Treatment for Kidney Disease and High Blood Pressure

About Us
The Division of Nephrology and Hypertension was formed over 25 years ago, when E. Lovell (“Stretch”) Becker was chairman of the Department of Medicine, to care for the rising number of patients with kidney disease on the Lower East Side of Manhattan. The division expanded and opened a research laboratory and a dialysis unit for both acute and chronic kidney disease.

Within a few years, the Division of Nephrology and Hypertension became the dominant research center for dialysis in Manhattan and the rest of the world. During the 1990’s, the peritoneal dialysis program was considered one of the premier programs in the country.

Today, the division continues to treat a large number of dialysis patients with the most advanced dialysis procedures, and we are actively involved in many research projects with these patients to improve treatments and outcomes. We are also involved in clinical research of other aspects of renal disease with patients at all stages of kidney disease. We are focused on preventing kidney disease in the context of overall cardiovascular risk reduction.

Staff
The Division of Nephrology and Hypertension faculty has vast experience in all aspects of kidney disease, with some having developed particular expertise in specific areas, as listed below.

James Winchester, MD
Division Chief & Vice Chair Department of Medicine
Hypertension, toxicology (dialysis for poisoning), inflammation in renal disease, general nephrology, acute kidney injury, dialysis (peritoneal dialysis and hemodialysis) and transplantation management (liver, kidney, pancreas), renal biopsy

Herman Rosen, MD
Training Program Director & Director of Yorkville Dialysis Center
Hypertension, dialysis, kidney disease, kidney stones, toxicology, electrolyte disturbances, acute kidney injury

Richard Amerling, MD
Director, Irving Place Outpatient Dialysis
Renal failure, hypertension, diabetes, obesity, kidney stones, kidney disease, hypertension, renal biopsy, general nephrology, peritoneal dialysis, transplantation (kidney and pancreas), bone biopsy, acute kidney injury

Alan Dubrow, MD
Director, Inpatient Hemodialysis
Hypertension, dialysis, acid-base disturbances, acute kidney injury, electrolyte disturbances, general nephrology

Steven Gruber, MD
Director, Nephrology Development
Hypertension, general nephrology, dialysis (peritoneal dialysis and hemodialysis) and transplantation management (kidney, pancreas), acute kidney injury

Nikolas Harbord, MD
Director, Nephrology Outreach Clinic
Hypertension, general nephrology, dialysis (peritoneal dialysis and hemodialysis) and transplantation management (kidney, pancreas), renal biopsy, acute kidney injury

Viktoriya Kuntsevich, PhD

Zinovy Z. Brener, MD

Nathan Levin, MD

Andrew Pomrantz, MD

Appointments
New patients may be referred by a physician or refer themselves. Any patients with an HMO insurance plan must have a referral before scheduling an appointment.

To schedule an appointment as a new patient, call (212) 420-4070.

For Patients
Nephrology is a medical specialty that studies the kidneys. Attention is given to their structure, function, and diseases. Treatment of kidney disease is directed toward control of blood pressure and treating the underlying disease. Genetic disorders, such as polycystic kidneys are also studied. Nephrologists also treat patients with failed kidneys by dialysis and transplantation.

Medical Glossary
Acid base disorders
Acidosis may occur as a result of increases in arterial partial carbon dioxide tension (PCO2; respiratory acidosis) or from a variety of organic or inorganic fixed acids (metabolic acidosis). Acid base disorder can be life threatening, but it can also be chronic and manageable by medicine.

Catheter
A hollow flexible tube for insertion into a body cavity, duct or vessel to allow the passage of fluids or distend a passageway. Its uses include the drainage of urine from the bladder through the urethra or insertion through a blood vessel into the heart for diagnostic purposes.

Dialysis
The process of filtering the blood, the way kidneys normally do, using a machine. A patient has two catheters, or small tubes, inserted. One catheter is placed in a vein and the other in an artery. The arterial catheter removes the blood from the patient, where it then travels into a dialysis machine. The dialysis machine filters the blood to rid it of waste products, similar to the way the kidneys normally do. The filtered blood then returns to the patient through the venous catheter.

Electrolytes
Elements or chemicals needed to enable the body and heart to work properly. The most frequently tested by blood test: sodium, potassium and chloride.

Glomerulonephritis
Acute glomerulonephritis is an inflammation of the glomeruli, bundles of tiny vessels inside the kidneys. The damaged glomeruli cannot effectively filter waste products and excess water from the bloodstream to make urine. The kidneys appear enlarged, fatty, and congested.

Hypertension
Blood pressure that is above the normal range. A condition in which the blood circulates through the arteries with too much force.

Immunosuppressive drugs
Medications developed to suppress the body's normal production of antibodies that fight foreign substances, such as transplants and bacteria.

Kidneys
The kidneys are two organs, each about the size of a fist, located in the upper part of a person’s abdomen, toward the back. The kidneys filter wastes and extra fluid from the blood to form urine. They also regulate amounts of certain vital substances in the body.

Kidney stones
A kidney stone is like a small rock that forms in the kidney when certain chemicals in the body clump together. This stone can either stay in the kidney or travel down the urinary tract.

Polycystic kidneys
Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys. When PKD cysts form, they are filled with fluid and can profoundly enlarge the kidneys while replacing much of the normal structure, resulting in reduced kidney function and leading to kidney failure.

Transplant
An operation in which a new organ, such as a kidney, is given to the recipient. Patients with end-stage renal failure are candidates for transplantation. A successful transplant frees the patient from dialysis and provides the kidney's other metabolic functions.

Helpful Links
Mount Sinai Beth Israel
National Kidney Foundation
Kidney Urology Foundation of America
The American Society of Nephrology

For Medical Professionals
Mount Sinai Beth Israel, a large urban hospital in New York City, is a major teaching affiliate of the Icahn School of Medicine at Mount Sinai. This academic affiliation provides the faculty with teaching appointments and facilitates the rotation of its fellows to Montefiore, the university’s hospital. Beth Israel’s participation in Mount Sinai Health System also facilitates the rotation of its fellows to Long Island College Hospital.

The Nephrology Laboratory, run by Viktoriya Kuntsevich, PhD, has an active basic research laboratory, which is actively used by the fellows to learn urinalysis and conduct basic research projects.

Research
The Division of Nephrology and Hypertension is recognized nationally as a leader in the refinement of state-of-the-art technology for both hemodialysis and peritoneal dialysis. Current active areas of research include dialysis kinetics; body composition; cytokine responses to dialysis and inflammation; hemodynamics; examination of the dialysis process; and the development of a new generation of hemodialysis machines that automatically adjust blood flow, temperature, online solute clearance and modify the concentration of dialysis chemicals. A major interest of the division is the treatment of renal osteodystrophy with new calcium receptor sensitizing agents.

In addition, the division has a clinical research laboratory supervised by Viktoriya Kuntsevich, PhD, located at Beth Israel. This laboratory supports the cytokine and chemokine studies being performed by the division in collaboration with both the Renal Research Institute and other divisions in the Department of Medicine. Residents are encouraged and mentored during their research experience and are given the opportunity to attend and present their findings at national meetings.