against COVID in this highly vulnerable population, and the development of innovative immunosuppression strategies. This academic year, the team welcomes three new surgeons, is hoping to add two new transplant nephrologists, inaugurate a new HLA lab, expand the inpatient transplant unit, and move to an expanded dedicated outpatient space in the West Complex that adds significant on-site treatment and infusion capabilities.
UVA Nephrology in Culpeper
The Culpeper unit serves patients in the Culpeper, Orange, and Northern VA area, and provides support for in-center self-care dialysis on Tablo dialysis machines. The home program growth has continued with an anticipated 1-2 additional PD patients to start transitioning from other UVA units this summer. We have hired Bobak Sharifi, MD, a former UVA nephrology fellow who will begin full-time work in the Culpeper/Orange area. He will open a CKD clinic in Culpeper and provide inpatient and outpatient services in Culpeper.
Augusta Hospital team led by Adam Campbell continues to have a strong performance. Daphne Knicely and Anita Vincent-Johnson have been excellent additions to Augusta. Pinnacle Clinic volumes continue to expand with more referrals from the Harrisonburg region.
UVA Nephrology in Farmville/Lynchburg
Our Farmville CKD Clinic has finally opened and will provide care for CKD patients in that region. Dr. Catarina Regis continues to service the Farmville area, and Dr. Hanna Zaraket continues to service the Lynchburg region.
Our outreach program for general and transplant nephrology is advancing into specific areas of strategic growth. Our specialty care has made for a strong Centra Lynchburg relationship, while North Virginia is identified as another area that shows great promise. This is evidenced by our Culpeper Dialysis station, Augusta Hospital, and our new Dialysis units in Lynchburg and Farmville. Dr. Bobak Sharifi will open a CKD clinic in Culpeper, and provide inpatient and outpatient services.
Advancing American Kidney Health
Advancing American Kidney Health Initiative was announced by the White House in 2019, and aimed to produce improved outcomes at a lower cost for our 37 million people in the US with chronic kidney disease. Although kidney transplantation is a significant focus and offers the best clinical outcomes at the lowest cost, not every person is eligible for a transplant. Thus, many individuals will receive some form of dialysis and home therapies. Home therapies offer similar outcomes to in-center dialysis at a lower cost. It is the hope of this effort to provide more “person-centered care.” Dr. Rasheed Balogun, our Director of the Regional Dialysis Program, is leading the value-based care effort. We applied and received an acceptance letter from the Center for Medicare & Medicaid Innovation (CMMI) into the alternative payment model, Kidney Care First (KCF). The KCF option is open to participation by nephrology practices and nephrologists only. Implementation will take place at the beginning of 2023.
Educational Update – Fellowship Program
Under the guidance of our new Program Director, Dr. Tushar Chopra, and Associate Program Director, Dr. Corey Cavanaugh, we had a remarkable fellowship recruitment effort. They are employing the use of surveys, and other methods, to continuously improve the fellowship program. We have also initiated several programs that will enhance our future pipeline. Our Nephrology Interest Group drew considerable interest among students and residents, and Dr. Chopra will begin a Kidney Disease Screening and Awareness Program (KDSAP) program in the fall. We were successful in recruiting four outstanding fellows starting July 1, 2022.
The Division of Nephrology and the Center for Immunity, Inflammation and Regenerative Medicine (CIIR) continue to advance the research from clinical to the bench. Despite COVID, our faculty and trainees never waivered and continued to work under the restrictive guidelines established by the institution. New grants were awarded totaling nearly $6 M, of which almost 90% is from NIH. Our efforts also focus on training the next-generation of investigators as we reach out to postdoctoral and predoctoral fellows, and college and high school students through our training grants. Members of the CIIR are shown below.
