“We are taking our outstanding care to the communities where our patients live,” says Dr. Benjamin Humphreys, Chief, Division of Nephrology, commenting on the expansion of the division’s clinical services beyond the Washington University/Barnes campus.
The North County Dialysis Center, which opened in February 2018, joins Home Dialysis South in providing more convenient, state-of-the-art services for our patients in the greater St. Louis area. In addition, the division has increased the number of off-site clinics, allowing our physicians to see patients in an ever-widening area of the region.
“The dynamics have changed over time,” says Jodean Baldauf, Director of Business Operations for the Division of Nephrology. “Previously, patients were willing to travel a far distance to receive their dialysis to be seen by our physicians. Now, physical locations become part of their decision-making as to where they will be dialyzed. We are meeting our patients’ needs by going to them.”
Dr. Brent Miller
Dr. Brent Miller, Professor of Medicine and Medical Director of Home Dialysis, details the services available to the south metro area. “We have Home Dialysis South, which provides training and support for patients doing peritoneal dialysis and home hemodialysis.” The center currently has 16 patients and they anticipate that it will eventually provide support for 40 patients.
“It is one of the few home-only dialysis centers in the St. Louis area,” says Miller who also sees kidney transplant patients in offices adjacent to the dialysis center. Both he and Dr. Dan Coyne, Medical Director of Chromalloy American Kidney Center, see patients with chronic kidney disease there.
“The advantages are its accessibility at the junction of two interstates and its convenient parking. It is like going to Walmart,” says Miller.
Dr. Dan Coyne
Home Dialysis South is located in the South County Center for Advanced Medicine, 5201 Mid America Plaza, Suite 2200 Saint Louis, MO 63129.
Clinical services have also expanded north of the WU/Barnes campus. The newly launched North County Dialysis Center is a 16-station, in-center hemodialysis unit that will have the capability for home hemodialysis and peritoneal dialysis training and support. Currently servicing two hemodialysis patients and one peritoneal dialysis patient, the unit has the potential to accommodate 90 in-center hemodialysis patients and up to 40 home modalities patients.
Dr. Tingting Li
Medical Director of the North County Dialysis Center Dr. Tingting Li says, “Our experienced and dedicated dialysis team will provide excellent, personalized care in a friendly and comfortable environment near our patients’ homes.”
“The North County Dialysis Center looks great,” says Ms. Baldauf. “It has a different feel to it. It is beautifully designed with a warm atmosphere, and the natural light gives the unit an open and inviting feeling.”
In conjunction with the new dialysis center, an outpatient clinic where Dr. Marcos Rothstein, Professor of Medicine, Nephrology, will see patients is now open on the campus of Christian Hospital Northeast.
“The idea is to provide consultative services and support to the medical and urgent care community in the North County and the nearby Illinois towns,” says Dr. Rothstein.
Dr. Rothstein’s office (co-shared with WU Division of Urology) is located at 11155 Dunn Road, Building 1, Suite 202N. The clinic is accepting referrals for patients with kidney disease and hypertension. For new appointments, call 314-362-7603.
“Kidney disease is reaching epidemic proportions and most patients in the U.S. are not seen until it’s too late to enact successful preventive strategies,” Says Rothstein. “This is another step to fulfilling our mission of providing care close to the communities in need.”
Young Man’s Music is Good for the Body and the Soul
Chase Cofer remembers the day he experienced the first symptom.
It was a day like any other, with Chase and his sister spending time with their cousins. Chase hadn’t noticed anything was wrong – but his sister did. She pointed out that his arm had been in a fixed, bent position for the entire day.
When Chase tried to straighten his arm, he found that it would not move. His sister and cousins thought he was joking around.
When they realized that he really could not straighten his arm, everyone, as Chase puts it, “freaked out.” The problem was initially diagnosed as a pulled muscle. However, his family found out that something was seriously wrong when he finally made it to St. Louis Children’s Hospital.
“I was nine years old at the time,” says Chase. “By the time that I was 11 or12, my legs were locked up, my other arm was locked up, my fingers were locked up.”
Through recent genetic testing, Chase was found to have a mutation in sphingosine-1-phosphate lyase (SGPL1), which can result in nephrotic syndrome, ichthyosis, facultative adrenal insufficiency, immunodeficiency, and neurologic defects.
Overall, there are only 30 people worldwide identified with SGPL1 deficiency. The individuals, from 15 families, are from Pakistan, France, Spain, Canada, Morocco, Saudi Arabia, Turkey, Iran, Austria, Israel, Serbia and the United States.
“I have a gene mutation,” Chase calmly states. “I’m the only person in the United States who has been reported with it.”
It has been a long road for Chase since that day 11 years ago. Occupational therapy helped straighten his arms. Surgery helped straighten his legs. But he was never able to get his fingers straight. Needing better home therapy for his fingers, he started playing guitar.
Chase has been playing guitar now for two years. “I am self-taught. I just love it. It’s great exercise.” But he also plays guitar because he loves music.
