Clinical Practice

• INPATIENT SERVICES AT UPMC PRESBYTERIAN
• CLINICAL PRACTICE
• General Renal Clinic
• Renal Transplant Clinic
• Lupus Clinic
• OUT-PATIENT DIALYSIS PROGRAMS
• VA PITTSBURGH HEALTHCARE SYSTEM

INPATIENT SERVICES AT UPMC PRESBYTERIAN

Renal Inpatient Rounds: In-patients with renal and/or electrolyte disorders are cared for by 2 rounding teams, each consisting of an attending physician, renal fellow, physician extender, residents, and medical students. Patients who are awaiting or have received a kidney transplant are cared for by a team consisting of an attending physician, renal fellow and physician extender. The transplant team also provides for the management of patients in the liver transplant ICU who are awaiting or have received a liver transplant. Weekend coverage is provided by 2 attending physicians and 2 fellows.

Consultations: Consults are seen on the same day a consult has been requested, and are available 24 hours a day, seven days a week. The number of in-patient consults seen each month varies between 190 and 230.

Dialysis: The 11th floor dialysis center performs approximately 10,000 dialysis treatments per year in the ICU setting. In addition, a large number of continuous renal replacement therapies are administered in the various intensive care units under the supervision of nephrology attendings and fellows. Mary Hrinya, BSN, MSN, serves as the director of this unit and Dr. James R. Johnston, MD, serves as the Medical Director.

CLINICAL PRACTICE

The Renal-Electrolyte out-patient clinics provide the specialized needs of the renal patient. Referring physicians are provided with rapid feed-back on their patients through the use of the EPICCare software program and the centralized transcription service of UPMC.

• General Renal Clinic: A wide variety of renal and hypertensive problems are treated at this clinic. Nephrologists and staff coordinate all aspects of patient testing and care, with continuity of patient care being a primary goal. A new clinic focusing on the care of patients with chronic kidney disease has recently been established.
• Renal Transplant Clinic: Nephrology physicians adjust the immunosuppression and manage medical/nephrologic problems related to pre- and post-transplantation and renal failure, including the medical management of kidney patients and participants in the Living Donor Program.
• Lupus Clinic: Nephrology consultative care is provided for patients with SLE.

• Outpatient Dialysis Programs (Dialysis Clinics, Inc. (DCI)): Renal-Electrolyte physicians and physician extenders care for patients at the Oakland DCI on a daily basis and the Squirrel Hill DCI on Mondays, Wednesdays and Fridays.
• VA Pittsburgh Healthcare System (VAPHCS): Both in-patient and out-patient services are provided for veterans with renal disease at the University Drive Division of the VAPHCS.

General Renal Clinic

• Frank Bruns, MD
• Kevin Ho, MD
• John P. Johnson, MD
• James R. Johnston, MD
• Jonathan Lebowitz, MD
• Nuria Pastor-Soler, MD
• Beth Piraino, MD
• Raymond Rault, MD
• Nirav Shah, MD
• Mark Unruh, MD
• Christine Wu, MD

• Michelle Shields, CRNP

Renal Transplant Clinic: Thomas E. Starzl Transplant Institute

• Geetha Chalasani, MD
• James R. Johnston, MD
• Jerry McCauley, MD, MPH
• Nirav Shah, MD
• Mark Unruh, MD
• Christine Wu, MD

• Reneé Burr, PA-C
• Alison Kaprove, PA-C
• Joan Marszalek, PA-C
• Kelli Sherry, PA-C
• Michelle Shields, CRNP

Lupus Clinic

• Frank Bruns, MD
• James R. Johnston, MD
• Christine Wu, MD

OUT-PATIENT DIALYSIS PROGRAMS

On site dialysis: Physicians care for patients during 5 dialysis shifts, including an evening shift on Monday, Wednesday and Friday. The daily presence of one of our four physician extenders at the facility aids us in providing excellent care to our patients.

Home Dialysis Program: The DCI of Oakland has a strong home dialysis program under the direction of Carol Dacko, BSN, with patients on peritoneal dialysis and home hemodialysis.

On site dialysis: Physicians care for in-center hemodialysis patients on Monday, Wednesday and Friday.

VA PITTSBURGH HEALTHCARE SYSTEM

• Linda Fried, MD
• Paul M. Palevsky, MD
• Mohan Ramkumar, MD
• Steven Weisbord, MD

Dialysis Program (Director: Mohan Ramkumar, MD): The VA Dialysis Program at the VAPHCS provides in-center hemodialysis and home peritoneal dialysis for veterans with end stage kidney disease, as well as in-patient dialysis services for hospitalized patients with chronic kidney disease or acute renal failure. The dialysis program serves as the primary venue for providing renal fellows instruction in outpatient dialysis management.

Renal Clinic (412-688-6242): The VA Renal Clinic provides out-patient management of patients with all forms of kidney disease. The clinic serves as a major teaching venue for internal medicine residents and renal fellows.

Consult Service: The VA Renal Consult Service provides in-patient management services for patients with acute and chronic renal failure, transplant patients, hypertension, electrolyte disorders, glomerulonephritis and a variety of other nephrologic problems. The service is staffed by a renal fellow who rounds with an attending. Medical students may also rotate on this service.

Renal Transplant Program: The VA Pittsburgh Healthcare System was designated as a VA regional renal transplant program as of January 2, 2002. As one of four VA renal transplant centers, the program provides renal transplant services for veterans with ESRD throughout the Northeastern United States.