Research Highlights – Basic Science
Dr. Rahul Sharma
Dr. Sharma studies autoimmunity and inflammation, primarily focusing on the role of the anti-inflammatory T-regulatory cells (Tregs). The central theme of his laboratory is to understand the role of alarmins in the pathophysiology of these disorders. Utilizing these pathways, he has generated novel biologics, such as a bispecific hybrid-cytokine IL233 bearing the activities of IL-2 and IL-33. This novel therapeutic agent, via T-regulatory cells, innate lymphoid cells, and macrophages, suppresses ongoing inflammation in autoimmunity (lupus, type-1 diabetes), acute kidney injury, and metabolic syndrome by inhibiting diabetes and converting white adipose into brown adipose tissue. Dr. Sharma’s work has generated two US (and international) patents for treating autoimmune and inflammatory diseases. His technology was among the top 11 of 130 participants in a global “Science to Startup” competition, a forum for top scientists from around the world to present their ideas and interact with leading investors and executives in the Boston biotechnology hub licensed to Slate Bio Inc. In this biotech start-up, Dr. Sharma is a co-founder. In July 2022, Dr. Sharma received a new 1.5-year $575,000 research award from the Virginia Catalyst to support IND-enabling research-based technology in collaboration with Virginia Commonwealth University (VCU), Virginia Tech, and Slate Bio Inc. The project is titled “Bifunctional Fusion Cytokine Therapy for Autoimmune Diseases.” Lastly, Dr. Sharma was awarded a new 3-year national Discovery and Development Partnership grant ($150,000/yr) from Juvenile Diabetes Research Foundation to perform translational studies in type-1 diabetes utilizing his work showing that a new immunomodulatory therapy developed by his laboratory can induce regeneration in pancreatic islets in T1D. This has been quite a year for Dr. Sharma!
Research Highlights – Clinical Science
Dr. Julia Scialla
Recently July 27, 2022, Dr. Julie Scialla, Associate Professor, and Shirin Pourafshar (former fellow in nephrology) had their important research highlighted in UVA Today as well as across 200 news media outlets. I want to bring your attention once again to this critical study. Using the National Health and Nutrition Examination Survey conducted between 1988 and 2018, Dr. Scialla and co-workers analyzed data on eating patterns of fruits and vegetables. They found that patients with chronic kidney disease included fewer fruits and vegetables in their diets, implying that consuming fruits and vegetables is strongly linked to good health. Their findings were published in the Journal of Renal Nutrition and have received widespread national news coverage. “Consuming more fruits and vegetables is strongly linked to health in many different diseases,” UVA Health kidney specialist Dr. Julia J. Scialla said. “We worry about overall health effects when we see patients with chronic kidney disease consuming low levels of fruits and vegetables.” blood pressure, heart disease, and stroke.“We hope that through this study and similar studies, we will be able to encourage both healthy individuals and patients with chronic kidney disease to reconsider their intake of fruits and vegetables by incorporating greater varieties and amounts of unprocessed or minimally processed fruits and vegetables into their everyday diets,” said Shirin Pourafshar, a nutritionist and dietitian who was co-author of the study.
The Nephrology Clinical Research Center (NCRC), which is led by Dr. Julie Scialla (Medical Director) and Dr. Igor Shumilin (Operational Director), continues to make significant progress. The NCRC is onboarding new trials in hypertension, lupus nephritis, focal segmental glomerulosclerosis, transplant immunosuppression, and polycystic kidney disease. The team leads investigator-initiated studies in ultrasound and the ketogenic diet and numerous data science projects on bone and mineral metabolism, nephrotic syndrome, and COVID treatments.
Research Highlights – Collaborative Science
Dr. Michael Brown
Research success depends on developing strong collaborations in other disciplines. A new Commonwealth Health Research Board (CHRB) Grant Award was made to Michael Brown, Medicine, Nephrology, Coleen McNamara (Medicine, Cardiovascular), and Vineela Bontha (Medicine, Cardiovascular) for their research on ‘Risky variants in human cardiovascular disease.’ The research project will investigate whether genetic variation in the glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR) expressed by NK cells and other lymphocytes may affect the development or progression of atherosclerosis, a major cause of cardiovascular disease and a significant contributor to disability and death in Virginia. Congratulations to Mike, Coleen, and Vineela!