“Music just spreads joy. I’ve learned that I can put a lot of emotion into my songs using the guitar and spread any kind of joy. I like just about any kind of music. I play anything from blues to jazz to rock to rap. Anything you can think of, I will try and play it on guitar. I will try my best at it as I do with everything. I always give it my all.”
Chase recently transferred from Children’s Hospital to Chromalloy Dialysis Center for hemodialysis three times a week. “You know, being on dialysis takes up a lot of time, takes up a lot of your day. Still, I manage to play guitar two hours a day.”
Since picking up the guitar and composing his own music, Chase has posted 11 music videos on his YouTube channel, Milk Toof. See here for his first video posted in 2016 and another composition, This is Not a Test.
“I’ve written a few songs, but I can’t sing, so I need other people to sing them for me! Actually, my friend Chris and I’m trying to start my own band right now.”
Chase also wants to use his YouTube videos to tell his story. “I want to reach out and find people who have this disease, because there are still people out there who are trying to figure out what they have. They honestly don’t know. I was there once, and I was lucky to find Dr. Megan Cooper, who through a blood test was able to identify my disease. For almost 10 years, I was just guessing. I want others to find their Megan Cooper.”
Dr. Megan Cooper
“Chase is such a great person,” says Dr. Cooper, Assistant Professor of Pediatrics and Pathology and Immunology. “Through all of his challenging medical problems he has retained a positive spirit. “Whenever I see Chase, his first question is always How are you doing? The cause of Chase’s disease was only recently uncovered by genetic sequencing. We are hopeful that now that we understand the mechanism of his disease, we will one day be able to provide a targeted therapy for him and others with his condition.” Dr. Cooper is co-author of the recent publication titled Mutations in Sphingosine-1-Phosphate Lyase Cause Nephrosis with Ichthyosis and Adrenal Insufficiency in the Journal of Clinical Investigation.
Right now, Chase is learning to learn to walk again. “I’ve learned how to walk a few times in my life, but every time, something would happen. In 2016, I was walking probably 20 minutes in therapy, and then my kidneys started to fail.”
Although Chase admits that dialysis has been hard and that he looks forward to eventually getting a kidney transplant, he says that if he had the choice to be someone else, he wouldn’t. “You know, it’s been an honor for me to actually have this disease because I’ve been able to meet so many people and just spread positivity.”
Chase says not many people would view this disease in a positive light. But he does.
“I am someone who can truly handle this. And handle it well.”
Jennifer Malson, mother of two, was recently surprised by KMOV’s Surprise Squad. She is part of the Forest Park Kidney Center’s home hemo program. Jennifer’s friend, Kim, nominated her for this special visit, not only to help her friend, but to raise awareness for World Kidney Day and transplants. Check out the story here…and have a hankie or two..or three ready.
A Nephrologist is The Cooking Doc – #ChangeYourBuds
The Cooking Doc is an online cooking series that features Dr. Blake Shusterman, a nephrologist. He whips up a delicious combo of his knowledge of the kidney and his passion for cooking. Healthy never tasted so good!
Poached fish in olive oil and citrus, yum!
Check out a chicken, squash and kale casserole.
Women and Kidney Disease – World Kidney Day is March 8
WKD is an annual, global campaign to stress the importance of kidney health, to reduce the impact of disease, and to educate people on the need for organ donation. It is a joint initiative of the International Society of Nephrology and the International Federation of Kidney Foundations.
WKD is celebrated with events such as kidney screenings and marathons. Are Your Kidneys OK? was the theme of the first WDK, held 13 years ago in 66 countries. The event (the second Thursday of every March), is now celebrated in over 90 countries participating in more than 1000 events.
The theme for 2018 is Kidney & Women’s Health: Include, Value, Empower. Chronic kidney disease affects approximately 195 million women worldwide. It is currently the eighth leading cause of death in women, with nearly 600,000 deaths each year. More information on women’s kidney health is here.
Fellows Dr. Pooja Koolwal (second from left) and Ryan Kunjal (right) along with Dr. Koolwal’s spouse (far left) and Dr. Kunjal’s wife and son.
Acknowledging the importance of the kidneys will occur on more than just March 8. March, after all, is Kidney Month! WU Nephrology celebrated and spread the word about kidney health and disease on March 4, when our team, Wash Ur Kidneys, participated in the 2018 National Kidney St. Louis Kidney Walk.
Working to Improve Patient Care – Third Annual Nephrology Update
The Nephrology Update Continuing Medical Education course is back for its 3rd year. The course is designed for healthcare professionals involved in the care of patients with kidney disease. This year, the event will be held at the Auditorium at City Place, 1 Cityplace Drive, St Louis, MO, March 24, 2018, 7:30 – 11:30 am.
Aimed at improving the care of patients, the course is co-planned and implemented by Washington University School of Medicine and the National Kidney Foundation (NKF). The American Medical Association, American Nurses Credentialing Center, and Accreditation Council for Pharmacy Education provide credits for the course.
Course Chair, Assistant Professor of Medicine Timothy Yau, MD, says, “We have some of the best teachers in the world here at Washington University and are excited to share this knowledge with providers who can make a positive impact for patients with kidney disease. We are pleased to continue our partnership with the NKF.”
