Tag Archive for: renal disease

group photo from nephrology training in Jamaica

Update: Collaboration across borders to improve access to nephrology care

Marva Moxey-Mims, M.D., division chief of Nephrology at Children’s National, has a grant from the International Pediatric Nephrology Association (IPNA) to bring care to children with kidney disease in Jamaica.

During her recent trip, Dr. Moxey-Mims was joined by peritoneal dialysis nurse, Jennifer Carver, RN, and three pediatric nephrologists in Jamaica, Drs. Maolynne Miller, Nadia McClean and Sandrica Peart. Together, they trained close to 30 nurses from three hospitals across the island, including the Bustamante Children’s Hospital, the University Hospital of the West Indies — both in Kingston — and the Cornwall Regional Hospital in Montego Bay.

Nurses were given hands-on training in using peritoneal dialysis cycler machines and manual peritoneal dialysis. The training is part of an initiative that focuses on:

  • Improving clinical training of staff (medical, nursing, and allied health) involved in caring for children with kidney disease
  • Developing and upgrading services for children and adolescents with kidney diseases
  • Educating the community on disease awareness and prevention strategies

“Our ability to offer innovative training and resources to nurses underscores our commitment to ensuring children throughout Jamaica receive the essential care they require,” said Dr. Moxey-Mims. “This signifies to both domestic and international audiences that we’re upholding our pledge to health equity.”

Marva Moxey-Mims

Revolutionizing pediatric nephrology one patient at a time

Marva Moxey-Mims

“With each kidney transplant, we’re not just restoring the health of children, we’re pioneering progress and setting new benchmarks for the field of pediatric nephrology,” says Marva Moxey-Mims, M.D., chief of Nephrology at Children’s National Hospital.

“With each kidney transplant, we’re not just restoring the health of children, we’re pioneering progress and setting new benchmarks for the field of pediatric nephrology,” says Marva Moxey-Mims, M.D., chief of Nephrology at Children’s National Hospital. “We offer not just treatment, but a chance for our patients to flourish and live their best life.”

Big picture

The Kidney Transplantation Program at Children’s National is the only one of its kind in the Washington, D.C., region focused on the needs of children and teens with kidney disease.

Performing an average of 15-20 kidney transplants per year, the program’s latest one- and three-year graft and patient survival data from the Scientific Registry for Transplant Recipients is 100%.

“Our program surpasses national numbers, reflecting a commitment to exceptional care, superior patient outcomes and a focus on setting a new standard for excellence in transplant support,” says Dr. Moxey-Mims.

Children’s National leads the way

At the forefront of groundbreaking treatment, the nephrology team is pioneering progress by providing innovative care and resources. One example is the hospital’s collaboration with the National Kidney Registry and MedStar Georgetown Transplant Institute’s Living Donor Program. This provides a greater chance of finding more suitable donors for difficult-to-match children and has resulted in altruistic donations.

“Through living kidney donations, we redefine the timeline for pediatric transplants. Children experience shorter waits and swifter paths to renewed health compared to the national wait list,” says Asha Moudgil, M.D., medical director of the Kidney Transplantation Program at Children’s National. “It’s a testament to our commitment to making a difference in every child’s life.”

That commitment is also seen in the hospital’s focus on making sure families have the resources they need during their medical journey.

“Caring for a child with renal disease is an immense challenge, not only for the young patients but also for their families. The demanding schedule of hospital visits, often three times a week, adds an extra layer of stress and disruption to daily life,” says Dr. Moudgil.

Through grant funding from donors and national programs, families with children undergoing kidney transplants and dialysis can receive financial assistance. In some cases, families receive up to $2,000 of mortgage or rental payment assistance. Families can also receive funds for medication co-pays and other expenses incurred around the time of the transplant.

“In the face of medical adversity, these funds become a source of support,” says Dr. Moudgil. “We make sure every family, regardless of financial constraints, can access the care and resources their child needs.”

Bottom line

Children’s National is at the forefront of pediatric kidney transplantation. “Our unique approach ensures every facet of a patient’s journey is considered,” says Dr. Moxey-Mims. “We’ve created an environment where success is not just a medical outcome but a comprehensive and sustained improvement in a child’s overall quality of life.”

