"Five Decades of Nephrology," celebrated the Washington University Renal Division, October 30, 2004.

Neal S. Bricker, MD, Renal Division Director, 1956-1972

 

Saulo Klahr, MD (1935-2010), Renal Division Director, 1972-1990

 

 

 

The Renal Division at Washington University is part of the Department of Internal Medicine and was created as a separate entity in 1956. If you would like to make an on-line gift or contribution to support activities of the Washington University (WU) Renal Division, please click on On-line Giving, and be sure to designate the WU Renal Division under Department/Division.

If you would like to learn more about dialysis and renal care at Washington University, please click on Dialysis. If you would like to learn more about kidney transplantation at Washington University, please click on Transplantation.

The history of investigative nephrology at the University antedates formation of the Division. It is rooted in the commitment to basic investigation of fluid and electrolyte physiology, mineral metabolism and renal endocrinology - a commitment that has always transcended departmental boundaries. It established the foundations for the multidisciplinary approach to clinical investigation and presaged the greatly broadened scope of investigation that characterizes the Renal Division today. For an historical perspective of the Renal Division, please click on Renal Division History.

For group photographs of Renal Division faculty, please click on Renal Division Group Photos.

In the early 1920s, Drs. A.F. Hartmann and Phillip A. Shaffer in the Departments of Pediatrics and Biochemistry were among the first to use insulin for treatment of the fluid and electrolyte imbalances of type I diabetes mellitus. Hartmann's Solution was developed to treat disorders of fluid and electrolytes in pediatric patients. Dr. David Barr and associates coined the term 'hyperparathyroidism' in 1927. The first successful parathyroidectomy in the United States was performed at the former Barnes Hospital/Washington University in 1928 by Dr. I. Y. Olch. Between World Wars I and II, Drs. Harvey Lester White and F.O. Schmitt pioneered the use of micropuncture to characterize renal glomerular and tubular function. Dr. White also carried out investigations that defined the actions of antidiuretic hormone, growth hormone and corticosteroids on the kidney.

Nobel laureates Carl and Gerti Cori delineated basic pathways of carbohydrate metabolism in the 1940s and 1950s. Dr. William Daughaday formulated the somatomedin hypothesis in 1955.

In 1956, Dr. Neal S. Bricker became the first director of the Renal Division. Dr. Bricker defined the "intact nephron hypothesis," explaining the nature of chronic renal failure. His studies established that the number of functioning nephrons is reduced in chronic renal disease and that the remaining nephrons undergo adaptations that maintain renal homeostasis. He was a founding member of the American Society of Nephrology and served as its first president in 1967. Dr. Bricker served as president of the American Society for Clinical Investigation in 1973. While Dr. Bricker was Division director, Dr. Eduardo Slatopolsky developed one of the first radioimmunoassays for parathyroid hormone and became well known as an authority in mineral metabolism. Dr. Slatopolsky's studies defining the control of phosphate excretion in uremia are true classics in nephrology.

Dr. Saulo Klahr assumed directorship of the Division in 1972. Internationally recognized as an authority in strategies aimed at prevention of renal disease progression, Dr. Klahr is also known for his expertise in the pathophysiology of obstructive nephropathy. Dr. Klahr served as the 20th president of the American Society of Nephrology and as president of the National Kidney Foundation.


Am. J. Nephrol 22:180-185, 2002.



J. Am. Soc. Nephrol 8:1470-1476, 1997.



Klahr S. Kidney International 69:1487-1488, 2006.



J. Am. Soc. Nephrol. 15:1126-1132, 2004



Slatopolsky et al: The control of phosphate excretion in uremia.
J. Clin. Investigation 1966.


Marc R Hammerman, MD, Chromalloy Professor of Renal Diseases in Medicine, Renal Division Director

Vikas Dharnidharka, MD, MPH, Associate Professor of Pediatrics and Director, Division of Pediatric Nephology

Keith A. Hruska, MD Professor of Pediatrics and Medicine, past Director Division of Pediatric Nephrology

 

 

The first human islet of Langerhans transplantation to achieve insulin independence in a diabetic recipient was carried out at Washington University and reported in 1990.

Dr. Marc R. Hammerman was named director of the Division in 1990. Dr. Hammerman, a nephrologist and an endocrinologist, carried out many of the original investigations that defined solute transport pathways in isolated renal membranes. However, he is best known for his innovative studies on the use of growth factors to treat renal disease, on kidney development and the potential for transplantation of developing organ primordia (organogenesis).

