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Highlighting Karen A. Griffin, MD, FAHA, FASN, FACP – Fellow of the American Heart Association (FAHA)

The Fellow of the American Heart Association (FAHA) is open to researchers and medical professionals with an interest in cardiovascular disease and stroke. To be eligible for this fellowship, one must have up-to-date membership of either Premium Professional or Premium Professional Plus of one of the AHA councils for at least two years and must be affiliated with the Council in which the application will be submitted. FAHA is not only a reflection of stature, but also a record of valuable service to the AHA and the council.

Karen A. Griffin, MD, FAHA, FASN, FACPDr. Karen Griffin, who presented a seminar in April 2019 at the University of Tennessee Health Science Center (UTHSC) Department of Physiology, has carried the FAHA designation for several years, but now serves as Chair of the Council on Hypertension. The Council’s mission is to “Foster excellence in hypertension research and education and to be a relentless force for a world of longer, healthier, lives.” Dr. Griffin was a Fellow of the American Society of Hypertension (ASH) for many years until recently when ASH became a part of the Council of Hypertension, which was an exciting venture for both Dr. Griffin and the Council. In 2016 she was nominated by Dr. Chris Wilcox, Chief of the Division of Nephrology and Hypertension at Georgetown University, and elected by the Council members as Chair-elect.  In that role she served as Chair of the program committee for the Council during which time a fourth concurrent session was added to the Hypertension Scientific Sessions that nicely dove tails additional clinical programming from ASH within the Council meeting.  This session, known as Concurrent D, consisting of Clinical Practice/Clinical Science and Primary Care tracks, was purposed to enhance translational advances from research to clinical practice as a means of improving patient care.

Dr. Griffin received her medical degree from Rush Medical College in Chicago, and subsequently completed her internal medicine residency and clinical/research fellowship in nephrology at Rush. She began her 28-year career at Loyola University Medical Center and the Edward Hines, Jr. VA.  and is currently a Professor of Medicine (Nephrology) at the Stritch School of Medicine, Loyola University and Renal Section Chief at the Edward Hines, Jr. V.A.  As a clinician, she is primarily focused on hypertension in kidney disease and has been Director of Loyola’s AHA Designated Comprehensive Hypertension Program.  Her research focus has been on the role of hypertension on the progression of chronic kidney disease and the impact of altered hemodynamics in the development and progression of diabetic and obesity-related nephropathies. She has received research funding from the NIH and Merit Review and published more than 80 articles, invited reviews and book chapters. Dr. Griffin has served as chair of the Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development Services of the Scientific Merit Review Board in addition to chairing the VA Merit Review Renal Study Section and National Kidney Foundation of Illinois, Research committee. Additionally, she has served as a reviewer for several NIH study sections. She has also served as chair of the Professional and Public Education committee for the American Heart Hypertension Council and was a member of the American Society of Nephrology Hypertension Advisory Group.  Dr. Griffin is recipient of the American Medical Women’s Association Awards for Leadership and Academic Excellence, the Student’s Choice Award from the Department of Physiology at the Medical College of Wisconsin, and the Arthur C. Corcoran Memorial Lecturer of the Council on Hypertension.

Yet, despite her numerous accomplishments as a physician scientist, she holds fast to her belief in compartmentalization as a strategy for a balanced life.  As a physician scientist the demands on one’s time are challenging and necessitates often working extended hours but she has learned the art of multi-tasking and makes an effort to get off the grid to prevent burnout and have time for family and friends. Dr. Griffin encourages early career professionals to create a life outside of work, which translates to increased productivity when returning to work.  Dr. Griffin, for instance, enjoys bicycling, pilates, gardening, fishing, and horse racing. Do you have any similarities?

Dr. Griffin also urges early career professionals to set short term achievable goals for the week and to tackle each day with vigor and passion, completing each defined task and moving goals closer to completion. In addition, you should network and become part of FAHA, along with the Fellows In Training (FIT) program, in order to open doors and participate in AHA leadership. These steps will lead to career advancement as well as being a mark of achievement. Finally, she says to not get discouraged as we all face those hurdles along the way and the difference between those that succeed and those that don’t is an unwavering persistence, be it with grant submissions, publications, promotions, etc.