On the agenda: Review and Update in Kidney Disease Management
Timothy Yau, MD, Primary Care Approach to CKD Detection, Management, and Delaying Progression
Dan Coyne, MD, Management of Anemia in CKD and Dialysis
Patricia Kao, MD, Hypertension Update
Steven Cheng, MD, Update on Novel Potassium Binding Agents
Seth Goldberg, MD, Bone and Mineral Disease
Brent Miller, MD, Home Modalities for Renal Replacement Therapy
If you’d like to see what the physicians will be working on, check out the brochure here.
5,000 Kidney Transplants – A Bittersweet Celebration
Left to right are Jason Wellen, MD and Director of Kidney and Pancreatic Transplantation; Dr. Benjamin Humphreys, Chief, Division of Nephrology, Dr. Andrew Malone, Division of Nephrology, Transplant, and Dr. Tarek Alhamad, Division of Nephrology, Interim Medical Director of the Kidney Transplant Program.
The Washington University and Barnes-Jewish Hospital kidney transplant program, one of the largest and oldest in the United States, celebrated a milestone in 2017: The 5,000th patient to receive an adult kidney.
The program began in 1963, with the first living kidney donor transplant performed in 1965. The team generally averages more than 230 kidney transplant surgeries each year: More than half of all the kidney transplants performed in Missouri. In 2017, a record 254 kidney transplant surgeries were performed. Washington University/Barnes-Jewish Hospital is consistently ranked among the nation’s best by U.S. News & World Report for the treatment of kidney disease and was ranked 9th best hospital for nephrology in the U.S. for 2017-2018.
Members of the Barnes Jewish Hospital kidney transplant team and WU Division of Nephrology, Transplant.
“Each of those transplants has a great story attached to it,” says Tarek Alhamad, MD, Interim Medical Director of the Kidney Transplant Program. “We are thrilled to see patients able to go back to work, continue education, do their favorite sport, run a marathon or travel around the world. Basically, patients get their lives back.”
(left) to Office Coordinator Laura Kipper (right) work to make the kidney transplant program a success.
Dr. Alhamad emphasizes that all the members of the kidney transplant team work together for one purpose – to provide the best patient care to kidney disease patients so that they will enjoy a longer and better life. “This is the philosophy of kidney transplant care at our center.”
The center offers innovative and life-saving treatment options that may not be available elsewhere. This includes the use of long-acting immunosuppression medications that have fewer side effects, which results in better patient adherence. Alhamad points out that the center is one of the few centers to monitor donor-derived cell-free DNA (dd-cfDNA), a sensitive biomarker used to assess graft health in kidney transplant recipients.
Drs. Wellen, Malone, Alhamad and Rowena Delos Santos.
More than 100,000 patients with kidney disease are waiting for a kidney transplant. A living donor kidney transplant provides better survival and avoids what could be a long wait for a decreased organ. In the St. Louis area, the waiting time for a deceased organ is approximately three to four years, whereas it can be up to ten years in other parts of the country.
After an intensive post-transplant follow-up in the transplant clinic, patients are seen once a year for the rest of their lives. Alhamad says it is rewarding when patients come in for their follow-ups and talk about how well their transplants are working, how they enjoy not being tied to dialysis, and how satisfied and grateful they are to be living their new lives. “That is the most exciting thing about our work.”
Nurse Practitioner Helen Wijeweera (left) and Brittany Heady, Physician Assistant.
Mary Myers, Barnes Jewish Hospital, and Dr. Venkatachalam.
Devin Wall and Rachel Cody of WU Nephrology work on kidney transplant clinical trials and studies.
Holiday Bingo at Chromalloy Kidney Center
The holiday Bingo games, an annual event for over 30 years, was held in the Chromalloy dialysis center during the three dialysis shifts (7:45 am, 10:45 am, and 2 pm) on December 20 and 21, 2017.
Organizer Brenda Bingel, Nurse Administrator, put out a call for prizes for the event, which is always a fun time for both patients and staff in the dialysis center.
Patients received a small prize for each winning Bingo card. Donations included patient favorites: large-print crossword puzzle books, “seek and find” books, and useable items such soaps, lotions, and candles and food items such as jams and jellies. Ever mindful of the kidney, no chocolate, nuts, or nut butters were given as they are high in potassium and not recommended for the patients.
Retired staff members came to help, call Bingo numbers and handed out prizes.
“Patients are happy to see retirees come back and visit with them while they help out with the bingo party,” says Brenda. “I really appreciate all of the staff, former and present, in making these parties a success. It really reflects their dedication to the patients and the unit.”
Brenda Bingel, RN, MSN, can be contacted at 314-362-0238; firstname.lastname@example.org.
New North County Dialysis Center Opening
Marcos Rothstein, MD
“Serving the population where they live” is the impetus behind the new Washington University dialysis facility about to open in North St. Louis County, according to Dr. Marcos Rothstein, Professor of Medicine, Nephrology, and one of the initial advocates of the project.
