Mark Perazella’s colleagues single him out not only for his extraordinary accomplishments in the field of nephrology, but for his kindness, humility, and commitment to mentoring others. Perazella, MD, is professor of medicine (nephrology), director of the Acute Dialysis Unit at Yale New Haven Hospital, and medical director of both the on-campus Yale Physician Associate (PA) Program and the online Yale Physician Assistant Program. He will retire at the end of this year as professor of medicine emeritus.
“I really can't say enough about what a great colleague Mark is,” says Alexandria Garino, PhD, PA-C, associate dean for PA education and assistant professor (general medicine). “Mark is very accomplished, yet very approachable. He's always ready to help. Mark actively sponsors students, junior faculty, and fellows. He finds opportunities for them to succeed and helps them realize their professional goals. He is not a self-promoter; he promotes others. These days that is a very rare gift.”
Perazella grew up in Waterbury, Conn. He earned a BS in biology from the University of Connecticut in 1981, followed by an MS in systemic and evolutionary biology in 1983. After graduating from New York Medical College in 1988, he started a nephrology fellowship at Yale School of Medicine. In 1995, he joined the faculty as an assistant professor.
“When I was deciding where to go, I looked at various places around the country as well as around the state,” Perazella says. “I decided that Yale was the best place to meet my needs as far as what I wanted to do and for my training. Part of it was wanting to being near to where I grew up, but primarily because Yale is such a great institution in all ways—academics, research, and education.”
Perazella says he’s always been interested in the physiology of the kidneys and in all aspects of kidney disease. “But probably as important were the mentors that I encountered along the way in my training,” he says. “That influenced me because the nephrologists who were my mentors and teachers really impressed me. They were smart, they were great teachers, they really cared about their patients. It was something to aspire to.”
Among the countless accolades and awards Perazella has received are the prestigious Robert G. Narins Lifetime Achievement Award for Education by the American Society of Nephrology (ASN) in 2022, and the Donald W. Seldin Distinguished Award for Excellence in Clinical Nephrology by the National Kidney Foundation in 2021.
His parents and brother attended the ceremony for the Narins Award. “I was very proud that my parents were able to attend my award presentation,” Perazella says. “I owe my career success to my mom and dad for their complete and selfless support my entire life. They instilled in me the true importance of education, and they sacrificed much to allow me to attend medical school. As such, they deserved the award as much as I did. The funny part is that they were completely amazed at what they heard about me, as I never really told them a lot of the details of my academic career. They just thought I was a kidney doctor.”
Perazella has been a nephrology subspecialty board member and item writer for the American Board of Internal Medicine. He has served on educational committees for the American Society of Nephrology since 2008, and he will be the co-chair of ASN’s annual Kidney Week conference in Philadelphia in November. He has published over 340 articles, numerous book chapters, and co-edited five textbooks. He also has been an associate editor for the Clinical Journal of the American Society of Nephrology and deputy editor of Kidney360. In 2017, he helped found the Journal of Onco-Nephrology and is a co-editor-in-chief.
Ursula Brewster, MD, professor of medicine (nephrology) and training program director, Nephrology Fellowship, calls him a “one-man publishing house.” Brewster was a member of Perazella’s first fellowship class in 2002, went on to work with him as the nephrology department’s associate training program director, and eventually succeeded him as program director in 2014.
She points out that around half of his papers have a fellow or a junior faculty member as a first author. “His mentees are always his priority, whether it’s a resident, a fellow, or a junior faculty member,” she says. “Every time he gets a great opportunity in his life, the first thing he does is go out there and figure out how many of the people here, the junior people, can he get involved? Can he get them an article to write? Can he get them a speaking engagement at a national meeting? When you have a senior person in a department who operates by that philosophy, others have followed suit, and sponsorship and mentorship become woven into the fabric of the place.”
