Division of Nephrology Research and Educational Updates 2024

Mark Okusa, MD

Message from Mark Okusa MD, Division Chief of Nephrology

I hope this message finds you well and thriving as we transition into the fall season. This season is an ideal time to celebrate the milestones we’ve reached, set new goals, and reflect on the meaningful contributions we continue to make in the field of nephrology.

I want to take a moment to highlight the outstanding efforts of our faculty, who are deeply committed to supporting community initiatives and training the next generation of nephrologists and scientists. Their dedication plays a crucial role in shaping the future of our field.

Unleashing the Future of Nephrology

As part of the Division of Nephrology’s NIH-sponsored VA K-TUTOR Program, directed by Drs. Rahul Sharma, Mark Okusa, and William Guilford, the Annual Kidney Urology and Hematology (KUH) Undergraduate Research Symposium in which ~175 undergraduate students and 40 mentors from around the country descended upon Charlottesville, VA, from July 31 to August 2, 2024. This event marked the pinnacle for undergraduate participants nationwide in the summer KUH research program.

Undergraduate students from around the country attended the annual National Institutes of Health Kidney, Urologic, and Hematology Summer Undergraduate Research Symposium at UVA. The meeting began in the Rotunda library, followed by two days of meetings held in Alumni Hall. Nearly 200 participants, including 175 students, attended. Keynote speakers included Griffin Rodgers, MD, the director of the National Institute of Diabetes and Digestive and Kidney Diseases, and Vivian Pinn, MD.

The assembly of undergraduates and faculty program directors marked the symposium with various activities and intellectual exchange. Students eagerly shared their research, forged invaluable connections with peers and faculty, and absorbed career development insights.

The symposium’s highlight was the presence of several keynote speakers: Dr. Griffin Rodgers, Director of NIH/NIDDK; Dr. Vivian Pinn (Pinn Hall is named in her honor), the Inaugural Director of the Office of Research on Women’s Health at NIH, and Mr. Paul Conway, the Chair of Policy and Global Affairs at the American Association of Kidney Patients.

The atmosphere was filled with enthusiasm, and the excitement was palpable. This immersive experience inspires undergraduates to pursue medical or graduate careers, ensuring a bright and innovative future for nephrology. Special thanks to Lena Garrison, Yadira Weaver, and Jackie McCauley for their significant contributions to the event’s success.

Championing Diversity and Equity in Nephrology

Angie Nishio-Lucar, MD

The Division of Nephrology is deeply committed to fostering diversity, equity, and inclusion (DEI) in all aspects of our work. Led by Dr. Angie Nishio-Lucar, our DEI efforts address disparities in kidney disease outcomes, particularly among minority populations. We actively recruit diverse faculty and trainees, reflecting the communities we serve. Our initiatives include a dedicated DEI leadership team, strategic partnerships with HBCUs, and a diversity-focused webpage.

Kidney disease disproportionately affects individuals of color, especially Black and Latinx populations, who face higher risks and barriers to treatment. We aim to remove these barriers and ensure equitable care for all. Notably, our UVA Food Pharmacy, supported by grants and the Ralph Cohen Fund, provides kidney-friendly food to needy patients, emphasizing our commitment to addressing food insecurity and improving health outcomes.

Empowering Tomorrow’s Health Leaders: UVA KDSAP

Tushar Chopra MD

Kidney Disease Screening & Awareness Program UVA Kidney Disease Screening & Awareness Program, or KDSAP, is an undergraduate student-led chapter that provides students with opportunities for career development through physician connections and community outreach via free kidney health screenings to promote chronic kidney disease prevention. This program, led by Dr. Tushar A. Chopra, offers a unique opportunity for undergraduate students to gain invaluable hands-on clinical experience aimed at the prevention of chronic kidney disease among individuals in medically underserved communities. Since its origin at Harvard University in 2008, KDSAP has expanded its reach nationwide. By fostering awareness and providing proactive measures, KDSAP has and continues to play a pivotal role in promoting the overall well-being of individuals, emphasizing the importance of kidney health awareness. In addition, this organization offers an array of professional encounters to facilitate student cultivation of professional skills.