“Missouri has over 9,000 patients undergoing dialysis, and that puts our state in the top ten for incidence and prevalence of End Stage Kidney Disease (ESKD),” says Dr. Rothstein. “Within both the state and our city, North St. Louis County has by far the highest number of patients suffering from this condition.”
Tingting Li, MD
Opening in early January 2018, the North County Dialysis Center is a 16-station, in-center hemodialysis unit that will have the capability for home hemodialysis and peritoneal dialysis training and support. The unit has the potential to eventually accommodate 90 in-center hemodialysis patients and up to 40 home modalities patients.
The center, designed to exude a warm and inviting esthetic, has an open atmosphere with lots of windows in the treatment area, and boasts easy accessibility with regard to parking.
The intake of patients at this top-of-the-line facility will begin gradually under the leadership of Medical Director Ting Ting Li, MD and Nurse Practitioner Lisa Koester-Wiedemann, along with a dedicated nursing staff, all bringing a wealth of experience to the endeavor. In conjunction with the new unit, Rothstein and Koester-Wiedermann will see patients in a new WU Nephrology CKD clinic located nearby in the Doctors’ Building at Christian Hospital Northeast.
Lisa Koester-Wiedemann, NP
The Washington University North County Dialysis Center will join the existing Renal Network of dialysis units – Chromalloy American Kidney Center (the oldest dialysis unit in operation in the St. Louis area), Washington University Dialysis Center at Forest Park, and South County Dialysis Center (Home Dialysis South). These dialysis units are independent, not-for-profit facilities, welcoming all patients under the care of nephrologists throughout the community.
Brent Miller, MD
“This certainly complements our ability to provide dialysis throughout the Metro area,” says Brent Miller, MD, Professor of Medicine and Medical Director of Home Dialysis. “We now have units covering South, West, Central and North locations in the St. Louis area.”
Dan Coyne, MD, Medical Director, Chromalloy American Kidney Center, says, “The opening of a Washington University Dialysis Center in North County reflects the commitment of the Division of Nephrology to provide state-of-the-art services and care across the entire Metro St. Louis area.”
Dan Coyne, MD
“For over 50 years, Washington University Nephrology has been committed to caring for and providing kidney replacement options to patients in our region,” says Dr. Rothstein. “Extending into North St. Louis County is the natural continuation of that mission. I’ve seen firsthand the need for a dialysis unit in North County, and it fills me with pride that Washington University Nephrology is fulfilling the needs and expectations of our patients.”
The North County Dialysis Center is located at 272 Mayfair Plaza in Florissant, MO, 63033, near the intersection of highways 367 and 270.
Welcome to Paul J. Scheel, Jr.
Paul J. Scheel, Jr., MD, MBA, recently joined Washington University School of Medicine new Associate Vice Chancellor of Clinical Affairs and CEO of Washington University Physicians. He is a nephrologist and will be seeing patients at Barnes-Jewish Hospital.
Heartburn and Kidney Disease
Leslie Spry, MD, FACP and spokesperson for the National Kidney Foundation, shared important information about the association of chronic kidney disease and use of medications to treat heartburn and other stomach acid disorders. Check it out here.
Hocus POCUS – Doctors Learn Importance of Ultrasound to Point of Care
“Turnout was excellent,” says Dr. Tarek Alhamad, Assistant Professor of Medicine in Transplant Nephrology and the symposium’s Course Chair. “For the Ultrasound Workshop, we reached a maximum of 25 participants, with 6 instructors.” The instructors, there to provide comprehensive training, were from the critical care divisions of Emergency Medicine, Surgery, and Anesthesiology.
The Ultrasound Workshop, directed by Dr. Enyo Ablordeppey, Assistant Professor in Anesthesiology and Emergency Medicine, was a new feature of the symposium this year. The intensive training course allowed participants to build skills in the examination of heart, lung, renal, and inferior vena cava volume assessment, as well as ultrasound-guided techniques for vascular access and renal biopsy. The workshop had hands-on ultrasound scanning with human models, case didactics, ultrasound diagnostics, and procedural simulation.
“Participants really seemed to enjoy the course and provided very positive feedback,” says Dr. Ablordeppey. “The workshop was a great start. Clinical providers will now have to go to the patient’s bedside to improve their skills with ultrasound.”
Testing at or near the site of patient care is referred to as point-of-care testing, which not only allows for more rapid therapeutic action, but is considered a more efficient use of healthcare resources. When performed with ultrasound, the testing is referred to as point-of-care ultrasound, or POCUS.
“POCUS of cardiac, lung, and inferior vena cava diameter and collapsibility have emerged as useful tools in volume assessment,” says Alhamad. “The ultrasound volume assessment has been underutilized in the care of our kidney disease patients in the floor, intensive care unit, and in hemodialysis centers.”
“POCUS plays a crucial role in patient care by allowing the clinician to immediately integrate the physical exam and acquire images to determine patient physiology and guide management,” notes Ablordeppey.
Programs like the ultrasound workshop will continue to highlight the importance of POCUS in patient hemodynamic volume assessment and procedural guidance.
