Division of Pediatric Nephrology Presentations and News From PAS 2021

UPMC Children’s Hospital of Pittsburgh Division of Pediatric Nephrology researchers presented a number of abstracts at the 2021 Pediatric Academic Societies (PAS) annual meeting.

Pediatric critical care nephrology specialist Dana Y. Fuhrman, DO, MS, was a senior author on three abstracts presented by trainees. These included:

1. Pelletier JH, Au A, Fuhrman DY, Clark RSB, Horvat CM. Ensemble Machine Learning Illustrates the Effects of COVID-19-Related Social Distancing Efforts on Pediatric Hospitalization in the United States.

2. Scocia A, Rakkar J, Pelletier JH, Ghassemzadeh R, Fuhrman DY. Virtual Learning at the Forefront of Medical Education During the COVID-19 Pandemic.

3. Sharp E, Rakkar J, Pelletier JH, Fuhrman DY. EMR Utilization Without Regard for Kidney Function Can Lead to Medication Errors.

Division clinical director, director of pediatric dialysis, and medical director of pediatric kidney transplantation, Michael L. Moritz, MD, gave a presentation on the topic of: “Diagnosis and Treatment of Primary Hyperoxaluria 1 (PH1) - A Rare Monogenic Kidney Stone Disease,” in a sponsored symposia at the conference. Dr. Moritz is an internationally respected authority on fluid management and electrolyte disorders. He leads numerous clinical trials for the Division and has a clinical emphasis on chronic kidney disease, glomerular diseases, hypertension, kidney stones, dialysis and transplantation, and rare diseases.

Division chief Carlton M. Bates, MD, hosted the Trainee Zone SPR Coffee Chat: Finding Your Independent Funding, a session for trainees and young investigators to learn more about the process and rigors of securing independent grant funding to further their research. 

Dr. Bates also co-hosted the SPR Grant Writing 101 Program meeting. Four years ago, Dr. Bates conceived and implemented a Society for Pediatric Research K-grant writing class for trainees and junior investigators. Since that time the class has attracted increasing numbers of applicants each year, and Christina Alvira, MD, from Stanford University has joined Dr. Bates as a class facilitator. The K-grant writing class is a six-month workshop where participants meet monthly with the class facilitators who provide instructions on writing sections of a K-grant. Participants also take part in follow-up sessions that involve oral critiques of their grant writing provided by the class facilitators and peers. The success of the class, from an initial 8 applicants to 38 in the current round has necessitated adding a third class facilitator, Steven McElroy, MD, from the University of Iowa, who will join Dr. Bates and Dr. Alvira in 2022.

Jacqueline Ho, MD, MS, was co-chair of a symposium session on the subject of the “Management of CAKUT: From Genetics to Optimizing Nephron Function. Dr. Ho. also gave a presentation for the “Trainee Zone: The APS Doctor Is In: Career Tips for Trainees: Nephrology Office Hours. Within the Division, Dr. Ho's clinical interests include congenital anomalies of the kidney and urinary tract. She is committed to educating future physicians and directs the Pediatric Nephrology Fellowship Program, and she also co-directs the Pediatric Scientist Development Program in the Department of Pediatrics at UPMC Children’s. Dr. Ho leads a nationally recognized laboratory studying microRNAs and their role in kidney development and disease, which has been continuously NIH-funded for more than 10 years.

Division fellow Elisabeth Cole, MD, led a study investigating the prevalence of transient hyperphosphatasemia (TM) in pediatric kidney transplant patients. The incidence of TH in this patient population has garnered little attention in the past, and its incidence rate has been unclear. 

Dr. Cole and colleagues from the Division examined cases of pediatric kidney transplant conducted at UPMC Children’s Hospital of Pittsburgh between the years 2008 and 2019. Their study examined 178 transplant cases and identified 11 patients that met the diagnostic criteria of alkaline phosphatase levels greater than 1000 IU/L.

Among the findings, Dr. Cole and colleagues note that the median time from kidney transplant to diagnosis of TH was 7 months, and the median age at diagnosis of TH was 7 years. Eight of the 11 patients had a peak alkaline phosphatase level over the level of laboratory detection (>2330 IU/L); the remaining had peak levels of 1227, 1528 and 1692 IU/L. The median length of time that TH persisted was 6 months. Median glomerular filtration rate at the time of diagnosis of TH was 84 mL/min/1.73m2 None of the patients had significant abnormalities of serum calcium, phosphorus, 25-OH vitamin D, or parathyroid hormone levels at the time of presentation with TH. Two patients reported bone pain and both resolved while the alkaline phosphatase level remained elevated. Four patients had normal bone x-rays. Three patients had EBV viremia, and one had RSV during the study period; the time course of these viral infections did not correlate with TH. One patient was on cholecalciferol. No patient was on calcitriol or calcium or phosphorus-containing medications. After resolution of TH, no patient had a recurrence of elevated alkaline phosphatase level.

Dr. Cole and colleagues conclude from their study that TH has the potential to manifest during the first year following a pediatric kidney transplant, while these cases typically resolve within a year from onset and are unlikely to recur.

Dr. Cole was joined on the study by Division colleagues Paul Fadakar, MD; Yosuke Miyashita, MD; Melissa J. Anslow, MD; Michael L. Moritz, MD; Also contributing to the study was  Armando Ganoza, MD, assistant professor of surgery and the surgical director of the pediatric kidney transplant program at UPMC Children’s.