Georgetown University - Department of Medicine

Historical Development
The division rose to international prominence during the period 1970 – 1990 under the direction of George E. Schreiner, MD who endowed a chair of nephrology. Thereafter, the division was directed by Jim Winchester, MD who established its clinical and dialysis programs. Since 1994, it has been directed by Christopher S. Wilcox, MD, PhD who has developed the research and educational mission, and expanded clinical programs within Georgetown University Hospital and in the community.

Faculty
There are 12 full-time faculty of which 60% of the majority have more than 70% time and effort devoted to research. All clinical faculty are actively engaged in research. The faculty has been highly successful in academic pursuits with a very active publication record. There has been a steady increase in income for research.

For details of individual faculty see our Faculty Page.

Administration
The division Administrator is Ms. Delphine Nguyen (202-687-9183, email: nguyenn@georgetown.edu) and the Program Project Grant administered by Ms. Sharon Clements (202-687-4932, email: sc72@georgetown.edu).

Clinical Activities
The clinical program of the Division is administered by Francisco Llach, MD (202-687-9183; email: fllach@pol.net). The division has a full time consulting practice at Georgetown University Hospital and Arlington Hospital. Nephrology faculty provide care for 12-28 in-patients at Georgetown and 8-10 patients at Arlington. A wide range of patients with renal disease, diabetes, hypertension, acid-base and electrolyte disorders are seen on the in-patient services. The faculty care for patients after renal transplantation in consultation with the transplant surgeons.

The division has 10 half-day outpatient clinics that serve a full range of subspecialty (refractory, renovascular, and adrenal) interests in the field of renal disease, hypertension, end stage renal failure, glomerulonephritis, renal disease and hypertension in pregnant women, metabolic bone disease, diabetes and transplantation.

The division has joint ventured its outpatient dialysis program with DaVita Inc. It has opened and directs three dialysis units in the community, where patients are followed by our physicians and fellows. Additionally, it holds medical directorships at three other hemodialysis units in the community. Overall, full-time nephrology faculty care for approximately 100 hemodialysis patients and 35 CAPD patients. The Georgetown University/DaVita Units are:

Georgetown on the Potomac
3223 K Street, NW #110
Washington, DC 20007
Tel: 202-333-5211
Fax: 202-333-4822

DaVita at Union Plaza
810 First Street, NE #100
Washington, DC 20002
Tel: 202-842-3127
Fax: 202-842-3160

DaVita at Oxon Hill
6192 Oxon Hill Road, First Floor
Oxon Hill, MD 20745
Tel: 301-839-3443
Fax: 301-839-6521

Research
Research activities in the division are growing rapidly. After establishing a strong basic research program, emphasis is currently placed on developing clinical research to an equivalent level.

Basic research is undertaken by a full time faculty of 8. The focus is on the role of the kidney in hypertension.

The laboratory of Dr. Wilcox and Dr. Welch is supported by six grants from the NIH (two R01 grants, two projects under a Program Project Grant and two cores). William Welch, PhD uses renal micropuncture and microperfusion to study tubular-vascular integration in the kidney in rat and mouse models of hypertension and renal disease. He also directs whole animal studies of these models. His studies, and those of Dr. Wilcox, focus on the roles of oxidative stress, nitric oxide and vasoconstrictor prostaglandins. Tina Chabrashvili, MD, PhD directs the molecular biology laboratory associated with these studies. She is focused on molecular mechanism of oxidative stress and vasoconstrictor prostaglandin generation. Dan Wang, MD, PhD and Yifan Chen, PhD conduct studies in the renal microvascular laboratory. They have developed techniques for isolation and perfusion of individual microvessels from the kidney and systemic vessels using both rabbit and mouse models. They combine in vivo perfusion with fluorescent techniques to contraction-relaxation and relate this to measurements of oxygen radicals and nitric oxide in tissues. Nori Kawada, MD, PhD has established renal micropuncture in the mouse. He used single gene deleted mouse models to study directly the role of identified genes in renal mechanism of hypertension. Glenn Solis, DVM has established long term studies of renal function and blood pressure in the mouse. These techniques provide a broad range of experimental methods to study the mechanisms of hypertension in the kidney and peripheral vessels. The development of mouse models allows the laboratory to take a leading role in use of current knock-in and knockout genetic mechanisms in mouse models.

Jason Umans, MD, PhD directs a laboratory that is closely integrated with that of Dr. Welch and Dr. Wilcox. His studies focus on microvascular physiology of peripheral vessels in models of hypertension. His special interest is mechanisms of preeclamptic toxemia.

Kathryn Sandberg, PhD directs a laboratory of molecular and cellular physiology. Her laboratory studies the molecular regulation of angiotensin receptors and their post-transcriptional modification. Her special interests include the regulation of angiotensin receptor function by sex hormones. Christine Maric, PhD has established methods to study osmotic regulation of angiotensin receptor expression in the renal medulla.

Clinical research focuses on cardiovascular disease in patients with chronic renal insufficiency. Christopher Wilcox, MD, PhD investigates new methods to diagnose and treat patients with renovascular hypertension. A collaborative study with Peter Choyke, MD (Chief of MRI at the NIH) uses novel MR techniques to diagnose renovascular hypertension in human subjects. Shakil Aslam, MD studies the mechanism of oxidative stress in patients with end stage renal disease, and its role in cardiovascular complications. Paco Llach, MD has a large program to investigate new methods to treat calcium, phosphorus and bone diseases in patients with end stage renal disease. He is developing methods to investigate the mechanisms and treatment of vascular calcification in these patients. Joyce Gonin, MD and Christopher Wilcox, MD, PhD have investigated the treatment of hyperhomocystinemia in patients with end stage renal disease. Vasilios Papademetriou, MD has a large program to evaluate new methods of treatment for patients with hypertension. The clinical research program is supported by a full-time clinical research nurse-coordinator (Susan Borgiasz, RN; 202-687-4344 email: sb249@georgetown.edu). She directs an outpatient clinical research center within the division and coordinates clinical research in the dialysis units.

In 2000, Georgetown University created a Center for Hypertension and Renal Disease Research under the direction of Christopher S. Wilcox, MD, PhD This Center grew out of research strengths within the division but encompasses faculty from a wide variety of other clinical and basic science departments. It brings together a diverse group of investigators and educators committed to working on areas of common interest in vascular biology, hypertension and renal disease.

Georgetown University is now considering the development of a cardiovascular-kidney institute which would expand further the center to involve new divisions of heart failure, hypertension and vascular biology and kidney disease (see xxx).

Education and Training
Faculty are actively involved in research training for graduates in undergraduate departments, notably physiology. Postdoctoral scientists are actively involved in the research of several faculty members.

Fellowship training has been strengthened with the recruitment of new clinical and science faculty. Currently, two fellows are recruited each year. The program has expanded from a two-year predominantly clinical training program to a three-year program in which fellows devote the first year to full-time clinical training and the subsequent two years primarily to research training. This transition has been facilitated by an NIH Fellowship training grant (PI Jason Umans, MD, PhD), which provides funds for training of selected fellows in nephrology and hypertension over two years.

Fellows receive clinical instruction on the wards, outpatient clinics and dialysis units at Georgetown University Hospital and at Arlington Hospital. Research training is provided by the faculty, either in basic science or clinical investigation projects.