Research Highlights – Training Focus
Our program in nephrology focuses on reaching out to earlier trainees from high school to postdoctoral fellows to engage trainees in meaningful kidney research with the hope that this will be an enduring opportunity. We have trained high school students during the summer with students from as far away as New York to conduct research in Nephrology at UVA. We have two additional programs: 1) VA K Tutor geared toward undergraduate students and 2) IGNITE KUH, which targets pre and postdoctoral fellows.
VA K Tutor
The VA K Tutor (Virginia Kidney Technology Development Research Education Program), UVA Nephrology undergraduate training program (NIH1 R25 DK124918: PI Sharma, Okusa, Gifford), now in its second year, provides an immersive research and education experience for technology-oriented undergraduate students to participate in cutting-edge research in kidney diseases, to generate innovative solutions for promoting kidney health. Four were from UVA, and one came from VCU. They enthusiastically immersed themselves in basic research and clinical rotations for ten weeks and were a wonderful addition to the Division. This NIH-sponsored training grant also allows for 6-12 months of additional research, and we welcome their continued participation and investigation of their chosen areas of interest.
We have recently completed our first year of a newly funded collaborative training grant (UVA PI’s Okusa, Portilla, Brown). The NIH-funded Integrated Virginia Research Training Centers in Kidney Urology and Hematology (IGNITE KUH; 1U2C) DK129500/1TL1DK132771) is based on a collaborative partnership involving three main research training centers in the Commonwealth of Virginia and is committed to developing the next generation of KUH researchers. The three IGNITE KUH institutions are the University of Virginia (UVA), Virginia Commonwealth University (VCU), and Virginia Polytechnic Institute and State University (VT). Unique IGNITE KUH Programs will foster a growing community of trainees with extensive networking opportunities across the Commonwealth while also providing professional development resources to ensure our trainees acquire the skills needed to pursue research as a career. Integral to IGNITE KUH is our outreach to undergraduate students throughout the Commonwealth, including Historically Black Colleges and Universities (Virginia Union, Virginia State U., Hampton University, and Norfolk State U.) and rural universities (UVA-Wise).
The program promotes interdisciplinary research that includes fundamental and translational research, as well as patient-oriented clinical research, and is targeted to highly-motivated predoctoral students and postdoctoral fellows (MD DO PhD or their equivalent). The IGNITE mentoring team includes outstanding physician-scientists and basic science investigators from the Departments and Centers of the three institutions. The program provides basic/fundamental training and didactic instruction in multiple disciplines, including molecular, cellular, and transgenic technologies, immunology, functional genomics, and novel imaging technologies, focusing on kidney, urology, and hematology. The patient-oriented clinical research program provides clinical investigation, epidemiology, biostatistics, and data sciences training.
Research Paper Highlights
Former postdoctoral fellow Shinji Tanaka in Mark Okusa’s laboratory has published a significant discovery in Science Translational Medicine on a signaling pathway that may play a crucial role in kidney fibrosis. Here Shinji and co-workers demonstrate that perivascular sphingosine 1- phosphate (S1P) signaling promotes kidney inflammation and fibrosis, which can be reversed by inhibiting the S1P transporter, spinster homolog-2 (Spns2), suggesting a different approach to treating kidney disease progression.
Research Trainee Highlights
Congratulations to the following winners at this year’s Research Scholar’s Day which was in May.
