Faculty Profiles

Steven Brunelli, MD, MSCE

Dr. Brunelli is a renal epidemiologist whose primary research focus centers on identification of novel determinants of mortality and cardiovascular morbidity among hemodialysis patients. Specific platforms of investigation consider the effects of dialysis dose, blood pressure management, anti-diabetic therapies and anemia management on patient outcomes. Dr. Brunelli also is involved in the development and application of novel statistical methodologies for improving causal inference from observational data.

Publications

Brunelli SM, Thadhani R, Ikizler TA, Feldman HI. Thiazolidinedione use is associated with better survival in hemodialysis patients with non-insulin dependent diabetes. Kidney Int 2009; 75(9): 961-8

Brunelli SM, Lynch KE, Thadhani RI, Ankers ED, Joffe MM, Yang W, Feldman HI. Association of hemoglobin variability and mortality among contemporary incident hemodialysis patients. Clin J Am Soc Nephrol 2008; 3(6): 1733-40

Brunelli SM, Joffe MM, Israni RK, Yang W, Fishbane S, Berns JS, Feldman HI. History-adjusted marginal structural analysis of the association between hemoglobin variability and mortality among dialysis patients. Clin J Am Soc Nephrol 2008; 3(3): 777-82

Brunelli SM, Thadhani RI, Lynch KE, Ankers ED, Joffe MM, Boston R, Chang Y, Feldman HI. Association between long-term blood pressure variability and mortality among hemodialysis patients. Am J Kidney Dis 2008; 52(4): 716-26

Brunelli SM, Lewis JD, Gupta M, Latif SM, Weiner MG. Feldman HI. Risk of kidney injury following use of oral phosphosoda bowel preparations. J Am Soc Nephrol 2007; 18(12): 3199-205

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Gary C. Curhan, MD, ScD

Dr. Curhan’s research focuses on the prevention of common diseases by investigating scientifically and clinically important questions and exploring the role of modifiable factors, chiefly in the areas of nephrology and urology. The synergy between his clinical training in nephrology and doctoral work in epidemiology has produced a strong interest in ‘metabolic epidemiology.’ In an effort to clarify and refine our insight into several prevalent conditions, much of his work has examined and challenged existing beliefs and commonly accepted practices, often motivating important changes in clinical practice and understanding. Major ongoing areas or research include: 1) epidemiology of nephrolithiasis—we are studying dietary and lifestyle factors as well as the genetics of stone disease; 2) epidemiology of hypertension; 3) risk factors for renal function decline and change in albuminuria; 4) epidemiology of gout; 5) epidemiology of hearing loss; 6) mineral metabolism and risk of cardiovascular disease; 7) risk factors for community acquired pneumonia; 8) epidemiology of incontinence; 9) epidemiology of hyponatremia. Dr. Curhan works closely with several faculty members in the Renal Division and their efforts will hopefully lead to new approaches to prevention and treatment of these common conditions.

Publications

Taylor EN, Fung TT, Curhan GC. DASH-style diet and the risk of incident kidney stones. J Am Soc Nephrol. 2009; (in press). (PMC Journal – In Process)

Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009 Jul 22; 302(4):401-11

Choi HK, Curhan GC. Soft drinks, fructose consumption, and the risk of gout in men – A Prospective Cohort Study. BMJ. 2008 Feb 9; 336(7639):309-12. PMCID: PMC2234536

Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med. 2009; (in press).

Curhan SG, Eavey R, Shargorodsky J, Curhan GC. Analgesic use and the risk of hearing loss in men. Am J Med. 2009; (in press).

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John Forman, MD

Dr. Forman is a cardiovascular and renal epidemiologist whose primary interest is the epidemiology, etiology, and prevention of hypertension, which is the leading preventable cause of death in the US. Broadly speaking, the Forman laboratory is interested in diet, lifestyle, genetics, and circulating biomarkers as independent risk factors for the development of hypertension, as well as control of the renin angiotensin system. Activities include epidemiologic studies with large databases, plus physiologic studies in smaller groups of individuals.

Publications

Forman JP, Fisher ND, Pollak MR, Cox DG, Tonna S, Curhan GC. Renin-Angiotensin System Polymorphisms and Risk of Hypertension: Influence of Environmental Factors. Journal of Clinical Hypertension. 2008;10(6):459-66.

Forman JP, Choi HK, Curhan GC. Uric Acid and Insulin Sensitivity and Risk of Incident Hypertension. Arch Intern Med. 2009;169(2):155-62.

Forman JP, Stampfer MJ, Curhan GC. Diet and Lifestyle Risk Factors Associated with Incident Hypertension in Women. JAMA. 2009;302(4):401-11.

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Julie Lin, MD, MPH

Dr. Lin is a renal epidemiologist whose research interests focus on proteinuric renal diseases, glomerulopathies, and chronic kidney disease progression. Research includes analyses of diet, lipids, genetics and inflammatory biomarkers and nephropathy in type 2 diabetes mellitus in participants of the Nurses’ Health Study and Health Professionals’ Follow-Up Study. Another area of interest is associations of chronic kidney disease with quality of life measures in cognitive and physical functioning. As the lead living kidney donor advocate for Brigham and Women’s Hospital, Dr. Lin is also studying outcomes and quality of life in living kidney donors in collaboration with the Division of Transplantation Surgery. She also has on-going collaborations with other investigators within and outside of Harvard Medical School in projects that examine cardiovascular disease risk in the setting of chronic kidney disease.

