Nephrology

The Nephrology Unit comprises 6 faculty members active in patient care, teaching and research.  The Unit provides inpatient consultations for patients with acute and chronic renal disorders, hypertension and fluid and electrolyte disorders; usually eight to fifteen such consults are seen each week.  Renal biopsies, acute hemodialysis and acute peritoneal dialysis are performed.  The Unit also manages the RGH chronic dialysis program, including in-center hemodialysis and home peritoneal dialysis.  5 - 10 new outpatient consults are seen each week, principally for evaluation and management of proteinuria, hematuria, hypertension, electrolyte disorders and renal failure.  The faculty research interests include the pathophysiology and treatment of fluid and electrolyte disorders, urea and phosphate metabolism, and the dialysis disequilibrium syndrome.

Residents and medical students on the service share the inpatient consultation and follow-up responsibility with the attending on service.  Outpatient evaluation will be emphasized by assigning outpatient clinic sessions at least once a week.  “Essentials of Renal Physiology” by Reddi and “Nephrology Secrets” by Hanley and Belfus will be given to the residents to use on the rotation.  Reading will be assigned to insure that a core curriculum in nephrology has been covered during the rotation.  In addition, the resident learns through case-based discussions, guided independent reading and in once weekly tutorial seminars by the assigned “teaching nephrologist”.  A 1 hour orientation to the dialysis unit is provided to elective participants.   There is a journal club each week that the residents are invited to participate in.  At a weekly clinical conference residents will present a patient based literature review in conjunction with the attending on service. This rotation is available for one or two residents at a time.  There is no weekend call for residents.

Faculty

Stephen M. Silver, MD - Head Medical School: SUNY, Upstate Medical Center Residency: Albert Einstein College of Medicine Chief Resident: Bronx Municipal Hospital Center Fellowship: Nephrology-University of Rochester Clinical Interests: Hypertension, Cardiovascular Risk Reduction, and Fluid & Electrolyte Disorders
Paul L. Bernstein, MD Medical School: Albert Einstein College of Medicine Residency: Yale University Chief Residency: Yale University Fellowship: Nephrology, Yale University Clinical Interests: Acute Renal failure, renal complications of systemic diseases
Donald E Kamm, MD Medical School: Albany Medical School Residency: Beth Israel Hospital, Boston, MA. Research Fellow in Renal Physiology, Boston University Research Fellow in Metabolism, Joslin Research Lab, Harvard Medical School-Peter Bent Brigham Hospital Research Fellow in Hypertension, Peter Bent Brigham Hospital
Egils Veverbrants, MD Medical School: George Washington University Residency: Boston City Hospital Research Fellow in Diabetes: Thorndike Memorial Laboratory Chief Resident, Medicine and Fellow: Rhode Island Hospital, Brown University Research Fellow in Renal Diseases: Rhode Island Hospital, Brown University
Marvin Grieff, MD Medical School: McGill University, Montreal, Canada Residency: Royal Victoria Hospital, Montreal, Canada Chief Resident: Royal Victoria Hospital, Montreal, Canada Fellowship: Nephrology-McGill University, Montreal, Canada Kidney Foundation of Canada Research Fellow: Washington University School of Medicine, St. Louis, MO Clinical Interests: Kidney Stones
Robert Mayo, MD Medical School: University of Michigan Medical School Residency: St. Joseph Mercy Hospital, Ann Arbor, Michigan Fellowship: Nephrology, University of Michigan Medical Center, Ann Arbor, Michigan

Research Interests

The major interest of Dr. Silver’s and Dr. Kamm's laboratory has been the influence of clinical disorders of osmolality on brain metabolism.  The development of novel in-vivo models in the laboratory has allowed the pathophysiology of several conditions to be investigated and described in manuscript form: the Dialysis Disequilibrium Syndrome, The Post Prostatectomy Syndrome, cerebral edema after diabetic ketoacidosis, and acute hyponatremia in the young.

Currently, work is being completed on the influence of exogenous administration of organic osmolytes on brain metabolism after acute hypernatremia, and further studies are planned to investigate the role of myoinositol as a therapeutic agent in the osmotic demyelination syndrome.   Also, a model of hyperammonemia (portacaval anastomosis) has been established in the laboratory; that has allowed us to examine the pathophysiology of the osmotic demyelination syndrome in the setting of liver failure. 

Dr. Silver is also participating in the Hemo Study, a multicenter study investigating the effect of high clearance hemodialysis on morbidity and mortality

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