Center for Tubulointerstitial Kidney Disease
Tubulointerstitial nephritis is a common form of kidney disease. While nephrologists have identified many potential triggers for acute interstitial nephritis, we know less about why patients may develop chronic interstitial nephritis. Ideal management strategies for both acute and chronic disease are unclear. Also a regional form of tubulointerstitial nephritis called Chronic kidney disease of unknown etiology has been described in Sri Lanka. Similarly Meso American nephropathy has been described in Nicaragua and El Salvador.
As Director of Stanford’s Center for Tubulointerstitial Kidney Disease, Dr. Anand is building a clinical and research portfolio focused on tubulointerstitial kidney disease.
Drs. Anand, Bhalla, Kambham and Montez-Rath are engaged in multi-disciplinary work researching CKDu (Chronic kidney disease of unknown etiology), the epidemiology and cause of a tubulointerstitial nephritis occurring at a high rate in Sri Lanka, predominantly among middle-age farm workers. These multi-disciplinary projects engage nephrologists, environmental scientists, anthropologists, epidemiologists and basic scientists. They are a collaboration with Kandy Teaching Hospital and University of Peridenya in Sri Lanka and University of Connecticut. This work recently highlighted in the Stanford Department of Medicine Annual Report.
Dr Anand has developed a standardized approach for evaluation of patients with non-proteinuric kidney disease, especially for those suspected of having tubulointerstitial nephritis (or chronic interstitial nephritis) but also in patients with diabetes or hypertension who don’t have supportive features of diabetic nephropathy or renovascular disease. Common causes of interstitial nephritis are medications. and environmental exposures including lead, cadmium (Itai-Itai disease) and aristolochic acid (Balkan nephropathy or Chinese herb nephropathy). Preliminary data show that early initiation of steroids in drug-induced acute interstitial nephritis or chronic interstitial nephritis may result in better outcomes.
2019 - WIGAMUWA
2018 - SRI LANKA
Field team in Sri Lanka investigating CKDu
2017 - CAPD UNIT, FIELD WORK, AND CLINIC
CKDu endemic areas, Teaching Hospital Kandy, and Girandurukotte, Sri Lanka
Nephrologist, Kandy Teaching Hospital, Kandy, Sri Lanka
Our projects are co-led by Nishantha Nanayakkara who provides extensive and expanding care to persons with CKDu, and has a long, established relationship with the community. He conducts satellite clinics in areas which are affected, with CKDu. He is an advisor to the Centre for Education, Research and Training on Kidney Diseases (CERTKiD) in Faculty of Medicine, the University of Peradeniya which is one of the leading institutes investigating current epidemic, chronic kidney disease of uncertain etiology (CKDu). Currently several M.Phil and Ph.D. students conduct their research under the supervision of Dr. Nanayakkara.
Dr. Anand is building a clinical and research portfolio focused on tubule-interstitial nephritis. She is a founding member of the International Society of Nephrology’s Consortium of CKDu Collaborators (i3C). She is also part of an International Society of Nephrology Sister Center grant to help support peritoneal dialysis for patients with advanced kidney disease at Kandy Teaching Hospital in Sri Lanka. CAP Profile
Vivek Bhalla is board-certified in Internal Medicine, Nephrology, and Hypertension. He currently directs a basic science research program on the molecular mechanisms of kidney disease. He has several projects related to mechanisms and consequences of dysregulation of tubular ion transport and the role of these changes on fluid and electrolyte balance and on overall tubular health and function. Dr. Bhalla has published on normoalbuminuric kidney disease in diabetes and works with Dr. Anand and other members of the International Consortium of CKDu Collaborators on the pathogenesis of this newly recognized tubulointerstitial disease. Dr. Bhalla has a long-standing interest in encouraging Nephrology research in our trainees. and directs the Renal physiology curriculum at the Stanford University School of Medicine, has served on the Biosciences Research Advisory Group for the American Society of Nephrology, and is the incoming Chair of the Council on Kidney and Cardiovascular Disease for the American Hearth Association.
As an academic renal pathologist with over 17 years of experience, Dr. Kambham has focused her clinical and translational research efforts in the areas of medical kidney diseases and transplant pathology. Primary tubulointerstitial diseases seen in native kidneys can often go unrecognized and the biopsy changes can be labeled as nonspecific. With concerted efforts, we hope to address these diagnostic challenges and contribute to better understanding of the disease mechanisms.
Dr. Brady is interested in improving how we deliver care to patients with kidney disease. As one of his projects at Stanford's Clinical Excellence Research Center (CERC), he is using a Danish longitudinal population registry to better understand the longterm effects of continuing or discontinuing lithium therapy in patients with chronic kidney disease. Commonly used for mood stabilization in patients with bipolar disorder, lithium is known to cause tubulointerstitial disease; the tradeoff between the renal consequences of continuing lithium and the psychiatric consequences of discontinuing lithium, in the face of chronic kidney disease, have not been well studied.
Maria Montez Rath
Dr. Montez-Rath completed her PhD in Biostatistics from Boston University in 2008 focusing on methods for modeling interaction effects in studies involving populations with high levels of comorbidity, such as persons on dialysis. She is a senior biostatistician and director of the Biostatistics Core of the Division of Nephrology at Stanford University where she has been collaborating with faculty and fellows since 2010 to study a variety of research questions relevant to kidney disease.
Anjali Bhatt Saxena
Dr. Saxena is heavily involved in the international PD community. She assumed the role of Treasurer for the International Society for Peritoneal Dialysis (ISPD) in January 2017, and is currently the President of the North American Chapter of the ISPD. She is committed to providing education and support for home dialysis therapies locally, nationally, and internationally. She is also an approved Educational Ambassador for the International Society of Nephrology (ISN), and has worked alongside Stanford colleagues to help develop services and training courses in Peritoneal Dialysis a low income area of Sri Lanka.
If you would like to contact Dr. Anand regarding a specific patient, please email firstname.lastname@example.org. To be HIPPA compliant please ensure your initial email does not have identifiable details.