Brewster says the fellows who come through the training program know they have access to Perazella’s expertise for life. “He still gets urine microscopy pictures sent to his cell phone from former fellows all over the world,” she says. “People with tricky cases who graduated long ago know that they can always find Mark to think through it with them. And it gives him joy to do that.”
As a clinician, Perazella’s expertise is in treating patients with drug-related kidney injury, allergic interstitial nephritis, and HIV-related kidney disease. He is also well-known for putting the field of onconephrology on the map.
Onconephrology looks at the relationship between cancer and the kidney. Chemotherapeutic agents and other medications to treat cancer (targeted agents and immunotherapy) are associated with various types of kidney injury and disease. In addition, certain forms of kidney disease are associated with an increased risk for cancer.
Perazella brought together colleagues with an interest in this area of medicine that combined nephrology, oncology, critical care medicine, palliative care medicine, radiology, and pharmacology. He also recruited a diverse group of young ASN members to form a committee. The ASN program “Cancer and Kidney Disease” provided an educational forum for all members, in particular trainees and junior faculty.
A seminal 2017 review paper, Acute Kidney Injury in Patients with Cancer, published in the New England Journal of Medicine, and co-authored by Perazella and Mitchell Rosner, MD, Henry B. Mulholland Professor of Medicine, and chair of the department of medicine at the University of Virginia School of Medicine, highlighted the various causes of acute kidney injury in patients with cancer and helped bring the field of onconephrology to the attention of many clinicians.
“Mark has consistently been a leader in the field of onconephrology and has especially led the way in understanding how various chemotherapy drugs affect kidney function. He was one of the first to highlight the effects of immune checkpoint inhibitors on the kidneys,” says Rosner.
On top of everything, Perazella has served as the medical director for the Physician Associate Program since 2008; in 2017, he took on the same role for the PA Online program as well. “Training physician assistants to become excellent patient care providers and teachers is as important as what I do on the medical school side with trainees,” he says.
Perazella says he’s been recruited by other institutions over the years, but he has never wanted to leave Yale or the VA Connecticut Healthcare System. He considers the people he works with family. “They'll do anything for you, and you'll do anything for them,” he says. “And that has certainly happened through the years. Someone gets sick or some catastrophic thing happens in their family, and you step up and say, ‘Don't worry about it, I got you.’ And I know that relationship exists for all of us and for each other.”
He says it never occurred to him to consider retiring until the Covid pandemic—to which he lost patients and friends—gave him some perspective and contributed to his decision. “I realized that, honestly, I spent so much of my time working due to the rigors of the job, working weekends, nights, traveling to give talks, and doing all these other things, that I didn’t spend enough time with my family.”
Perazella has two sons, Mark and Andrew, and a 10-month-old grandson, Leo Anthony. He and his wife, Donna, will be moving to Boynton Beach, Fla., close to where Perazella’s brother Scott lives, and with whom he is very close. He plans to visit New Haven regularly to visit friends, family, and colleagues. Though he will stop working as a clinician, he will continue editing journals and working with the ASN, along with the other organizations he’s involved in. He will also give guest lectures.
“You go from the youngest person in a section or division to the oldest clinician,” Perazella says. “Now I'm the oldest clinician here. It’s interesting to watch that happen and think back on it.”
Glen Markowitz, MD, professor of pathology and cell biology, and executive vice chair for anatomic pathology at Columbia University Irving Medical Center, and a close friend of Perazella’s, calls him “a remarkable guy.”
“I think academic physicians have to really excel in three areas,” he says. “They have to be great clinicians, they have to be great teachers, and they have to make academic contributions. You have to write, you have to lecture, you have to bring the field forward. And Mark is absolutely, unequivocally all three of those things.”
Brewster again emphasizes Perazella’s deep commitment to mentoring and to looking out for his students’ best interests.
“There are generations now of people that have come through this training program that feel like we owe him our careers and our livelihoods,” she says. “He has built so many people into what they are and done it in such a generous and kind way. People like him are just really rare, and we are lucky to have had him here at Yale.”
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