Division Highlights

Enhancing Glomerular Disease Care with Exceptional Expertise

Yeshwanter Radhakrishnan MD

We welcome Dr. Yeshwanter (Yesh) Radhakrishnan, Assistant Professor of Medicine, to our faculty. Yesh completed his residency at the Cleveland Clinic Akron General in June 2021, followed by fellowship training at the Mayo Clinic, where he developed a strong interest in glomerular and tubulointerstitial pathologies under the mentorship of renowned experts Drs. Fernando Fervenza and Ladan Zand. He also has expertise in genetic kidney diseases, critical care nephrology, and acid-base disorders.

Yesh is an exceptional clinician and educator. He will lead our renal glomerulonephritis clinic and contribute to the Lupus clinic. He will be available on Wednesday and Friday mornings to treat patients with various glomerular diseases, including membranous nephropathy, minimal change disease, FSGS, lupus nephritis, vasculitis, hereditary nephritis, C3 glomerulonephritis, and more.

Dedicated to Excellence in Service: A Commitment to the Apheresis Society

We welcome Dr. Yeshwanter (Yesh) Radhakrishnan, Assistant Professor of Medicine, to our faculty. Yesh completed his residency at the Cleveland Clinic Akron General in June 2021, followed by fellowship training at the Mayo Clinic, where he developed a strong interest in glomerular and tubulointerstitial pathologies under the mentorship of renowned experts Drs. Fernando Fervenza and Ladan Zand. He also has expertise in genetic kidney diseases, critical care nephrology, and acid-base disorders.

Dedicated to Excellence in Service: A Commitment to the Apheresis Society

Rasheed Balogun MD

The American Society for Apheresis (AFSA) Presidential Award committee has selected Rasheed Balogun MD for the 2024 Presidential Award. This distinguishing award recognizes Dr. Balogun’s commitment to apheresis and consistency in contributing to and performing outstanding service for the Society over several years.

UVA Transplant Nephrologists: Advancing Leadership and Elevating National Presence

UVA’s transplant nephrologists are shaping the future of transplantation through leadership in prestigious national societies and committees: Dr. Swati Rao is currently the medical director of the kidney and pancreas transplant program, completed a 2-year term on the AST Women’s Health COP Executive Committee, co-chairs the Leadership Workgroup, and serves on the AST Transplant Nephrology Fellowship Training Accreditation Program. Dr. Alden Doyle, Quality Director of UVA Transplant Service Line, co-chairs the OPTN Expeditious Task Force. Dr. Angie Nishio, Medical Director of Living Donor Kidney Transplantation at UVA, chairs the Education Workgroup of the AST Living Donor COP and is a member of the ASN Diversity Committee. Drs. Sarthak Virmani and Jeanne Kamal co-chair the AST Trainee and Young Faculty COP, supporting the next generation of transplant professionals.

Dr. Swati Rao, recipient of the Department of Medicine’s Women in Medicine Excellence Award

Swati Rao MD

At UVA, Dr. Swati Rao has integrated reproductive health counseling into the care of kidney transplant patients, ensuring that these critical conversations start from the first intake visit. Her leadership has successfully managed 11 pregnancies in kidney transplant recipients over the last five years, with seven resulting in live births. She has been a mentor and role model for women in medicine within and outside the Nephrology Division, guiding colleagues in their clinical, educational, and research pursuits. Nationally, she serves as an Executive member of the Women’s Health Community of Practice at the American Society of Transplantation, where she has spearheaded initiatives promoting equity for women and minorities in medicine.

Lena Garrison, recipient of the Department of Medicine’s Outstanding Staff Contributor Award

Lena Garrison

Even after her retirement in late 2021, Lena has remained a vital part of the Division of Nephrology and the Center for Immunity, Inflammation, and Regenerative Medicine and a member of the UVA community for over 44 years. She began her career in Radiology, then moved to work with Dr Shu Man Fu, former Chief of Rheumatology at UVA, in 1994 as she was interested in lupus research. She has been in Nephrology CIIR since 2007.