Likewise, as Chair (and Member-At-Large) of the Council on Hypertension, Dr. Griffin encourages membership in the Council because “it is all inclusive of basic and clinical research making it a hub for all specialties related to the field of hypertension research in addition to realizing the translation of such research to the evaluation and management of patient care.  The annual Council meeting is of a size that allows excellent opportunities to network and enjoy the fellowship of scientists and clinicians that form the hypertension community at-large in addition to seeing good friends acquired over the years of Council membership.” She encourages you to submit your abstracts for Hypertension Scientific Sessions 2019, held in New Orleans, Louisiana, from September 5-8, 2019 and hopes to see you there!

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Chronic Kidney Disease: The Silent Killer

“He felt well, so he didn’t follow up with his doctor.”

Our nephrology team was gathering history about a patient who had landed in the Emergency Department with advanced kidney failure and its consequences: confusion, severe anemia, metabolic acidosis, and a high blood potassium threatening to push him into cardiac arrest.  We asked the family: Did he have any known kidney problems?

“His doctor mentioned abnormal kidney function 3 years ago.  But he’s felt really healthy, and has been too busy to go back to the clinic.”

Convincing someone they have chronic kidney disease can be tough.  “But I feel fine!” is a common response along with a look of disbelief or suspicion (like they’re not sure if I’m trying to sell them something).  This is usually followed by: “What can I do to make my kidneys better?”  This part is a real downer because they find out I actually don’t have anything to sell – there isn’t any therapy that can regenerate kidney function.  It’s all about preventative measures to preserve the functioning nephrons – we focus on improving lifestyle practices and treating comorbidities so as to avoid further kidney injury.

World Kidney Day has been recognized on the 2nd Thursday of March every year since 2006 and tends to pass by with little fanfare.  Public awareness and media coverage of kidney disease is relatively low compared to conditions such as heart disease or cancer.   However, the statistics associated with chronic kidney disease are downright scary.  Chronic kidney disease doubles the risk of mortality from cardiovascular events or infection.  Every year, more Americans die from kidney disease than from breast cancer and prostate cancer combined.  End-stage kidney failure requiring dialysis has an average survival of 10-15 years.  If an individual transitioned to dialysis at the same time that he welcomed a baby to the family, he might not live to see his child graduate from high school.

person shruggingAbout 1 in 10 people worldwide, and >20 million in the US, have chronic kidney disease.

The functioning unit in the kidney is the nephron, and humans are born with 900,000 to 1 million nephrons per kidney (or less, if born premature).  No new nephrons form after birth.  We are actually born with more kidney function than we need to maintain electrolyte and fluid balance – evolutionary proof that the kidneys are so important!

In most cases of progressive kidney disease, the body is remarkably adept at adjusting to the buildup of toxins.  The person “feels well” until the kidney function falls below 15% at which point the “crash” happens and they feel terrible.

Research is ongoing to develop saliva tests that quantify levels of toxins that have diffused from the blood, as a measure of kidney function.  These are yet to be validated and commercialized.  For now, periodic blood tests (inconvenient and painful, but necessary) are the only way we can reliably monitor chronic kidney disease to guide treatment recommendations.

Wei Ling Lau Headshot
Wei Ling Lau, MD is Assistant Professor in Nephrology at University of California-Irvine, where she studies vascular calcification and brain microbleeds in chronic kidney disease. She is currently funded by an AHA Innovative Research Grant, and has been a speaker for CardioRenal University and the American Society of Nephrology.

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Social Media In Medical Education: #mindboggling IMHO

I have always been late in the game in terms of catching up with social media.  When I started college in Canada, it took some convincing before I joined Friendster as a way to keep in touch with friends and family in Southeast Asia.  Friendster lost popularity soon after, thus I was not jumping on the boat when Facebook surfaced a few years later.  When it became apparent that FB was here to stay, I created an account and have found it to be valuable for maintaining connections in various circles (family, friends from elementary / high school / college / medical training, and last but not least, parents of my kids’ friends because that’s how I meet people now).  But until very recently I still viewed social media as “social” and kept it separate from “work” and professional development. 
 