“We are looking forward to expand the program next year to have a full day as POCUS and another day focusing on renal ultrasound,” says Alhamad, already planning the next workshop!
FREE Community Health Fair at St. Cecilia’s 10/22
The Laborers’ Local 110 is holding its annual St. Cecilia’s Church Community Health Fair on Sunday, October 22, 10 a.m.-2 p.m. at 5418 Louisian Ave., St. Louis, MO 63111.
Attendees will have access to FREE:
kidney function tests
blood sugar screening
blood pressure check
HIV & Hepatitis C screening
EKG Heart Health Test
Physicians will be on site for free consultations
Free geriatric screenings.
Additionally, there will be information on citizenship, health and nutrition, immigration, education, healthcare insurance and more.
National Kidney Foundation
Latinos en Axion
Center for Hearing & Speech
City of St. Louis
St. Louis University
A Remarkable Gift
Detective Shane Pierce delivering check donation to local charity from Guns and Roses event.
Lake Ozark Police Detective Shane Pierce cares about his community. He mentors youth in his community through a Police Kids Academy. He started a Coffee and a Cop program. He organized a Guns and Hoses charity basketball game. He’s even appeared as McGruff the Crime Dog at many community events.
So, when Detective Shane Pierce developed kidney disease, someone in his community decided to return the favor and chose to care about him after reading about his need for a kidney donor on his Facebook page.
A member of the Lake Ozark community, Courtney Powell, a wife and mother of four children, is donating a kidney to Shane. Courtney heard about, and was touched by, Shane’s situation and decided to see if she was a match. She was.
Courtney Powell and Shane Pierce. Photo courtesy of Amy Wilson, Lake News Online
The detective was diagnosed with with IgA nephropathy (Berger’s Disease) in August 2015. “I really wasn’t having any symptoms that made me think I had a possibly fatal disease,” he says. “I tell everyone that I just figured since I was 40 years old, that I was naturally getting a little slower, more tired – and fatter!”
Shane admits that he had high blood pressure and wasn’t exactly a compliant patient when it came to taking his medications. “My primary care physician said she would not refill my Lisinopril if I didn’t come in for fasting labs. That is when we learned my creatinine level was 4 times higher than it should have been. She then scheduled me with the specialist.”
Shane was sent to Barnes-Jewish Hospital for treatment under the care of Dr. Benjamin Humphreys, Chief of the Division of Nephrology at Washington University. “I was very happy to move my treatment to Barnes, they have been great,” says Shane.
Shane Pierce and family
After the diagnosis, Shane says he was either in shock or didn’t quite understand the implications of the news. “When I would tell people, they kept saying ‘I am so sorry’. I remember thinking why would you be sorry, what’s the big deal? Once I started reading a little bit, it sank in. I tried to buy as much life insurance as possible and really had to start thinking about what would happen if I weren’t here anymore.
Shane has been on peritoneal dialysis since May of this year. “I chose that over hemodialysis because I felt like doing my treatment at home would make life seem more normal as opposed to sitting in some depressing room at a hospital.” He recently contacted Dr. Humphreys to update him on the good news about the kidney transplant, which will take place at Barnes in November of this year.
“I hope us sharing our story sheds some light on kidney disease and living organ donation,” says Shane. “I know I was woefully ignorant when it came to organ donation until I needed an organ. It’s a remarkable gift to give someone, to give them the gift of life, and I think there are plenty of people who would if they understood the process and how much it means to the recipient. If sharing my story convinces one person to help another, I will be happy!”
About, Cortney, the donor of his soon-to-be new kidney, Shane says, “Cortney is a wonderful person. I feel blessed to know her. I don’t think you can ever adequately say thank you.”
One of Shane’s favorite community projects is the Lake Ozark Police Youth Academy, a two-day camp for ages 9-15 that he started in 2011. “We cover many aspects of policing and show them what it’s like to be an officer. It’s a great way to connect with the youth and show them you are just a normal person. It builds relationships that last into high school and beyond.”
One of the students, an 11-year-old boy, went door to door and raised $300 for “his favorite officer” when he heard that Shane had kidney disease.
Dr. Humphreys’ pilot project is one of only 38 chosen from 481 applications submitted from around the globe. Mark Zuckerberg, founder and CEO of Facebook, and his wife, Priscilla Chan, a pediatrician, co-founded CZI in December 2015. The goal of the initiative is to advance human potential and promote equal opportunity, starting with science and education.
The Human Cell Atlas project will create a comprehensive, open-reference map of every cell type in the body. The project will catalog where the cells are located, which genes, proteins and other molecules are expressed in each cell type, what processes control their activities, how the cells normally interact with one another, and what happens during disease.
The atlas will serve as a resource to study health and to diagnose, monitor and treat disease. Data from the Human Cell Atlas will be free and available to all.
As part of the Human Cell Atlas project, Dr. Humphreys’ research will provide information on cell types of the kidney. His grant is titled Comparing Microfluidic-Based Single Cell RNA-Sequencing Approaches for Development of a Human Kidney Cell Atlas.