Carey, Marshall, Thorner Scholar’s Day
Jessica Annis (Poster) from Mike Brown’s Lab
Aspen Robinson (Poster): from Sanja Arandjelovic’s lab
Immunology Research Day
Shuhei Kuwabara (Oral presentation): Okusa lab
Nabin Poudel (Poster): Okusa lab
Awards and Recognition
Our faculty and staff continue to achieve excellence in their respective areas. This is a testimony to their hard work and effort despite COVID barriers. This year several individuals were recipients of the Department of Medicine Excellence Awards, including:
Daphne Knicely, MD, recipient of the Clinical Excellence Award
Uta Erdbrûgger, MD, recipient of the Educator Excellence Award
Mary Lenahan, recipient of the Outstanding Staff Contributor Award
Robert Young, recipient of the Administration Excellence Award
Jitendra Gautam, PhD, recipient of the Outstanding Staff Contributor Award
Amanda Renaghan, MD, recipient of the Award for Excellence in Clinical Care
Rasheed Balogun, MBBS, was appointed Harrison Distinguished Teaching Professor of Nephrology. This is a tremendous honor and well deserved. Rasheed was elected to the University of Virginia Academy of Distinguished Educators in 2005, and selected to be one of our four foundation College Deans. As part of the Next Generation medical education curriculum initiated by the School of Medicine in 2010. He served in this role for five years; together with three other deans, Rasheed contributed significantly to our undergraduate medical education mission by taking on the dean of student affairs role. He has created a first-of-its-kind independent Therapeutic Apheresis Academy. This multidisciplinary focused annual educational conference attracts an international audience. It has since been emulated by others, writing clinical guidelines used in treatment decisions internationally and authoring chapters, and editing textbooks in this niche field. The endowed chair is a well-deserved honor!
Corey Cavanaugh, DO, has been appointed a member of the 2023 ASN Kidney Week Education Committee (a.k.a. Program Committee) in Philadelphia. This committee is responsible for the educational content (sessions and abstracts) of Kidney Week. This is a great honor and a testimony to Corey’s emerging reputation and impact in the field of glomerular disease. Congratulations Corey!
Karen M. Warburton, MD, received a Distinguished Mentor Award from the American Society of Nephrology for 2022. This is a highly competitive award hosted by the American Society of Nephrology with over 20,000 members. Dr. Warburton has had a lifelong commitment to mentorship and faculty development. She has impacted many trainees and faculty members locally and nationally through direct interactions, or her faculty/trainee program development. She is a stalwart advocate for all faculty, especially women faculty. Congratulations Karen!
Alden Doyle, MD, who has been appointed Chair of UNOS Operations and Safety Committee, effective July.
Uta Erdbrûgger, MD, who will co-chair the annual meeting of the International Society for Extracellular Vesicles in May, 2023.
Congratulations to Mitch Rosner, MD who was a recipient of the Thomas Jefferson Award, the highest honor given to a member of the University of Virginia community. He is credited with developing strategic programs as Chair of the Department and his unparalleled work in navigating the entire university safely during the COVID pandemic by establishing testing management and policy.
“Mitch led the infrastructure changes necessary to care for COVID patients, organized and managed for surge capacity, quickly launched a telehealth initiative, and led the creation of community-based testing and vaccination centers,” ~President Jim Ryan
“What he did and how he did it drove the effectiveness of this University’s response to a once-in-a-lifetime challenge….He is thoughtful, level-headed, good-humored, invaluable, wise, even-keeled, humane, and humble. A consummate servant leader.” ~Provost Liz Magill
Korshie Dumor, MD MPH, will join the Division of Nephrology on September 1, 2022, as an Assistant Professor of medicine. He was previously Assistant Clinical Professor of Medicine in the Division of Pulmonary, Critical Care, and Environmental Medicine at the University of Missouri. He received his Bachelor of Medicine and Bachelor of Surgery (MBChB) in 2002, MPH at Harvard School of Public Health, Harvard U. Boston, Mass in 2005, Residency training in Medicine at Harlem Hospital, Columbia University College of Physicians and Surgeons 2010, Fellowship Training in Nephrology and Hypertension, University of Missouri, Columbia, MO, 2018 and Pulmonary Critical Care fellowship training in the Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri. He is Board Certified in IM, Nephrology, and Critical Care. He also worked in an internal medicine practice at Mercy Clinic and Phelps Health, Rolla, MO, from 2010-2016. We are excited that he will help build ICU Nephrology at UVA and contribute to research and education.