Social icon collageThat all changed when I was accepted into the AHA Early Career Blogger team this recent November and was given an ultimatum to start a Twitter account.  I wanted to throw a fit right there on that comfy sofa in the #AHA17 Early Career lounge.  We already spend too much time with electronics – for research, scientific writing, patient care, charting, email, Facebook lurking.  I had the impression that Twitter was an avenue for self-promotion, cutesy looping videos and sales ads.  Why would I create a social media “work” account that wouldn’t get me grants or patient referrals?
 
This is what I have learned during my first 2 months on Twitter: a lot of great information.  I was correct to have misgivings in the sense that I am spending a *little* more time with my laptop.  (Had to get over the fear-of-missing-out mentality with an obsessive need to refresh that Home icon…)  The access to medical knowledge and peer experts is really quite amazing.  For a succinct discussion on the benefits – and limitations – of social media for medical professionals, check out the recent article by #AHAEarlyCareerBlogger @chadialraies.  From a nephrologist’s standpoint, below are some of the highlights of my Twitter experience to date:
 
Doctors and scientists doing each other’s homework: Posting a query to @askrenal or @nephjc taps into the collective Twitter nephrology community.  There are dedicated educators out there who regularly provide feedback and links to helpful publications.  Personal anecdotes from fellow clinicians are also valuable.  As an example, I was curious as to how other nephrologists were monitoring for severe hypocalcemia which can happen when denosumab (a relatively new osteoporosis drug) is given to patients with advanced chronic kidney disease; @hswapnil offered his approach and @edgarvlermamd forwarded a Japanese cohort study that had a lot of useful information (but may not have popped up on my radar as it was not PubMed indexed).
 
Gender and minority representation: It is encouraging to see the diversity and achievements showing up in the posts with #WomenInNephrology, #IlookLikeADoctor or similar hashtags.  (But don’t buy into this #ILookLikeANephrologist post.)
 
Live discussion forums: @nephjc hosts journal clubs where take-home points are summarized in high-yield visual abstracts and participants can join chat forums at designated times to contribute comments and questions to a live feed.  It was especially neat when both the lead author and senior author from the PRESERVE trial were online to answer questions – equivalent to a celebrity sighting in our world.  (See my prior blog about the PRESERVE trial.)
 
Inter-disciplinary learning: Who knew there were so many smart people out there besides nephrologists?  (just kidding!)  I read about platypnea-orthodeoxia syndrome, DNA-sensor technology to diagnose rare diseases, updates to the Infectious Diseases Society of America treatment guidelines for infectious diarrhea, and fascinating @neiltyson musings such as “If you accumulate all the flora, fauna, and metal your true love gives you each day in the “Twelve Days of Christmas” song, you’ll own 12 Trees, 40 Gold Rings, 140 Humans, and 185 Birds of 6 different species.”  I know some of this info will serve me well during Internal Medicine boards recertification.
 
Of course, careful judgment is warranted since no policies are in place to guarantee that social media reflects evidence-based medicine.  This an honor system that assumes medical professionals are engaging with social media in a responsible and ethical manner.  Medical education through social media has evolved as an area of research in itself; a search on PubMed using the keywords “social media AND medicine” yields >7000 reports.  When approached correctly, there is no doubt that social media is a powerful tool that connects patients, clinicians, scientists and industry, and facilitates learning via a global collective of experiences and differences.

 

Wei Ling Lau Headshot
Wei Ling Lau, MD is Assistant Professor in Nephrology at University of California-Irvine, where she studies vascular calcification and brain microbleeds in chronic kidney disease. She is currently funded by an AHA Innovative Research Grant, and has been a speaker for CardioRenal University and the American Society of Nephrology.