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Divisions

Nephrology

Nephrology is a branch of medicine dealing with the study of the function and diseases of the kidney.

The Division consists of 12 members with primary appointments at Providence, who have responsibility for the clinical, research, administrative teaching program of the division. In addition there are 10 members who are primarily based at VGH but who have Providence appointments.  The clinical program is divided into chronic kidney disease, hemodialysis, peritoneal dialysis, transplant and inpatient. These programs serve as a provincial resource for tertiary and quaternary care. There is a strong divisional research focus with success in obtaining peer reviewed funding including CIHR, BC Ministry of Health Innovation Fund and Michael Smith Foundation support. There is an extensive teaching program at the undergraduate and postgraduate level. Members of the division have key administrative positions regionally and provincially in support of renal programs.

Contact Information
The Division of Nephrology
1081 Burrard Street
Vancouver, B.C., V6Z 1Y6
Telephone: 604-806-8936
Fax: 604-806-8031

Email: idukic@providencehealth.bc.ca

Head
Dr. David Landsberg, Clinical Professor and Division Head

Members

Dr. Jag Gill, Assistant Professor

Dr. Monica Beaulieu, Clinical Associate Professor
Dr. Adeera Levin, Clinical Professor and UBC Division Head
Dr. Ron Werb, Clinical Professor
Dr. David Landsberg, Clinical Professor and Division Head
Dr. Paul Taylor, Clinical Professor
Dr. John Gill, Associate Professor
Dr. Linda De Luca, Clinical Assistant Professor

Dr. Myriam Farah, Clinical Assistant Professor
Dr. Mercedeh Kiaii, Clinical Associate Professor
Dr. Beverley Jung, Clinical Assistant Professor
Dr. Abeed Jamal, Clinical Assistant Professor
Dr. David Prchal, Clinical Instructor


Teaching
The Division is highly rated for the teaching of medical students, and residents from General Internal Medicine, Urology, and Anesthesia. St. Paul's Hospital is one of two sites for nephrology subspecialty training and there are up to 5 nephrology trainees at any one time. There is also an accredited transplant nephrology fellowship program. As an integral part of the teaching program the nephrologists give a series of morning lectures four days each week, which are repeated every two months. Bedside teaching occurs continuously. There is a weekly academic half-day for sub-specialty residents and a bi-weekly city-wide round attended by all of the academic nephrologists in the City.

Research
The Division is a leader in clinical research. Dr. Levin, Dr John Gill and Dr. Jagbir Gill are GFT and have research careers.
Dr. Levin’s research encompasses the broad range of epidemiology, outcomes, and health policy in chronic kidney disease. Particular interests include the impact of anemia on renal co-morbidity, analysis of cardiovascular disease risk in patients with impaired renal function, strategies for and benefits of co-ordinated care for chronic kidney disease, the role of vitamin D in cardiovascular health and clinical outcomes, measurement of kidney function, and societal implications of renal disease burden.

 

Dr. Levin leads an active clinical training program for researchers in clinical epidemiology, translational physiology and health outcomes, which numerous collaborations with international and national groups: currently she is co-supervising a Clinical Investigator Program (CIP) research fellow originally from UBC, currently at U of Toronto, in addition to supervising residents and fellows locally.   

 

In addition, she continues to be involved in active research projects, the largest of which is CANPREDDICT, a large ($5 million) study which aims to improve our understanding of CKD progression and CVD progression in a Canadian cohort of 2500 patients, which has completed enrolment and 1 year of follow up. The observational cohort study collects blood samples and clinical and demographic data on these patients over a 2 year period, and seeks to characterize the population with specific attention to biomarker profiles of vascular health, inflammation, ischemic heart disease and heart failure. This grant is investigator-initiated and supported by an unrestricted industry grant, and has spawned successfully peer review funded sub studies and 6 abstracts to date. A CIHR grant extension and enhancement has been submitted as well. She was the Canadian principle Investigator in the largest ever nephrology trial SHARP (Study of Heart and Renal Protection), which concluded and was presented in numerous international venues over the last quarter of 2010.

 

She has successfully obtained, in 2010, a research grant examining the role of vitamin D in vascular health of patients with CKD.

 

She is author of over 200 publications in peer reviewed journals, and continues to actively pursue original research grants and subsequent publications. Multiple additional collaborations both nationally and internationally for education, research and administrative organization have been ongoing.

