A Re-Energized Kidney Program
Drs. Neiha Arora, Alan Pao, Wolfgang Winkelmayer, Vivek Bhalla, Glenn Chertow, and Richard Lafayette make up Stanford's Nephrology Practice.
For patient referrals, please call the Referring Physician Resource Center at 866.742.4811, send an email to referral@stanfordmed.org or fax to 650.320.9443.
Who's at risk for kidney disease?
- » Persons with diabetes
- » Persons with hypertension
- » Elderly
- » African Americans, Hispanics, Native Americans, and Pacific Islanders
- » Family members of persons with kidney disease
Kidney disease is not sensational. There are no superstars with kidney disease. And even though one in nine adults in the U.S. has kidney disease, it doesn’t get a lot of attention. Glenn Chertow, MD, head of Stanford’s Nephrology Division, would like to change that.
A silent disease
Kidney disease often goes undetected,
and afflicts poor and minority groups at
a higher rate. Many patients are not diagnosed
until their disease is in an advanced
stage, when treatment is more
complex, and less able to preserve kidney
function.
The early signs of chronic kidney disease
can be very subtle– changes in urination,
swelling, fatigue, shortness of
breath, itching, metallic taste in mouth,
nausea and vomiting, feeling cold, dizziness
and trouble concentrating. And
many of these symptoms can be caused
by conditions other than kidney disease.
Yet kidney disease can be easily detected by routine blood and urine tests. Because patients with even mild or moderate cases of kidney disease are at heightened risk for a cardiovascular event, early detection can help improve their outcomes and prevent other serious complications, Chertow explains.
A team effort
“We want to bring kidney disease and its
treatment to the forefront,” he says. Just
two years into his appointment as Director
of Nephrology at Stanford, Chertow
has recruited several researchers
and clinicians to join Stanford’s growing
division. “Bringing in new faculty with
new interests re-energizes the staff, and
the clinical and teaching programs,” he
says.
“All of our clinicians practice evidence based medicine,” Chertow says. “There
is a heightened attention to detail here,
with a keen understanding of how kidney
disease affects people’s lives. We help
patients learn to live with kidney disease,
not suffer from kidney disease.”
Stanford is well known for its cardiovascular and cancer care, he says. What’s less well known is that the Division of Nephrology at Stanford is among the top 20 programs in the country, and Stanford’s kidney transplant program consistently yields among the best patient outcomes in the nation.
Part of that patient care philosophy is having patients with mild to moderate disease cared for in their own communities by their primary care physicians. For patients with more advanced kidney disease, Stanford nephrologists work in concert with other Stanford specialists in internal medicine, cardiology, urology, oncology and other subspecialties, all of whom have an interest in kidney disease. “Access to other outstanding Stanford physicians and surgeons is a big advantage for our patients,” says Chertow. Another advantage is that the group has many cutting-edge research protocols available for patients. These include studies of controlling hypertension to reduce the risk of cardiovascular disease, slowing the progression of chronic kidney disease, treating glomerular diseases and polycystic kidney disease, forestalling the need for dialysis, as well as studies on improving outcomes for transplant patients.
Preserving kidney function is one of
the hallmarks of the Stanford program.
Helping patients forestall dialysis and
transplant with comprehensive, detail oriented
medical care helps patients
enormously, Chertow explains. For patients
with advanced kidney disease,
Stanford nephrologists care for them until
they undergo transplantation, when
the multidisciplinary transplant team
takes the lead. “Most people have to
wait for years, unless they have a living
donor,” he says. “Helping our patients
stay healthy while waiting increases their
chances of a successful transplant.”
Communication and access
After a patient is seen at Stanford, their
referring physician receives a detailed
letter, outlining the patient’s diagnosis
and care plan. “We strive to have a
very open dialogue with our referring
physicians,” says Stanford nephrologist
Richard Lafayette, MD, a fourteen year
veteran of Stanford’s program. “Through
our electronic health record system,
physicians outside of Stanford can log in
and see their patients’ test results, labs
and physician notes. We keep physicians
informed while their patients are in
our care,” he adds. With regard to access,
Lafayette says “New patients can
be seen within two weeks, or two hours
if necessary.”
Internal Staff Login