A merger initiated between Barnes and Jewish hospitals in 1996 created Barnes-Jewish Hospital and also united Renal Divisions at both institutions. Dr. Keith Hruska, who directed the Renal Division at Jewish Hospital, is internationally recognized for his studies of signal transduction in kidney and bone. Dr. Hruska went on to direct the Division of Pediatric Nephrology at Washington University/St. Louis Childrens' Hospital for many years.

Since 2000, the first year for which Nephrology programs were ranked by U. S. News and World Report, Washington University/Barnes-Jewish Hospital has been rated in the 'top dozen' in the United States. It has one of the largest dialysis practices in the midwest and is one of the premiere kidney transplant centers.

Research has been a major priority of the division since its establishment. Many of the major figures in renal research have made their breakthrough discoveries here. Faculty who trained in nephrology at Washington University now direct many renal divisions in the United States and abroad.

In 2012, Dr. Vikas Dharnindharka was named director of the Division of Pediatic Nephrology at Washington University/ St. Louis Children's Hospital. Dr. Dharnindharka is a patient-oriented researcher with interests in chronic renal failure, pediatric kidney transplantation and post-transplant infections. He performs epidemiological analyses of very large national databases to elucidate risk factors for events and the outcomes after events, typically infectious events. He is particularly well known for his work related to a post-transplant malignancy called post-transplant lymphoproliferative disorder (PTLD), caused in most cases by Epstein-Barr virus infection.

For photos taken at our October 30, 2004 Reunion, please click on Reunion. For photos taken with Seth Goldberg's Model T Ford, please click on October 2013.




 

 

Eduardo Slatopolsky MD, Joseph Friedman Professor of Renal Diseases in Medicine, Director Chromalloy American Kidney Center 1966-1996

James A. Delmez, MD, professor of medicine and medical director of the Chromalloy American Kidney Center.

 

Daniel C. Brennan, MD, Alan A. and Edith L. Woolf Professor in Renal Diseases and medical director of renal transplantation

Aubrey Morrison MBBS, professor of medicine and pharmacology

 

Judy Jang MD, assistant professor of medicine

 

Richa Pandey MD, postdoctoral fellow

 

Anuja Java MD, postdoctoral fellow (transplantation)

 

Derek Larson MD, postdoctoral fellow

 

 

Washington University School of Medicine

Washington University School of Medicine has one of the richest traditions of any medical school in the country. The school was formed in 1891 by the union of the first two medical schools established west of the Mississippi River, the Missouri Medical College and the St. Louis Medical College. When the two were united as the Medical Department of Washington University, they combined their strengths in clinical teaching and research, offering the finest medical instruction between the East and West coasts.

In 1910, Washington University formed an agreement with what was then Barnes Hospital, which was in the planning stages, and the existing St. Louis Children's Hospital, to allow students into the wards as clinical clerks. The agreement between Washington University, Barnes and Children's hospitals was a major milestone in the history of American medical education. Washington University's program was successful immediately and soon was emulated by other medical schools throughout the country.

Today, the Washington University School of Medicine is one of the premier medical schools in the world. It excels at defining the scientific and research bases of medicine and the application of that knowledge to patient care and clinical practice. Seventeen Nobel laureates have served as faculty. Currently, 14 faculty members belong to the National Academy of Sciences and 30 are members of the Academy's Institute of Medicine.

Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis Childrenís Hospital, the Alvin J. Siteman Cancer Center and Central Institute for the Deaf comprise the WU Medical Center. The medical center generates an annual financial impact of nearly $2.6 billion for the St. Louis area, according to an economic model maintained by the St. Louis Regional Commerce and Growth Association. With more than 20,000 employees, the combined medical center institutions are among the largest employers in the metropolitan area. The 155-acre WU Medical Center, spread over portions of 15 city blocks, is located along the eastern edge of Forest Park in St. Louis. At the western boundary of the park is the 169-acre Danforth Campus of WU in St. Louis. New facilities that have opened recently include; the BJC Institute of Health (2009); the Siteman Cancer Center at Barnes-Jewish West County Hospital (2008); the Genome Data Center (2008); the Orthopedic outpatient center (2007); and the Northwest Tower, faculty office space (2006).

The 302,000-square-foot Southwest Tower houses the Charles F. Knight Emergency and Trauma Center on the street level; 28 operating rooms and a cardiothoracic intensive care unit opened in 2005. The School of Medicine occupies 75,000 square feet of research space in this building. The Southwest Tower and the 650,000-square-foot Center for Advanced Medicine completed the medical centerís $350 million campus integration project that began in 1996. Most outpatient, diagnostic and testing services, as well as cancer services, are now located on the north side of the campus. All high-intensity, complex surgical cases and related care are delivered on its south end. Also in 2005, construction was completed on the 110,000-square-foot Farrell Learning and Teaching Center at Scott and Euclid avenues. The six-story building houses all of the medical schoolís teaching spaces and individual student study areas, as well as two lecture halls and a cafe. In the aggregate, the School of Medicine occupies more than 4.5 million gross square feet on campus. Research and instructional endeavors occupy more than 2.1 million gross square feet.

