2023 Department of Pediatrics Academic Annual Report

RESEARCH IN GLOMERULAR DISEASE The Division of Pediatric Nephrology is currently active in multiple initiatives investigating childhood glomerular disease. Cure GN (Cure Glomerulopathy Network) is a multi-center consortium that seeks to advance glomerular disease studies. The VALLIANT Study is a clinical study evaluating the safety and effectiveness of pegcetacoplan for C3 glomerulopathy. The VERTEX study is a clinical trial evaluating the efficacy and safety of VX-147 for patients with APOL1-mediated kidney disease. The latter two studies are critical, as currently neither condition, C3 GN or APOL1 mediated disease, have effective specific therapy. PARTICIPATION IN NATIONAL AND REGIONAL RESEARCH COLLABORATIVES, QUALITY-IMPROVEMENT PROJECTS AND LEARNING NETWORKS We are also involved in leadership of national quality improvement efforts. IMPROVED RENAL OUTCOMES (IROC) IROC is a national consortium of 17 pediatric renal transplantation programs. Generous donations have allowed us to both participate and lead aspects of this program. We have automated data collection that is now monitoring more than 30 benchmark issues. We have initiated intervention programs aimed at improving blood pressure (BP) control after transplant, which is critical for organ longevity, and standardization of immune suppression induction. Upcoming projects include standardization of post-transplant biopsy schedules and therapy of asymptomatic acute rejection episodes that may presage future graft dysfunction. A new effort in this collaborative is to investigate the causes of, and mitigate the impact of, medication non-adherence among renal transplant recipients. He also leads national efforts to increase COVID-19 vaccination among kidney transplant patients. Michael Seifert, M.D., leads our site. STANDARDIZATION CARE TO IMPROVE OUTCOMES IN PEDIATRIC END STAGE RENAL DISEASE (SCOPE) SCOPE is a collaborative of 78 pediatric nephrology programs to prevent infections in peritoneal and hemodialysis patients using large-scale collaboration to identify and disseminate effective interventions across pediatric care settings. In the past year, since we have joined SCOPE, our dialysis-associated infection rates have fallen more than 25%. This represents substantial cost savings and prevention of numerous infection-related hospitalizations. Sahar Fathallah, M.D., leads the local chapter. NEGATION OF RENAL INJURY BY JUST-IN-TIME ACTION (NINJA) NINJA is a collaboration between Children’s of Alabama and Cincinnati Children’s Hospital in which hospitalized patients receiving medications that can cause kidney injury are automatically identified by using the electronic medical record system and scheduled for dose adjustments and increased renal function surveillance. The rate of acute renal injury in inpatients has been decreased by more than 60%, resulting in substantially decreased morbidity across the hospital and reduced hospitalization duration. A very recent application of this program in the Neonatal Intensive Care Unit, a project only at Children’s of Alabama, has nearly eliminated medication-associated acute kidney injury in our most vulnerable premature infants. The NINJA program has been so successful that in 2018, it became the first new program added to the Solutions of Patient Safety consortium and instituted at 147 children’s hospitals worldwide. David Askenazi, M.D., MPH, leads our site. 2023 PUBLICATIONS HIGH-IMPACT PUBLICATIONS BMC Nephrol. 2023 Feb 18;24(1):39. Burden of chronic kidney diseases and underlying causes in Zambia: evidence from the global burden of disease study 2019. Samuel Bosomprah, Erica C Bjonstad, John Musuku, Namasiku Siyumbwa, Mwila Ngandu, Mukobe Chisunka, Patrick Banda, Fastone Goma, Aggrey Mweemba. Pediatr Nephrol. 2023 Mar 29. Use of extracorporeal therapies to treat life-threatening intoxications. Kyle Deville, Nathan Charlton, David Askenazi. Pediatr Nephrol. 2023 Sep 5. A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children: a report from the 26th Acute Disease Quality Initiative (ADQI) conference. Dana Y Fuhrman, Natalja L Stanski, Catherine D Krawczeski, Jason H Greenberg, A Ayse Akcan Arikan, Raj K Basu, Stuart L Goldstein, Katja M Gist. ADQI 26 workgroup (David Askenazi, Erica Bjornstad). Pediatr Nephrol. 2023 Jan 9. Adverse childhood experiences are associated with vascular changes in adolescents that are risk factors for future cardiovascular disease. Cailin E Kellum, Keri M Kemp, Sylvie Mrug, Jennifer S Pollock, Michael E Seifert, Daniel I Feig. Pediatr Transplant. 2023 Sep 26;e14617. Follow-up biopsies identify high rates of persistent rejection in pediatric kidney transplant recipients after treatment of T cell-mediated rejection. Adina Landsberg, S Sikandar Raza, Michael E Seifert, Tom D Blydt-Hansen. Pediatr Res. 2023 Feb 9. Premature infants born <28 weeks with acute kidney injury have increased bronchopulmonary dysplasia rates. Michelle C Starr, Robert H Schmicker, Brian A Halloran, Patrick Heagerty, Patrick Brophy, Stuart L Goldstein, Sandra E Juul, Sangeeta Hingorani, David J Askenazi; PENUT Trial Consortium.

Click here for the full list of publications from the division faculty in 2023.

2023 Academic Annual Report

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