Contents:

• Inpatient Services
• Outpatient Services
• Research

The Nephrology Faculty are the primary clinical providers for patients with renal diseases, fluid and electrolyte disorders, and complicated hypertension in Vermont and upstate New York. Patients are seen in consultation as inpatients, or in our outpatient clinic, located in the UHC campus of Fletcher Allen Health Care.

In our outpatient clinic, both new and long-term followup visits, spanning over 30 years of patient care, occur five days a week. Our inpatient clinical activity includes all patients admitted to the Nephrology Faculty and patients seen in consultation on other services.

We provide hemodialysis therapy, either at home or in one of our six dialysis centers in the state, and peritoneal dialysis for patients with end-stage renal disease. For patients with acute renal failure, we provide continuous venovenous renal replacement therapy in addition to hemodialysis and isolated ultrafiltration.

Our kidney transplant program, run in conjunction with the department of Surgery, has been active since 1972, and all patients who have received transplants are followed in the Nephrology clinic. In addition, we recently started our pancreas transplant program for patients with diabetes.

In conjunction with the departments of Surgery and Radiology, we have an active program for the management of renovascular hypertension. The unit is internationally recognized for its expertise in fluid, electrolyte, and acid-base disorders, and is nationally known for its expertise in managing renovascular disease.

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The Nephrology Service is the sole provider of consultation for problems in renal and electrolyte disorders and hypertension for all services within the hospital (average five to ten consults/week), and also admits its own patients to the Internal Medicine Service on a regular basis (average census, five to ten patients).

Continuous venovenous replacement therapy, peritoneal dialysis, hemodialysis, and plasmapheresis, when appropriate, are used to manage renal failure in hospitalized patients. Renal biopsies are performed with ultrasound localization in both native and transplant kidneys by the Nephrology service.  In addition, fellows may spend time in ultrasonography, interventional radiology, vascular surgery, and Pediatrics to further their education in these areas.

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Chronic outpatient hemodialysis services are provided at four dialysis units. In addition, an unstable outpatient dialysis facility operates in conjunction with the inpatient dialysis service to provide transitional outpatient hemodialysis support. A home dialysis program provides support both for peritoneal dialysis and home hemodialysis.

The Nephrology outpatient clinic provides outpatient consultative and followup care for patients with acute and chronic renal disease, hypertension, and transplantation.

Renal transplants have been performed at Fletcher Allen Health Care for over 25 years, allowing for training experience in short-term as well as long-term transplant management. Currently, 25-30 transplants are carried out each year. All transplant patients are followed by the Nephrology service during their acute hospitalizations, and are followed as outpatients in the Nephrology clinic at Fletcher Allen Health. 

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Research

All fellows are expected to engage in either basic research or in clinical research projects. Under the direction of Dr. Segal, a basic research laboratory is studying ion channels using a variety of patch clamp techniques in oocytes, isolated cells and intact tubules. Dr. Solomon is involved in clinical trials to delay progression of renal disease and to study endothelial functions in patients with hypertension, diabetes, and chronic kidney disease. Dr. Weise is involved in a variety of studies in end stage renal disease patients including treatment of osteodystrophy and anemia and prevention of cardiovascular events. Dr. Rimmer is involved with innovative anticoagulation trials in end stage renal disease and studies of platelet functions. Drs. Hussain and Hood are involved in studies of the treatment of anemia in chronic kidney disease. Dr. Weidner is involved in immunosuppression trials and in the prevention of cardiovascular events in post transplant patients.

For more information, visit our Nephrology Academic website at www.med.uvm.edu/medicine/nephrology

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