As a part-time Grants & Contracts Administrator, she manages the Division’s most complex grants, including the R25 and U2C-TL1 training and research awards. Lena’s exceptional support, built on solid relationships with subsites, trainees, and faculty, reflects her deep understanding and quick adaptability.

UVA’s R25 students along with Griffin Rogers, Director of NIDDK and Lena Garrison, Grants Administrator, at UVA huddle around Vivian Pinn, MD

Her meticulous attention to detail, organizational skills, and willingness to take on project management tasks showcase her passion for excellence. Lena is also actively hiring and training her successor, ensuring a seamless transition. Her continued dedication exemplifies her commitment to the Division’s mission, even in retirement. The photo is of Lena Garrison (kneeling) with Dr. Vivian Pinn, Dr. Griffin Rodgers (Director of NIDDK), and R25 students (VA K-TUTOR).

Tushar Chopra Recognized As Reviewer of the Year

Dr. Tushar Chopra was recognized by the American Society of Nephrology’s Kidney360 Journal as “Reviewer of the Year”. This award recognizes Dr. Chopra as an outstanding reviewer of articles published in the journal and ensures that publications are of the highest quality.

Research Update

IGNITE KUH: Empowering the Next Generation of Kidney, Urology, and Hematology Researchers Through NIH/NIDDK-Funded Training

UVA Nephrology Launched in 2021 with NIH/NIDDK funding, the IGNITE KUH program supports pre- and postdoctoral trainees in kidney, urology, and hematology research. A collaboration among UVA, VCU, and Virginia Tech, IGNITE KUH prepares the next generation of researchers through networking, professional development, and outreach to undergraduates, including Historically Black Colleges and Universities and rural universities. The program offers interdisciplinary training in cutting-edge technologies and methodologies, focusing on recruiting diverse candidates and advancing research through collaboration. Our mentoring team includes the three institutions’ top physician-scientists and basic science investigators.

Unveiling the Power of EVs: Pioneering Insulin-Induced Vascular Revolution in Type 2 Diabetes

Dr. Uta Erdbrügger, an associate professor in the Division of Nephrology within the Department of Medicine, alongside her colleagues at Rutgers, has been awarded a five-year NIH-NIDDK R01 grant for their research titled “Insulin, Extracellular Vesicles, Exercise, and Vascular Function in Type 2 Diabetes.” The Erdbrügger lab is at the forefront of studying Extracellular Vesicles (EVs), emerging as crucial intercellular and interorgan messengers in conditions like kidney disease, hypertension, and metabolic disorders. These submicron vesicles, which all cells release, carry essential cargo such as proteins and nucleic acids.

In their work, Dr. Erdbrügger and colleagues have explored the effects of exercise and insulin on circulating EVs in individuals with prediabetes and obesity. Their findings reveal that low cardiorespiratory fitness correlates with higher EV counts in adults with obesity and that acute exercise reduces fasting and insulin-stimulated EVs while enhancing vascular function in this population. Their new grant combines their expertise to investigate the hypothesis that EVs mediate insulin-induced vascular effects in Type 2 Diabetes. This research promises to shed new light on insulin resistance and uncover potential mechanisms through which exercise may reduce the risk of chronic disease.

Exploiting Apoptotic Cell Clearance: A Strategy for Treating Acute Kidney Injury and Beyond

Sho Morioka, PhD, is an Assistant Professor in the Division of Nephrology at the Center for Immunity, Inflammation, and Regenerative Medicine. After completing his postdoctoral training, Dr. Morioka joined the Division and CIIR. His research primarily focuses on exploring the therapeutic potential of enhancing apoptotic cell clearance, a strategy that has garnered significant attention.

