University of Florida Division of Nephrology and Hypertension – Jacksonville | UF Health Nephrology

UF Health is a safety-net hospital. That means that we do take care of patients
who otherwise have no insurance and wouldn’t be able to get care, so the Duval County here
works with the UF Health with a specific program that allows those patients to be seen and
cared for. We also take care of a large number of trauma
patients. This is the main Level I trauma center for
both North Florida and South Georgia. Within the division of nephrology, we have
several different programs. One of the major programs we have is our clinical
program that exposes all of our trainees to dialysis, predialysis, acute and chronic kidney
disease. Another aspect of our program is translational
as well as basic research. The third aspect is an educational program
that we provide here in different forms of kidney disease. Translational research goes hand-in-hand with
clinical care, and the type of translational research we’re doing here has to do with identifying
risk factors for the progression of chronic kidney disease. The basic science research program is very
important in terms of moving forward in new areas of investigation which might lead to
new therapies for slowing or stopping – if not reversing – chronic renal disease, and
the fellows are able to learn some of the basics about how to ask the right questions,
prepare proposals and carry out research. Here at UF Health Jacksonville we have two
trained transplant nephrologists, and we want to make sure that the patients that we serve
here are served well. I also want to make sure that we take care
of the community folks who have had a kidney transplant, and lastly we also want to give
an opportunity for our fellows to get trained in transplant, especially in the outpatient
setting. I think our model is very much patient-based,
with a strong emphasis on clinical education, so we want to make sure that we have enough
exposure for both fellows and for the patients so they get what they need out of us. One of things we are looking forward to is
publishing our data as it pertains to access to transplantation and the health disparities
that exist in this arena. This is an out-of-state hemodialysis unit
offering peritoneal dialysis as well as outpatient chronic hemodialysis. Involving fellow training, it’s composed of
two units – one with 40 hemodialysis chairs and the other one with 24 hemodialysis chairs
– mostly involved in the fellow indications during the fellowship training. The programs that we provide for our fellow
trainees are extremely important. Some of our trainees will go into clinical
medicine, where they’ll finish their their training. Others will go into research. But our exposure to the various aspects of
our division in what we provide them helps prepare them for the future no matter what
they go into. Simulation lab is very special to our training
program. It allows us to train our fellows with procedures
such as kidney biopsies and placing central lines. The simulation lab is an extremely sophisticated
facility where you can take pictures and cameras of the trainees as you’re doing the procedure. We guide them through the procedure. We can then go back and look at the video
presentation that was made and let them look at it and see where they went right, where
they went wrong and how we can correct any errors they may have before they actually
do the procedure on a living patient. The research has worldwide impact. One example has to do with research on the
role of glucose transporters in different diseases. Our focus currently has to do with scarring
of the kidneys. So, based upon early findings we had in animals
that show that diabetic levels of glucose upregulate the glucose transport system in
mesangial cells, we designed transgenic mice to overexpress the glucose transporter – in
this case GLUT1 – in the mesangial cells when there’s no diabetes present. And what that shows is that you can recreate
many of the features of diabetic kidney disease simply by this upregulation of the glucose
transport system without having diabetes per se present. So it’s research that’s recognized worldwide
and it’s an area that really is relatively new, investigating really new mechanisms about
how glucose and glucose metabolism are involved in the scarring process in many different
types of kidney disease. We have a couple of other clinical projects
in our division. One of them is actually further studying the
interdialytic creatinine rise and its effects on the interdialytic volume gain. This is a picture of simulation we can see
that IDCR has a major influence on the volume gain in between dialysis. We have shown the same effects clinically
as far as the low IDCR values associated with volume gain and actually they contribute to
excess mortality in patients. We have great aspirations for the future of
our division and the rest of UF Health. We’ll continue to recruit trainees as we are
currently doing presently. We’d like to expand our program – we have
a new campus, a north campus – where we will eventually have our trainees go there. And we’ll continue maintaining the same aspects
– educational, clinical as well as research aspects – of our program during the time of
our expansion.