A network of pedestrian bridges connects Barnes-Jewish and St. Louis Children's hospitals and other research and educational facilities on the Medical Campus. The ability to move freely throughout the Medical Center enhances interaction and benefits research and patient care.

The Medical Center is engaged in the teaching and training of scientists, medical students, house staff and fellows in all areas of medical and surgical specialties. Research facilities common to many divisions are provided by the School of Medicine. The Bernard Becker Medical Library houses an extensive collection of journals, books, audiovisual aids and computerized reference sources.

Grants and contracts totaling nearly $484 million support faculty research efforts at the School of Medicine. The school is one of the largest recipient of National Institutes of Health dollars among the 125 U.S. medical schools.With more than 15,000 employees, the Medical Center has the largest private payroll in the City of St. Louis and the second largest in the St. Louis Metropolitan Area.

The Department of Internal Medicine at Washington University possesses both extensive clinical and investigative expertise. Its clinical strength is apparent in the number and broad spectrum of patients referred to physicians within the Department and by the high quality of care that is provided to them. Clinical publications that originate from its faculty members include the Manual of Medical Therapeutics, the largest selling medical text of its kind. Strength in the area of biomedical research is reflected by the Department's long-standing role of leadership in the biomedical research community.

The Department has had only seven chairmen - each a major figure in American medicine - since it was established in 1910. The longevity of the chairmanships has permitted uninterrupted leadership, the single-minded goal of which has been the pursuit of excellence in the art and science of medicine.

The stability of leadership in the Department of Internal Medicine has been reflected in the Renal Division. The contributions of Drs. Bricker, Klahr, and Hammerman have included a major commitment to fellows and their careers. Their personal concern with the direction of those careers is demonstrated by the success that fellows have had in obtaining positions in science, academic medicine and clinical practice after completion of training. A total of twenty-eight individuals who were Washington University renal post-doctoral fellows have gone on to direct nephrology divisions in the USA and abroad. Most are pictured in the 'Renal Division History' section.



The Renal Division welcomes you to its website


Barnes-Jewish Hospital

Barnes-Jewish Hospital is the largest hospital in the Medical Center, with approximately 1,442 licensed beds, 47,957 annual admissions and more than 2,500 staff physicians. Barnes-Jewish Hospital has nearly two dozen areas of clinical excellence, many of which are recognized among the best in the country. Recognized as an outstanding hospital with a superior medical staff, it is committed to patient care, medical education, research and community service.

St. Louis Children's Hospital

St. Louis Children's Hospital provides the major pediatric clinical and research facilities for the Medical Center. The Pediatric Nephrology Division is based at Children's, which has been recently renovated and provides 235 beds for patients 21 years of age and younger. The Division sees patients with a variety of renal and urologic disorders including genetic and congenital diseases (such as obstructive uropathy, polycystic kidney disease, cystinosis and Alport's Disease), acquired glomerulopathies and tubulo-interstitial diseases, fluid and electrolyte disorders and hypertension. Children with both acute and chronic diseases are cared for.

A pediatric dialysis and transplant facility provides hemodialysis, peritoneal dialysis and CVVHD, as well as the preoperative evaluation and postoperative care for approximately 50 children who are renal allograft recipients. The average inpatient census is nine, and about 50 outpatients are seen weekly.

The BJC Health System

The BJC Health System was created in 1993, and has 16 hospital sites throughout the St. Louis region and has more than 5,000 licensed beds. It includes Barnes-Jewish and St. Louis Children's hospitals, which are affiliated with the Washington University School of Medicine; Christian Hospital Northeast-Northwest and Missouri Baptist Healthcare System. It is the region's only fully integrated health care delivery system and the first system in the nation to integrate an academic medical center with suburban, rural and metropolitan-based health care facilities.

Research Facilities and Personnel

At Barnes-Jewish Hospital, the Renal Division occupies approximately 25,000-square-feet of laboratory and office space on the first, seventh & eighth floors of the Wohl Clinic Building. Pedestrian bridges connect research facilities, facilitating close coordination and interaction between Division sites.

Equipment as well as support personnel is available for the execution of sophisticated research. Internationally recognized senior faculty members provide a rich environment for renal clinical investigation. The free flow of ideas and expertise across divisional and departmental boundaries is a hallmark of the Medical Center and encourages collaboration between clinical and basic scientists.

Renal Division
Department of Internal Medicine
Washington University School of Medicine