 

Dr. John Gill is an established clinical outcomes and health services researcher in the field of kidney transplantation. He is the PI on three active CIHR funded studies and co-investigator on six other CIHR funded studies. John is primary supervisor of one Ph.D candidate and two Masters Candidates at the UBC School of Population and Public Health. John has published 75 peer reviewed manuscripts.  John was awarded the 2010 Clinical Research Award by the American Society of Transplantation (AST) at Associate Professor Level. John is the Co-Chair of the Canadian Renal Transplant Study Group, Associate Editor of the American Journal of Transplantation, Editorial Board Member of the Clinical Journal of the American Society of Nephrology, and Advances in Chronic Kidney Disease. John was the Chair of the CIHR-Kidney Foundation of Canada Krescent Peer Review Committee in 2009, 2010. He is a member of the CIHR Health Services Peer Review Panel and an ad hoc reviewer for NIH/NIDDK.

 

Dr. Jagbir Gill conducts clinical health outcomes research in the field of organ donation and renal transplantation, with an emphasis on examining factors to expand organ donation, addressing disparities in access to transplantation, and the implications of transplant tourism.  He has also conducted research to examine outcomes in elderly kidney transplant recipients transplanted with older aged living donors and has examined optimal immunosuppressive therapeutic approaches in the aging transplant population.

Clinical Services
Dr. M. Kiaii is the Physician Operations Leader of the Hemodialysis Program. The
44-station outpatient hemodialysis unit is located on the 6th floor of the Providence building and is the largest outpatient dialysis service in British Columbia. Dr. Kiaii has also developed a Vascular Access Clinic and Monitoring Program.

Dr. Jamal is the Medical Director of Inpatient Services, which has 13 inpatient beds for the renal program and 2 urology/vascular surgery beds. Six short-stay beds have been established which are used efficiently to provide treatments such as kidney biopsies, the insertion of peritoneal or hemodialysis catheters, the treatment of kidney transplant rejection and as minor surgery beds for patients who require surgery to establish an arterio-venous fistula for hemodialysis blood access.

The Home Hemodialysis Program was started in September 2004, and is led by Dr. Bev Jung. This innovative program allows patients to do hemodialysis at home on a daily basis. Following the closer to home philosophy, patients are trained in two of our Community Dialysis Units.

Dr. P.A. Taylor is the Physician Operations Leader of the Peritoneal Dialysis Program. There is an active education program to teach patients and their families the techniques of peritoneal dialysis. PHC led a regional planning process to develop peritoneal dialysis in a residential care setting. This service was implemented in Sept 2007.

A Plasma-exchange Program is run jointly by the Divisions of Nephrology and Hematology.

Dr. D. Landsberg is the Physician Operations Leader of the Kidney Transplant Program. It is one of the most active transplant programs in the country and the living donor program is consistently in the top three in Canada in terms of living donor activity.
A total of 99 kidney transplants were performed in 2010, the highest amount ever. Following transplantation, the discharged patients are followed in the very active outpatient area on 6A, adjacent to the inpatient ward. As of January 2011 there are 723 post transplant patients being followed. There is a close liaison with Community Kidney Transplant Clinics located throughout the Province. Patients are seen at these regional clinics after their return to their own homes throughout BC. The critical barrier to the growth of the renal transplant program is the organ donor shortage. The program has developed some innovative strategies to increase living donation including a Living Donor Paired Exchange program, launched in 2009. As of January 2011, 15 LDPE recipients have been transplanted.


Dr. A. Levin is the Physician Operations Leader of the Kidney Function Clinic. As of January 2011 this clinic is following 1,972 patients. In addition there is an innovative award winning integrated care clinic directed by Dr. Monica Beaulieu which cares for patients with renal disease plus the comorbdities of cardiac disease and diabetes. This clinic is the first of its kind in Canada.

The nephrologists serve 7 community hemodialysis units located from as far away as Powell River to Richmond, B.C. These patients now receive hemodialysis close to their homes.

For more information on Nephrology, please explore these useful websites:
BC Provincial Renal Agency (BCPRA) www.bcrenalagency.ca
BC Transplant Society (BCTS) www.transplant.bc.ca
Kidney Foundation of Canada (KFOC) www.kidney.bc.ca
Chinese Renal Association www.kidney.bc.ca