Hand in Hand: Research and Leadership Directly Translate into Improved Patient Care
Wake Forest Baptist Health nephrologists are utilizing developments in research and a broad range of outpatient resources to provide cutting-edge treatment options for patients with kidney disease. Researchers have broken new ground in the genetics of kidney disease, assessment of blood sugar control in dialysis patients with diabetes, management of dialysis vascular access, and short daily and nocturnal hemodialysis. In addition, 10 of the 17 doctors in the Nephrology Section at Wake Forest Baptist have the distinction of being named to the 2011–2012 list of Best Doctors in America®.
“Our research programs are completely patient-focused,” said Barry I. Freedman, MD, chief of the Section on Nephrology. “Although our doctors are all involved in research, they are also clinicians who make dialysis rounds and see patients. At Wake Forest Baptist, work isn’t limited to discoveries in the lab; it is also about improving the lives of people with kidney disease.”
Michael V. Rocco, MD, professor of nephrology at Wake Forest Baptist, chairs the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI), where he has expanded the scope of the organization from guideline development to include the topics of research, public policy and educational components. “Our goal is to improve the morbidity, mortality and quality of life of patients with chronic kidney disease,” said Rocco.
Rocco has served as the clinical center principal investigator at Wake Forest Baptist for several NIH trials, including the HEMO Study, the Acute Renal Failure Trial Network (ATN), the Dialysis Access Consortium (DAC) and the Frequent Hemodialysis Network (FHN). In the HEMO Study, he served as the chair of the Nutrition Committee and the vice-chair of the Outcomes Committee. In the FHN Trial, he is the Clinical Core Consortium PI for the Nocturnal Trial and the chair of the Outcomes Committee.
Rocco has been instrumental in the NIH-sponsored Frequent Hemodialysis Network (FHN) Consortium, a randomized clinical trial of standard 3-times-weekly hemodialysis with 6 nights per week home hemodialysis. The study investigated the effectiveness of higher frequency and duration of hemodialysis on a number of outcomes including heart size, quality of life, blood pressure, anemia and other complications of dialysis therapy.
Nephrologists at Wake Forest Baptist are also leading the way toward testing novel blood sugar assays, such as glycated albumin (GA), in patients with diabetes and kidney disease. These studies revealed that the hemoglobin A1c, the standard test of long-term blood sugar control, was not as accurate as the glycated albumin in patients on hemodialysis, peritoneal dialysis or advanced chronic kidney disease. Freedman published these results in Kidney International, Peritoneal Dialysis International, and American Journal of Nephrology. “More accurate assessment of blood sugar control in patients with kidney disease is critical,” said Freedman.
Wake Forest Baptist's large outpatient dialysis program encompasses 16 dialysis facilities and a vascular access center in northwestern North Carolina. The program provides expert care to more than 1,500 patients with end-stage renal disease. John M. Burkart, MD, corporate director of Wake Forest University Outpatient Dialysis Facilities, oversees the operation of the network, and says its value to research and patient care is unparalleled. “We are working from every angle to improve the lives of dialysis patients, through active research and leadership in ensuring that care is provided optimally in treatment centers and at home,” Burkart said.