Since joining the Division, Dr. Morioka’s innovative work has been recognized through various grants and awards. He is the recipient of the NIH K01 DK123497 grant, which supports his research on removing apoptotic cells during acute kidney injury. Additionally, he has been honored with the American Society of Nephrology (ASN) Transition to Independence Award and an O’Brien Center Pilot and Feasibility Grant. Most notably, Dr. Morioka recently received an outstanding score on his NIH R01 submission, with a pending final decision. Dr. Morioka’s work represents a promising approach to treating kidney diseases, potentially paving the way for new therapeutic strategies that could significantly impact patient outcomes.

From Mice to Humans: Neuroimmune Control of Inflammation in Acute Kidney Injury

Dr. Mark Okusa’s lab discovered that ultrasound pulses can reduce inflammation and acute kidney injury (AKI). Through NIH support, his group has explored how the biomechanical effects of ultrasound initiate systemic anti-inflammatory responses. The accompanying diagram highlights key pathways in the inflammatory reflex, including the efferent and afferent vagus nerve, the sympathetic efferent nerve, and the splenic nerve. Dr. Okusa’s team has employed electrical stimulation and optogenetic techniques to map out these pathways. The lab is now moving these findings into human studies, launching clinical trials to test whether pulsed ultrasound can block inflammation in healthy volunteers. Pending NIH approval, Dr. Okusa, Dr. Mitchell Rosner, and collaborator Dr. Ourania Preventza, Chief of the Division of Cardiothoracic Surgery, will explore pulsed ultrasound’s potential protective effects against AKI in high-risk cardiac surgery patients.

Harnessing the Power of the Intracellular Complement System to Transform Kidney Disease Therapy

UVA Nephrology The complement system, an ancient part of the innate immune system, is known for recognizing and eliminating pathogens. However, recent findings reveal that complement also functions within cells, influencing key processes like cell survival, differentiation, and metabolism. Dr. Didier Portilla, Professor of Medicine, Division of Nephrology/CIIR, utilizes single nuclei RNA sequencing, spatial transcriptomics, and immunofluorescence demonstrates that complement components are compartmentalized in specific cell types and contribute significantly to kidney fibrosis. We propose that the intracellular complement system is a critical driver of kidney function loss and scarring. It is a promising target for therapies, some currently in clinical trials or already in use for treating certain kidney diseases.

Decoding the Role of Efferocytosis in Inflammation and Autoimmune Diseases

UVA Nephrology Research in the Arandjelovic Lab focuses on the process of apoptotic (dying) cell clearance, also known as efferocytosis (from Greek effero “bury” or “take to the grave”). Apoptotic cells are frequently observed at sites of ongoing inflammation, and inefficient clearance of apoptotic cells can lead to secondary necrosis and the release of their cellular contents, which can further fuel the inflammatory process. However, the nature of dying cells and phagocytes that clear them remains unclear. We aim to address the questions in this project: 1) Who are the phagocytes in inflamed tissues? 2) What are they “eating” (infiltrating leukocytes, dying tissue-resident cells)? How does modulation of efferocytosis pathways impact disease parameters? These studies will identify new modulators of inflammatory and autoimmune disease and uncover novel pathways that can be targeted for therapeutic benefit.

Education Update

Graduation 2024
Memories from Graduation 2024, farewell to Lalida Kunaprayoon, Ayman Alghamdi, Monarch Shah, and Ben Silverberg as they embark on new adventures in life. We had a fantastic turnout, and I wanted to thank everyone for making it to this special day for fellows.

Celebrating Fellows Success

Our second-year fellows Sindhu Krishna Marampudi, Michelle Tran, Abdallah Saleh Abdelrazeq, and Alexander Olegovich Gogoli have made us proud! They showcased their research posters at the National Kidney Foundation Meeting, representing UVA Nephrology. Abdallah bagged a travel grant from ASN to attend the Home Dialysis University and participate in a virtual course. Michelle and Sasha diligently revised the 11th edition of the Nephrology Fellows Handbook for our new fellows, while Sindhu received a travel grant from Women in Nephrology and has been focusing on enhancing fellow wellbeing and UVA Nephrology’s social media presence.