For decades, the kidney biopsy has been the “gold standard” test used by clinicians for detecting kidney disease, providing critical diagnostic and prognostic assessment as well as therapy guidance. Biopsies are read using light microscopy, electron microscopy and indirect immunofluorescence using a limited number of antibodies.
However, advances in single-cell genomic analysis allow newer ways to characterize cells. Rather than measuring the expression of several genes at a time by immunofluorescence, it is now possible to simultaneously measure the expression of thousands of genes in thousands of single cells.
“In this project, we will define new methods to perform single cell RNA-sequencing on human kidney tissue,” says Dr. Humphreys. “Our goal is to develop a Human Kidney Cell Atlas that accurately describes genes that are present in all of the more than 30 different cell types present in human kidney. This work will lay the foundation for a transformation in our understanding of kidney cell diversity, and ultimately bring diagnosis based on kidney biopsy into the molecular age.”
A CZI grant is also being awarded to another Washington University researcher, Samantha Morris, PhD, Assistant Professor of Developmental Biology and Genetics, whose work was an inspiration to Dr. Humphreys (see article). Using single-cell RNA sequencing, Dr. Morris will analyze cells in the liver and small intestine. Her project will also help with multiplexing and standardization of this new technique so that results can be compared across labs.
The pilot project awardees were announced on the CZI Facebook page Oct. 16, 2017. Information on all 38 projects can be found here.
Put on your walking shoes and join the annual St. Louis NephCure Walk, to be held October 22, 2017 at Creve Coeur Lake Memorial Park, Maryland Heights, MO.
The patient advocacy group NephCure Kidney International sponsors the event. The organization’s mission is to support research that seeks to discover the cause, improve treatment, and find a cure for Focal Segmental Glomerulosclerosis (FSGS) and Nephrotic Syndrome.
NephCure Walk 2017 is not only a fundraiser, the event brings together patients, their families and friends, and community businesses to help spread the word about FSGS and Nephrotic Syndrome.
Diane Salamon, a Clinical Research Coordinator in the Division of Nephrology participated in the 2016 NephCure Walk last October. “It is a family-friendly – and dog-friendly – event, and the walk is very short, probably less than 1 mile. They also have fund raising booths, raffles, prizes and music.”
This year, Diane will again join the WashU Pediatric Renal Team since she recruits patients for clinical studies involving children with Nephrotic Syndrome. However, she suggests, “Next year, it would be nice to get a Division of Nephrology group together!”
From the NephCure Walk in 2015. Dr. Suleiman is in the back row, second from the left.
Dr. Hani Suleiman, an Instructor of Medicine in the Division of Nephrology and the 2014 recipient of NephCure Young Investigator Award, participated in the previous year’s event. “It is a nice event, for all age groups,” says Dr Suleiman. “And for Saint Louis, it is the best time of the year to be outdoor, doing something fun.” The NephCure Kidney International newsletter recently featured Dr. Suleiman for his NephCure-funded research that uses microscopic imaging of injured kidney cells in FSGS.
Registration for the walk is on-line or at the event. On-site registration opens at noon, and the walk begins at 1 PM at the Tremayne Shelter in Creve Coeur Lake Memorial Park, 13725 Marine Ave, Maryland Heights, MO 63043.
Be a part of Diane Salamon’s team and donate here!
Mangia! Ravioli Dinner Fundraiser
RoseMarie Bianchi, a dialysis patient at Chromalloy Dialysis Center and co-founder of The Sick and Elderly Program of the Hill, is getting ready for the foundation’s annual fundraiser – a big, Italian, ravioli dinner.
The Sick and Elderly Program of The Hill is a volunteer home health care foundation that provides free medical equipment and supplies to the residents of The Hill neighborhood in St. Louis, which proudly celebrates its Italian heritage.
RoseMarie and her husband, John, founded the program over 40 years ago. Today, RoseMarie is Chairwoman of the Board, John is President, daughter Debbie Hilderbrand is Vice-President, and sons Bob, John, and James are on the foundation’s board.
The Bianchi’s generosity extends well beyond the boundaries of The Hill. It is not uncommon for the foundation to provide patients in the Chromalloy Dialysis Center with much needed medical equipment. See here for a previous Division of Nephrology news article featuring RoseMarie and her son Bob.
All proceeds of the Ravioli Dinner fundraiser benefit the foundation. Click here for the flyer.
You can follow The Sick and Elderly Program of The Hill on Facebook.
Community Organizations Team Up to Offer Free Health Care Screenings
The NKF will offer free kidney screenings as part of its KEEP Healthy Program. This community-based initiative helps educate the public about the kidneys, risk factors for kidney disease, and steps to take to keep kidneys healthy and reduce risk.
Participants will have access to screenings for hearing, blood pressure, blood glucose and cholesterol, as well as albumin-to-creatinine ratio urine tests for individuals at risk of kidney disease. Hepatitis C and HIV testing will be available. Flu shots will be offered to the uninsured.
