Overview
Since the first dialysis in the Commonwealth of Virginia was performed at UVA on March 27, 1959, the University of Virginia has been recognized for its excellence in treating kidney diseases. Today, patients can receive our full range of services and medical expertise in one beautiful location: The UVa Kidney Center.
For patients with End-Stage Kidney Failure, dialysis acts as an artificial kidney machine that cleans the blood and restores its chemical balance. Your medical team will explain what the different dialysis options involve and which one is best for you.
Many patients prefer the convenience of dialysis at home. In our Home Training Unit, patients and their families receive extensive one-on-one training on how to perform dialysis, manage problems that arise and order supplies. Patients return monthly for follow-up visits.
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Division of Nephrology
University of Virginia
Activities-at-a-Glance
Clinical Activities. The division of nephrology is composed of 11 full-time clinical faculty, 4 full-time research faculty, 9 adjunct faculty (adjunct faculty participate in satellite programs), 8 clinical fellows and 4 postdoctoral fellows. Our clinical activities include but not limited to: in patient consultation service, outpatient longitudinal care, out patient hemo- and peritoneal dialysis with over 700 dialysis patients, renal replacement therapies (IHD, CAPD and variations, CRRT, apheresis). Acute renal failure electrolyte and acid-base abnormalities, hypertension, renal/kidney/pancreas/liver transplantation, parenchymal renal disease and vascular access complications. We have one of the largest nocturnal dialysis facilities in the country.
Research activities. The division of nephrology maintains an active research program funded by NIH grants to support basic research in immune response to acute ischemia-reperfusion injury, hemolytic uremic syndrome, Goodpasture syndrome, allograft rejection and the renin-angiotensin system in vascular biology. We have a newly established T32 training grant on “Kidney Disease and Inflammation” that is focused on training postdoctoral fellows in research. We have a dedicated Nephrology Clinical Research Center with dedicated nurse coordinators and business administrator.
Transplantation. Established in 1967, the kidney transplant program at the University of Virginia is one of the busiest programs of its kind in the Commonwealth of Virginia and the region. The program has provided care to more than 1500 kidney recipients, many of whom have been high-risk candidates. The program is structured as multidisciplinary with combined medical surgical clinics and inpatient services. Over the last 4 years, the program has grown dramatically with renal transplant volume increasing from 65 to 110 transplants annually (approximately half of which are living donor transplants) and pancreas transplant volumes of 15-20 transplants per year. Sustained growth (20% annually for all abdominal transplant programs over the last two years) is anticipated. The renal transplant program includes innovative translational research protocols and programs for ABO and cross-match incompatible transplants, altruistic live donation, and donor advocacy. An islet transplant program has been initiated and a FDA approved islet isolation facility has been completed and is operational. An active clinical research program in collaboration with various pharmaceutical companies is also available.
Training Program. Our fellowship program includes 4 first year and 4 second year fellows. We have a traditional clinical track composed of 2 years of training and a research training track that is now funded by an NIH T32. In the research track, candidates can pursue training along several pathways in order to achieve the goal of becoming an independent investigator. The pathways are: Pathway 1: Training in basic translational research; Pathway 2: Training in clinical investigation; Pathway 3: Training in basic translational research or clinical investigation with pursuit of an advanced degree.
Many of the tests and procedures kidney patients need can be provided conveniently on an outpatient basis at the Kidney Center's Nephrology Clinic. With our stat-of-the-art technology, we are able to diagnose and treat kidney problems in their earliest stages to prevent or delay kidney failure.
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Transplant Services
Kidney and pancreas transplants are provided through the Transplant Service at the UVa Medical Center. Our kidney transplant experts work closely with transplant surgeons to make this option available for patients who are interested.
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Inpatient Care
When medical complications arise, patients can receive high caliber care in our inpatient kidney unit on the third floor of the University Hospital.
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Other Specialists
Additional expertise at the UVa Kidney Center includes a vascular surgeon for patients who need an acces for dialysis, and pediatric nephrologists for children with kidney problems.
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Promising New Treatments
At the UVa Kidney Center, we're always searching for new and better treatments - ones that will help our patients live longer, healthier lives. Patients have the option of participating in clinical trials on promising new drugs as well as studies on new technologies. We are currently testing new drugs that could delay the progressions of kidney disease in people with diabetes or hypertension.
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Geriatric section
The Division also has a section of geriatrics headed by Dr. Emaad Abdel-Rahman . It is one of the few divisions in the country with an emphasis in this area. It has been established in collaboration with Dr. Mark Williams in the Geriatrics Division. The major focus is to deal with the impact of age on kidney function, drug metabolism, and day-to-day activities. The goal is to anticipate and prevent hospitalization and maintain patients at home rather than in assisted care facilities.
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Disease Management Program
The Division has developed a disease management program patterned after the evidence based Clinical Practice Guidelines of the National Kidney Foundation (NKF) and Renal Physicians Association (RPA). This program will place into operation seamless integrated care of patients with kidney disease including outpatient chronic kidney disease, inpatient care, and transplantation. The goal is to improve patient care with decreased admissions, length of stay, costs and readmission, with better outcomes and better patient and referring physician communication. This program is directed by Dr. Kline Bolton and will utilize a team approach of case management, patient education and physician extended services to implement the program.
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Home Training Program
Dr. Mitchell Rosner is the director of the Home Training Program. A patient and family education program run by the clinical nurse director of the home dialysis program, the dialysis social worker, dietitian, clinic and dialysis nurses, is partly responsible for the growth in our home program and early preparation for renal replacement therapy. An abstract describing the educational program for patients facing the need for renal replacement therapy was presented at the National Dialysis Conference in Seattle, WA in 2002. Over 500 patients and family members have now attended this educational program. In addition, a new program aimed at those with earlier stages of chronic kidney disease is now in place and meeting monthly. The purpose of this program is to educate patients and families about early chronic kidney disease and methods to delay progression of kidney disease.
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The addition of the Lynchburg Nephrology Program to the UVA Dialysis System will expand our home dialysis arena to include nocturnal daily home hemodialysis. It is one of the few nocturnal dialysis programs in the entire country and is currently performing studies supported by NIH in this new methodology for renal replacement therapy.