Bobak Sharifi, MD, is no stranger to all of you. Bobak was chief fellow in the Division of Nephrology at UVA. Bobak will join the Division of Nephrology as an Assistant Professor of Medicine. Bobak received his medical degree from Xavier University School of Medicine, Oranjestad, Aruba, followed by residency training at Virginia Tech Carillion System. He joined our program as a clinical fellow, and because of his outstanding performance, he was appointed Chief Fellow. Dr. Sharifi’s primary responsibility will be to develop a robust clinical nephrology practice in the Culpeper region. He will care for ESRD patients in UVA HS dialysis units and CKD patients in outpatient CKD clinics in Orange and Culpeper. We are excited about the growth potential up the 29 corridors, and we are thrilled and confident that Bobak is the right person to spearhead this initiative. We are delighted that Dr. Sharifi will be joining our Division.
Faculty and Staff Departures
Dr. Anjushree Kumar left the University of Virginia on June 19, 2022; she has accepted a Transplant Faculty position at the University of Missouri (St Luke’s Health System) beginning August 2022.
Robert Young will be leaving us after more than 16 years of outstanding contributions to our Division. Though we are sad to see him go, we wish him well as he pursues new opportunities. Bob has accepted an appointment as a Department Administrator for Family Medicine & Population Health, Virginia Commonwealth University, Richmond,VA. Bob will continue to manage operations and finance in his new position, as he had done in our Division at UVA. Still, the patient care, research, and education volume will be considerably larger. The Department at VCU also is responsible for a residency program at INOVA and a new one in South Hill, VA, and it houses a graduate-level MPH program. Bob has overseen and managed the growth of the Division and clinical programs, which have doubled in size. He has led and managed the addition of the Center for Immunity, Inflammation and Regenerative Medicine and a significant increase in our NIH grants portfolio. He was instrumental in acquiring a new state-of-the-art research space in Pinn Hall. Bob was awarded the Department of Medicine’s Administrative Excellence Award for his outstanding contributions in 2008, 2012, and 2022. We will miss his “can-do attitude” and his guidance and support of the Division over the last 16 years. The Department at VCU is very lucky to have recruited such a talented individual. We wish Bob and his family the best of luck in the future. He will proudly hang the picture of the Rotunda on his wall at Virginia Commonwealth University.
Remembrance – Amber Lanter
We are saddened that Amber Lanter died July 9, 2022. Many of you know her well and worked with her in the acute and chronic HD unit. Some of you have worked with her for many years. Please see the thoughtful remembrance written by Christy Hodge below. She will be missed.
Amber is survived by her son, Jacob Tolman, and sister Nikki Brookman. Amber maintained very close relationships with both of them. She had recently celebrated her birthday at the beach with her sister. She was immensely proud of Jacob, who had just graduated from college, bought a home, and started his new career.
Her nursing career began in 1996 as she graduated with her BSN from the University of Virginia School of Nursing. For the past eleven years, she has worked with renal patients in the inpatient acute dialysis center and recently celebrated two years as a Post Kidney Transplant Coordinator. Amber was deeply admired and respected by her patients, peers, leadership, and physician colleagues. She was best known for the hours of on-the-phone support she offered to her patients and her infectious and slightly mischief laugh. Her laugh was simply the best.
As a transplant family, we will honor her in memorial in days to come and infinitely celebrate the person she was, her life’s work, and her selfless contribution to so many patients over her 26 years of nursing. We are so thankful to have known her and for the fond memories that will carry us through this difficult time. You may read her obituary here.
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Tags: DOM, Education, medicine matters, Nephrology, profile, Publications, Research, September 2022, september medicine matters, september medicine matters newsletter, staff