Nephrology

Welcome to the webpage of the Division of Nephrology at the University of Texas Medical Branch in Galveston, Texas. The division is dedicated to providing the highest level of patient care, training the next generation of academic nephrology leaders, and to conducting research and innovation that will lead to improved patient outcomes and quality of life. The Division was the third center in the United States to offer chronic dialysis care, being a leader in home hemodialysis and also having a renal transplant program.

OUR FACULTY

Our faculty members are committed to providing leading-edge diagnosis and treatment for the entire spectrum of renal disease, with expertise in chronic kidney disease, polycystic kidney disease, renal transplantation, renal pathology, hemodialysis, glomerulonephritis, peritoneal dialysis, electrolyte and acid-base disorders, and kidney stones. We are dedicated to ensuring compassionate, high quality care to patients with end-stage renal disease.

At the present time, the Division of Nephrology and Hypertension consists of general nephrologists and transplant nephrologists. Besides Transplant Nephrology, no clinical niche exists for any of the general nephrologists, except for John Badalamenti, MD, who is a certified hypertension specialist, but who has not limited his clinics to hypertension-related issues. Our highly qualified faculty includes 3 Advanced Practice Providers (APPs).

OUR RESEARCH

Research in our laboratory is focused on cellular and molecular mechanisms regulating renal tubule electrolyte transport, with emphasis on regulation of acid-base transport in the thick ascending limb. The goals of our current research are to define how innate immune signaling pathways affect renal tubule function and to determine the role of these pathways in the impairment of thick ascending limb bicarbonate absorption and the pathogenesis of metabolic acidosis in sepsis. Our studies use an integrative approach that combines methods for direct study of ion transport and cell signaling in microdissected renal tubules with a clinically-relevant sepsis model to advance understanding of the molecular mechanisms underlying sepsis-induced renal tubule dysfunction. In addition, we are investigating cellular mechanisms by which a novel therapeutic agent prevents sepsis-induced thick ascending limb dysfunction. These studies are designed to uncover new therapeutic targets that may aid in protecting renal tubule function during sepsis and a variety of inflammatory kidney disorders. This research has been supported continuously by NIDDK/NIH funding for more than 25 years.

The Division has been funded since 1987 to study the Regulation of Thick Ascending Limb Acid-Base Transport. The goal of this project is to study the cellular, biochemical, and molecular mechanisms involved in the regulation of HCO3 absorption by the renal medullary thick ascending limb. We are in the early stages of discussions with several companies to conduct registries of patient outcomes from kidney transplants. The addition of Interventional Nephrology presents opportunities to add additional research components.

OUR EDUCATION

The Division of Nephrology’s strength and distinction has been at the level of medical school education with the Renal Fluid and Electrolyte (RFE) Course for the second-year medical students. This is a problem-based (not lecture-based) basic and clinical science renal course that has been well-received by the UTMB Curriculum Committee and the medical students who have participated. The Nephrology Fellowship Program has adapted aspects of the RFE Course to develop a Core Curriculum that is problem-based and has been well-received by fellows and faculty. Faculty participate in other medical school courses, such as POM 2, with excellent evaluations.

The tension between clinical productivity and education endeavors limits our ability to develop innovative ways of delivering information to our students and house staff irrespective of the designated percent FTE for education. This is especially evident in the clinical outpatient arena, where the ability to generate wRVU’s is limited. Calculating inpatient and outpatient wRVU’s differently would reduce the clinical pressure on educators at UTMB.

OUR PATIENT CARE

The Nephrology Division distinguishes itself by offering Chronic Home Dialysis (CHD), Kidney-Pancreas Transplantation and Interventional Nephrology. We also have subspecialty trained APPs and we have developed a pseudo-medical home in the Victory Lakes Town Center location (faculty, fellows and APPs), potentially allowing all medical providers to be involved with every patient and providing the flexibility to serve new patients.