Nurses, physicians and advanced practitioners will be on hand to review health screening results with participants. Information concerning health insurance options, free/reduced cost medical services and prescription medicine will also be provided.
This event is open to the public and all services are free of charge. Interpreters will be available on site, provided by LAMP (Language, Access, Multicultural People). Participants can enter a free raffle to win a $50 grocery gift card.
Anyone interested in volunteering for the event should contact Sal Valadez at 319-383-6200 email@example.com. General volunteers and interpreters are always needed!
WU Nephrology Awarded Grant to Reduce ESRD Patient Readmissions
“One of our core values in the Division of Nephrology is to improve the health of our patients,” says Benjamin Humphreys, MD, PhD, Joseph P. Friedman Associate Professor and Chief of the Division of Nephrology.
The Division of Nephrology has been awarded a two-year grant from the Barnes Jewish Hospital (BJH) Foundation for a proposal to reduce 30-day hospital readmissions for ESRD patients.
On average, a dialysis patient is admitted to the hospital twice a year and over 30% of those admissions will have an unplanned recurrent hospitalization within 30 days. This is double the readmission rate of non-dialysis Medicare beneficiaries.
Frequent hospital readmissions contribute to high mortality rates and poor health-related quality of life of ESRD patients, and are costly, as well, to the dialysis unit and hospital involved. Improving readmission rates is beneficial to all involved.
The two in-center dialysis centers operated by Washington University – Chromalloy American Kidney Center and Forest Park Kidney Center – manage approximately 400 patients, as well as another 200 patients in the community. In 2016, of the 771 hospital admissions for these patients there was a 28% rate of readmission within 30 days.
Humphreys states that improving the readmission rates “will require direct monitoring, enhanced communications between providers and patients, specific and focused patient education, and interactive provider interventions”. The plan is to establish a robust transitional care program to target dialysis patients admitted to Barnes Jewish Hospital for intensive follow-up to prevent readmission.
Humphreys notes, “I am excited that this grant from the BJH Foundation will allow us to test new ways of keeping our dialysis patients out of the hospital, and in so doing, reduce costs, improve outcomes and enhance patient quality of life.”
Specific aims of the program are:
Create a 30-day readmission risk-assessment tool that will allow optimal communication between the provider and the patients. Patients will be categorized as a low, medium, or high readmission risk based on criteria such as the patient’s social support system, laboratory parameters, adherence record, discharge destination, and dialysis modality.
Once the readmission risk is assigned, an intervention plan will be developed to meet the challenges of each patient’s individual needs when discharged. The plan will focus on matters such as reviewing medication and discharge instructions with both the patient and caregiver, providing dietary support and counseling, scheduling visits by nurse coordinator/physician during first week post discharge, following-up with phone calls to the patient/caretakers, and ensuring appointments are kept with non-renal outpatient providers.
Develop patient education tools to target clinical problems that affect readmission rates. This will include development of patient-friendly tool to manage medication, diet, and fluid restriction at home and one-on-one education with patients and families.
Monitor and track patient outcomes.
Dialysis Patient’s Kidney Walk Entourage: Five Years and Growing
Garland Patton, a dialysis patient in the Chromalloy Kidney Center at Washington University, and a group of more than 50 family and friends, turned out for the annual St. Louis National Kidney Foundation (NKF)-sponsored Kidney Walk held last April. This was the fifth year in a row that the Patton group took part in the fundraiser.
Garland’s oldest daughter, Erica, says the family was originally encouraged to join the NKF walk by her niece Michaiah, who wanted to do something for her grandfather. So, a group of ten including Garland, Erica, her siblings Trineice, Garland Jr., Ebony and Terrence, and mother Sheila gathered for their first walk in 2012. “We got so much knowledge from it – about how to take care of our bodies and how to help with our dad. We loved the event so much,” says Erica.
Kidney Walk 2015 with Garland Patton (center) and family members.
Since that first walk, the group has made t-shirts and participated in various fundraisers and outreach programs to “get the word out” about the kidneys and the important role they play in your body. “This year was the best year ever,” says Erica. “Not only did we get to donate a nice amount but we had over 50 people to join and help out with the movement. Family and friends from all over got a chance to enjoy the NKF walk.” The family event is so popular that a nephew from Atlanta, Georgia, has travelled to St. Louis to join in the last few walks.
Garland, who just turned 56 and who has been on dialysis for 18 years, is very enthusiastic about the event, “We enjoy it. It gets bigger and bigger, you know, more and more people want to come. It‘s not the biggest group, but we’re in there!” Garland says the NKF walks are a place to get to know others in your situation – and more. “You get to meet people. You get to meet different doctors, nurses, and staff. There are a lot of other people there.”
Garland Patton with cousin at the 2013 Kidney Walk.
The Kidney Walk is usually held on the St. Louis University campus at Laclede Park. This year, due to weather that forced cancellation of most outdoor events in St. Louis that day, the event was held in the Chaifetz Arena. “We made the quick decision to change venues to an inside facility in order to still be able to hold the walk,” says Cherie Gilderbloom, Development Manager for the National Kidney Foundation serving Eastern Missouri and Metro East. “We were able to work with Chaifetz Arena, who was fantastic in helping us figure everything out in a short amount of time to pull off an incredible event.” The walk featured The King of St. Louis as emcee and live music from Blackdog and the Rainmakers.
