Nephrology

Stefan Somlo, MD, Section Chief

Aldo Peixoto, MD, Clinical Chief

Research

Investigators in the section explore a variety of topics from renal physiology and nephrology to patient-oriented investigation.

Several studies to note:

A study led by Stefan Somlo, MD, and Sorin Fedeles, PhD, MBA, demonstrated that the activation of the transcription factor XBP1 in vivo can improve the residual function of a mutant form of the PC1, protein thereby decreasing the severity of autosomal dominant polycystic kidney disease (ADPKD) in animal models.

Researchers identified a biomarker called CXCL9 that may help diagnose acute interstitial nephritis (AIN). Led by Dennis Moledina, MD, PhD, the study concludes that the CXCL9 test could allow faster treatment for AIN patients and prevent permanent kidney damage.

A randomized clinical trial led by F. Perry Wilson, MD, MSCE, demonstrated that automated electronic alerts in the hospital electronic health record could improve outcomes for patients with acute kidney injury (AKI).

Research led by Leyuan Xu, PhD, provided insights into the role of immune cells in kidney injury and fibrosis. The research contributes to a better understanding of the mechanisms underlying unresolved kidney injury and fibrosis, paving the way for the development of novel therapeutic strategies to prevent or treat these conditions.

Yale is one of several institutions participating in Caring for OutPatiEnts after Acute Kidney Injury (COPE-AKI), a study aimed at finding new approaches to managing AKI, with Wilson as principal investigator and Moledina as co-investigator.

A study is underway titled “Assessment of Biomarker-Guided Calcineurin Inhibitor (CNI) Substitution Kidney Transplantation,” in which patients can administer abatacept, a self-injecting medicine, at home. Richard Formica, MD, is the investigator and William Asch, MD, PhD, is co-investigator.

From September 2022 through September 2023, the section secured nearly $21.5M in funding.

The U.S. Department of Defense (DOD) awarded $4.7M over a four-year period to Madhav Menon, MBBS, MD, and Wilson, to study Focal Segmental Glomerulosclerosis (FSGS).

Other projects funded:

• Menon received $2.6M from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for Role of AMPkinase pathway in the regulation of Minimal change disease-to-FSGS transition.
• Shuta Ishibe, MD, received $2.1M from NIDDK for Role of LRP1 in Podocyte Biology.
• Lloyd Cantley, MD, received $1.8M from NIDDK for Macrophage Function in Kidney Repair.
• Xu received $1.8m from NIDDK for Targeting immune dysfunction during transition from AKI to CKD.
• Menon received $1.7M from DOD for Role of Immune Cell-Podocyte Cross Talk in the Pathogenesis of APOL1-FSGS and Proteinuric Kidney Disease.

Clinical Care

Yale Nephrology has a number of comprehensive clinical programs for various diseases and disorders involving the kidney. Faculty provide care to patients across the state at 20 outpatient sites and three inpatient sites.

The Yale Onco-Nephrology program, a new clinical and research program, was established in October 2022. Anushree C. Shirali, MD, is the director of the program, which is a joint endeavor with Yale New Haven Hospital (YNHH). While the main focus is on patients with kidney-related complications as a result of cancer or treatment of cancer, clinical research is also part of the long-term plan.

In early 2023, Yale School of Medicine (YSM) and Yale Medicine were named a Center of Excellence (COE) by the Polycystic Kidney Disease (PKD) Foundation, along with 27 other clinical organizations nationwide. The center offers patients the opportunity to receive care from experts who can help skillfully manage the illness.

Yale continues to be one of the top providers for kidney transplants in New England with a 96 percent survival rate one-year post transplant, while also exceeding national benchmarks in preemptive transplant listings. Yale New Haven Transplantation Center (YNHTC) lists 50 percent of its patients preemptively—prior to initiating dialysis—over double the 20 percent national average. Black patients also exceeded the national average on the preemptive waitlist. The team, led by Asch, combed through patient records to retroactively place Black patients higher on the transplant list after the Organ Procurement and Transplantation Network (OPTN) eliminated its race-based calculation when reporting kidney function in January 2023.

Education

The section is dedicated to training aspiring nephrologists. With four nephrology fellowship tracks, each has its own robust training and educational opportunities.

In July, the first fellow who matched in the three-year nephrology and critical care fellowship began training. The new track offers formal nephrology training with subspecialty training in critical care medicine, and once completed, the person will be board-eligible for both.

Anna Qian, MD, was awarded the Yale International Physician-Scientist Resident and Fellow Research Award from the Yale School of Medicine Office of Physician-Scientist and Scientist Development (OPSSD). The award will help Qian pursue a fellowship at Yale Nephrology.

Awards and Recognition

Peter S. Aronson, MD, received the Fund for Physician-Scientist Mentorship Annual Award presented by YSM’s Janeway Society Retreat announced in May 2023.

William Asch, MD, PhD, was elected Chair of American Society of Transplantation’s education committee.

Ursula Brewster, MD, won the 2023 Rosemarie L. Fisher, MD, Excellence in Graduate Medical Education (GME) Award.

Lloyd Cantley, MD, gave the Robert Schrier Endowed Lectureship at the 2022 American Society of Nephrology meeting.

William Chang, MD, PhD, was a recipient of Kidney Innovation Accelerator (KidneyX) Summit’s Artificial Kidney Prize Phase 2 for research on engineering bioartificial kidneys.

Irene Chernova, MD, PhD, was selected as the recipient of the department’s 2023 Iva Dostanic, MD, PhD, Physician-Scientist Trainee Award.

Richard Formica, MD, was named vice president/president-elect of the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN) in June 2023.

Sherry Mansour, MD, received the American Heart Association (AHA) Second Century Implementation Science Award.

Madhav Menon, MBBS, MD, received the American Transplant Congress’ Young Investigator Award.

F. Perry Wilson, MD, published a book, How Medicine Works and When It Doesn’t: Learning Who to Trust to Get and Stay Healthy.