Learn more about our latest advances in pediatric Nephrology.

sister center team

Collaboration across borders to improve access to nephrology care

sister center teamChildren’s National Hospital is joining the International Pediatric Nephrology Association (IPNA) to bring care to children with kidney disease in Jamaica. With early screenings, diagnosis and optimal treatments, this collaboration will help decrease the morbidity and mortality associated with renal disease.

“This partnership shows our hospital’s willingness to assist with education and resources in a country will fewer resources,” says Marva Moxey-Mims, M.D., division chief of Nephrology at Children’s National. “This is a signal to those within and outside the United States that we live our stated commitment to health equity.”

This effort will focus on:

  • Improving clinical training of staff (medical, nursing and allied health) involved in caring for children with kidney disease
  • Developing and upgrading services for children and adolescents with kidney diseases
  • Educating the community on disease awareness and prevention strategies

IPNA facilitates the exchange of knowledge and expertise about kidney disease in children in the areas where care is needed most.

“I am excited about our ability to provide specialized clinical training and additional resources to our colleagues in Jamaica,” says Dr. Moxey-Mims. “This will empower them to provide improved care to children with kidney disease on the island through multidisciplinary teams.”

Zhe Han

Fruit flies can model human genetic kidney disease

Zhe Han

Zhe Han, Ph.D., has found that a majority of human genes known to be associated with nephrotic syndrome play conserved roles in renal function, from fruit flies to humans.

Drosophila melanogaster, the common fruit fly, has played a key role in genetic research for decades. Even though D. melanogaster and humans look vastly different, researchers estimate that about 75 percent of human disease-causing genes have a functional homolog in the fly.

A Children’s National Health System research team reported in a recent issue of Human Molecular Genetics that the majority of genes associated with nephrotic syndrome (NS) in humans also play pivotal roles in Drosophila renal function, a conservation of function across species that validates transgenic flies as ideal pre-clinical models to improve understanding of human disease.

NS is a cluster of symptoms that signal kidney damage, including excess protein in urine, low protein levels in blood, elevated cholesterol and swelling. Research teams have identified mutations in more than 40 genes that cause genetic kidney disease, but knowledge gaps remain in understanding the precise roles that specific genes play in kidney cell biology and renal disease. To address those research gaps, Zhe Han, Ph.D., a principal investigator and associate professor in the Center for Cancer & Immunology Research at Children’s National, and colleagues systematically studied NS-associated genes in the Drosophila model, including seven genes whose renal function had never been analyzed in a pre-clinical model.

“Eighty-five percent of these genes are required for nephrocyte function, suggesting that a majority of human genes known to be associated with NS play conserved roles in renal function from flies to humans,” says Han, the paper’s senior author. “To hone in on functional conservation, we focused on Cindr, the fly’s version of the human NS gene, CD2AP,” Han adds. “Silencing Cindr in nephrocytes led to dramatic impairments in nephrocyte function, shortened their life span, collapsed nephrocyte lacunar channels – the fly’s nutrient circulatory system – and effaced nephrocyte slit diaphragms, which diminished filtration function.”

And, to confirm that the phenotypes they were studying truly caused human disease, they reversed the damage by expressing a wild-type human CD2AP gene. A mutant allele derived from a patient with CD2AP-associated NS did not rescue the phenotypes.

Thus, the Drosophila nephrocyte can be used to explain the clinically relevant molecular mechanisms underlying the pathogenesis of most monogenic forms of NS, the research team concludes. “This is a landmark paper for using the fly to study genetic kidney diseases,” Han adds. “For the first time, we realized that the functions of essential kidney genes could be so similar from the flies to humans.”

A logical next step will be to generate personalized in vivo models of genetic renal diseases bearing patient-specific mutations, Han says. These in vivo models can be used for drug screens to identify treatments for kidney diseases that currently lack therapeutic options, such as most of the 40 genes studies in this paper as well as the APOL1 gene that is associated with the higher risk of kidney diseases among millions of African Americans.