Publications

LIN J, Hu FB, Curhan GC. Associations of Diet with Albuminuria and Kidney Function Decline. Clin J Am Soc Nephrol. 2010 May;5(5):836-43. PMCID: PMC2863979

LIN J, Hu FB, Mantzoros C, Curhan GC. Lipid and inflammatory biomarkers and kidney function decline in type 2 diabetes. Diabetologia. 2010 Feb;53(2):263-7. PMCID: PMC2809803

LIN J, Glynn RJ, Rifai N, Manson JE, Ridker PM, Nathan DM, Schaumberg DA. Inflammation and progressive nephropathy in Type 1 diabetes mellitus in the Diabetes Control and Complications Trial (DCCT). Diabetes Care. 2008: 31(12):2338-43. PMCID: PMC2584192.

LIN J, Curhan GC. Kidney function decline and physical function in women. Nephrol Dial Transplant. 2008;23(9):2827-33. PMCID: PMC2727301

Solomon SD, LIN J*, Solomon CG, Jablonski KA, Rice MM, Steffes M, Domanski M, Hsia J, Gersh BJ, Arnold JMO, Rouleau J, Braunwald E, and Pfeffer MA, for the Prevention of Events with ACE Inhibition (PEACE) Investigators. Influence of albuminuria on cardiovascular risk in patients with stable coronary artery disease. Circulation. 2007 Dec 4;116(23):2687-93. (*co-first author).

Ajay Singh, MD, MBA

Dr. Singh's research group is interested in the epidemiology of chronic kidney disease (CKD) and the role of inflammatory cytokines in the pathogenesis of CKD. They are also interested in management of anemia in CKD patients. Their research includes publications in the New England Journal of Medicine in November 2006, the CHOIR trial (Correction of Hemoglobin and Outcomes in Renal Insufficiency). This trial was pivotal in updating the hemoglobin target in The National Kidney Foundation Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines (NKF KDOQI ™) and in adding a black box warning on the erythropoietin by the Food and Drug Administration (FDA). CHOIR demonstrated increased risk of death and cardiovascular complications in patients targeted to a higher hemoglobin level. It also raised concerns on whether higher Epo doses are associated with increased risk. His research group has recently focused on metabolic syndrome and CKD. They have published the first characterization of kidney pathology in patients with metabolic syndrome in the American Journal of Kidney Disease in May 2009. They have observed a high prevalence of vascular sclerosis, tubular atrophy, and interstitial fibrosis in patients with metabolic syndrome. These changes collectively suggest a primary vascular insult. Globally, Dr. Singh and his group are studying the global epidemiology of CKD in several countries in South East Asia and the Middle East through the Screening and Early Evaluation of Kidney Disease (SEEK Project) and the SEEK sub-studies, SEEK-PREDICT and SEEK-Andhra and others. They are also studying the practice patterns in management of CKD and dialysis patients through the Global Renal Information Database (GRID Project). Participating countries in the global projects include but not limited to India, Philippines, Malaysia, Vietnam, Saudi Arabia and Egypt.

Publications

Servilla KS, Singh AK, Hunt WC, Harford AM, Miskulin D, Meyer KB, Bedrick EJ, Rohrscheib MR, Tzamaloukas AH, Johnson HK, Zager PG. Anemia Management and Association of Race With Mortality and Hospitalization in a Large Not-for-Profit Dialysis Organization. Am J Kidney Dis. 2009 Jul 21. [Epub ahead of print]

Alexander MP, Patel TV, Farag YM, Florez A, Rennke HG, Singh AK. Kidney pathological changes in metabolic syndrome: a cross-sectional study. Am J Kidney Dis. 2009 May;53(5):751-9. Epub 2009 Apr 1

Szczech LA, Barnhart HX, Inrig JK, Reddan DN, Sapp S, Califf RM, Patel UD, Singh AK. Secondary analysis of the CHOIR trial epoetin-alpha dose and achieved hemoglobin outcomes. Kidney Int. 2008 Sep;74(6):791-8. Epub 2008 Jul 2

Keithi-Reddy SR, Addabbo F, Patel TV, Mittal BV, Goligorsky MS, Singh AK. Association of anemia and erythropoiesis stimulating agents with inflammatory biomarkers in chronic kidney disease, Kidney Int. 2008 Sep;74(6):782-90. Epub 2008 Jun 11

Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, Reddan D; CHOIR Investigators Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006 Nov 16;355(20):2085-98

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Sus Waikar, MD, MPH

Dr. Waikar’s research efforts focus on acute kidney injury (AKI) and hyponatremia.His methodologic approaches includes large scale epidemiology, patient-oriented research with biological sample collection, and mathematical modeling. To study the epidemiology of AKI and hyponatremia the laboratoryuses large databases such as the Nationwide Inpatient Sample and the Research Patient Data Registry.A number of prospective observational cohort studies with blood and urine collection in hospitalized patients at risk of kidney disease are in progress. Active research projects include: creatinine kinetics and the definition of AKI, novel biomarkers of AKI and chronic kidney disease, phosphate clearance during continuous veno-venous hemofiltration, and sodium flux during hemodialysis.

Publications

Waikar SS, Bonventre JV. Creatinine kinetics and the definition of acute kidney injury. J Am Soc Nephrol. 2009 Mar;20(3):672-9.

Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med, in press

Waikar SS, Curhan GC, Wald R, McCarthy EP, Chertow GM. Declining mortality in patients with acute renal failure, 1988 to 2002. J Am Soc Nephrol. 2006

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