Over 1,000 participants walked in the 2017 event and raised over $135,000 (and counting) to raise awareness of kidney disease and to fund programs that educate and support patients, their families and those at risk. “We were so grateful for the turnout. It’s so awesome how dedicated our walkers are and show up year after year,” says Cherie.
The Patton family wants to continue to spread the word about kidney disease. “The awareness starts with us letting people know that knowledge is out there for them,” says Erica Patton. I just really want people to look at my dad and know that he is more to us than a dad. He is our hero every day. He fights to be here with his family. If you know someone going through something similar, support them! Get out there and gain as much knowledge that you can about it. Be their hero!”
As for Garland, he’s enthusiastic about the annual event and proud to be part of raising the awareness of kidney disease. “It’s pretty nice, it really is. You’ve got people involved. It was all new to me, but I got a chance to tell somebody.” Known in the dialysis center as someone who is “always being so upbeat and positive”, Garland is more than happy to have his story posted on social media. “Maybe we can find more people!”
As Garland sits hooked up to a hemodialysis machine in Chromalloy, patiently waiting for his session to finish, he points to a woman whose family had taken part in the walk. “They want to join my team next year.”
For more information on the annual St. Louis NKF Kidney Walk, contact Cherie Gilderbloom: firstname.lastname@example.org or 314-961-2828 ext. 486.
Follow links to see the sponsors and in-kind donors who helped make the event possible.
Surviving Orientation Can Be Murder for First-Year Fellows
A week’s worth of meetings, talks and training conferences were not the only activities on the orientation schedule for the first-year nephrology fellows. The fellows also had to break out of a murder mystery Escape Room.
“We always like to promote teamwork and camaraderie among the fellows – so I thought taking them to an Escape Room would be a fun way to do that,” says Dr. Stephen Cheng, Associate Professor of Medicine in the Division of Nephrology and co-director of the Nephrology Fellow program. The fellows took part in an interactive entertainment exercise in which players are “locked” in a room and have to use their wits (sorry, no electronics) and work as a team to solve a series of mysteries or puzzles in order to “escape.”
The scenario presented to the fellows was the disappearance of Smilin’ Jimmy Pagano, a small-time crook with a big-time heart. They had one hour to sift through a variety of clues to solve the mystery of Jimmy’s disappearance or risk being “wrapped in an old rug and dumped in a landfill.”
The fellows had to figure out the combinations to a variety of locks, find hidden rooms, and interpret coded messages to get out of the room. Dr. Ryan Kunjal, one of the participating fellows says, “The escape room was definitely a fun exercise. We worked very well as a team to ultimately solve the scenario given to us.”
Another fellow, Dr. Miraie Wardi also enjoyed the experience. “I thought it was a really good way to get the five of us to work together,” she says. “It can be really stressful to start at a new place when you don’t know anyone, so the escape room was also a good way of getting us to just hang out and get to know each other a little better.”
“The division will be happy to know that our fellows ‘solved’ the mystery with 4 minutes to spare!” says Dr. Cheng.
Gateway Escape Rooms, located at 150 Concord Plaza Shopping Center in Sappington, MO, hosts the immersive events.
Dr. O’Brien Joins Nephrology
The Division of Nephrology welcomes Frank J. O’Brien, MD, who will be joining the division as an Assistant Professor of Medicine and seeing patients in the Chromalloy American Kidney Center Dialysis Unit.
Dr. O’Brien received his medical degree, with first-class honors, from University College Cork, Ireland. He completed his residency in internal medicine at the Royal College of Physicians of Ireland, with subsequent transplant specialty training at Beaumont Hospital Dublin. Dr. O’Brien completed higher specialty training in nephrology at the Royal College of Physicians of Ireland, followed by a fellowship in nephrology at Stanford University in Palo Alto, California.
Dr. O’Brien has received multiple awards (Transplant Medal, Dialysis Medal and the Vincent Dolan Memorial Medal) from the Irish Nephrology Society in recognition of his research presentations at the society’s meetings. He recently received an award for Outstanding Clinical Research from the University of California San Diego Young Investigator Forum (2017).
From 2016-2017, Dr. O’Brien was a Jack and Marion Euphrat Pediatric Translational Medicine Fellow at the Child Health Research Institute at Stanford. He received a fellowship grant for his project Assessment of dialysis efficacy in pediatric patients. The goal of the project was to investigate the extent to which uremic solutes are elevated in the plasma of pediatric dialysis patients by assessing dialysis kinetics and solute generation.
Dr. O’Brien’s main research interests focus on dialysis and acute kidney injury. He is primarily interested in discovering better markers to assess dialysis adequacy and more accurate techniques to predict the need for dialysis in acute kidney injury.
Off-time interests include traveling around Europe and the US, gourmet food, bar trivia, movies and the outdoors. He enjoys hiking, and exploring new areas.