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Research

Stock image of person in white lab coat conducting research with light blue border background

From the time of its foundation, the Division has made key contributions to understanding and treating kidney disease. Dr. Welt’s seminal work helped define renal physiology and fluid and electrolyte disorders. Dr. Blythe was instrumental in establishing the first dialysis programs in the country at UNC. Notable focus areas of research have included immune-mediated kidney disease, advancing dialysis care, and patient-reported outcomes and priorities. From 1948 to 1950, Dr. Gottschalk conducted research at the Harvard Medical School, where his focus was kidney function, eventually revolutionizing the study of renal physiology. He was the first to prove the counter-current theory, explaining how the kidney excretes fluid that is more concentrated than any other body fluid. He was Chair of a workshop held in 1969 at the National Academy of Sciences that eventually led Congress to adopt the Medicare kidney disease entitlement (or the Social Security Amendments of 1972) that extended Medicare coverage to those with chronic kidney failure.

Investigations, primarily led by Dr. Falk, have achieved international recognition for basic and translational research that has helped characterize the cell, tissue, and overall physiologic changes in the development of specific autoimmune kidney diseases as well as new approaches for the study of innate and adaptive immunity, inflammation, and basic neutrophil and monocyte biology. Dr. Flythe’s research has launched fluid management to the forefront of the national dialogue about dialysis best practices and prompted nationwide protocol changes at dialysis centers. The Centers for Medicare and Medicaid Services (CMS) incorporated an ultrafiltration rate quality measure into the CMS ESKD Quality Incentive Program, citing Dr. Flythe’s work in the Federal Register as their primary justification. In 2019, the US Centers for Disease Control and Prevention made a screening tool for chronic kidney disease an integral part of its Chronic Kidney Disease (CKD) Surveillance System. This self-administered screening tool was developed by Abhi Kshirsagar, MD, MPH, who is the Marion Stedman Covington Distinguished Professor of Medicine. Developed with the National Health and Nutrition Examinations Surveys (NHANES) and independently validated with a large community cohort study, Atherosclerosis Risk in Communities (ARIC), the tool was the first of its kind to offer a calculator for the probability of chronic kidney disease.

The Division has accomplished much of its recent research through the UNC Kidney Center (UNCKC). In 2005, Dr. Falk became co-founder and director of the UNCKC, whose mission is to reduce the burden of chronic kidney disease through discovery about the pathophysiology and therapeutics of kidney disease. The UNCKC provides a multidisciplinary and multi-school approach to research pertaining to kidney disease spanning the gamut from basic molecular biology and genetics to broad epidemiological studies and clinical trials. In 2022, UNCKC investigators have been awarded over $18.2M for sponsored research.


Teaching

teaching stock imageThe clinical nephrology fellowship program was established under the leadership of Dr. William Blythe in 1972. The training program was led by Dr. Romulo Colindres from 1992-2009, and by Dr. Gerald Hladik from 2009 – 2020. The program is currently led by Dr. Koyal Jain. Joseph Dwight Russell, MD had the distinction of being the first clinical nephrology fellow at UNC. Since then, over 110 fellows have graduated from the program as of 2022. Fellowship alumni have assumed leading positions in academia, industry, and community practice.

As the division grew and the field of nephrology advanced, the division launched a specialized training program in research. In 1999, Dr. Falk founded the UNC Renal Epidemiology Training Program that has been continuously funded through a National Institutes of Health Ruth L. Kirchstein National Research Service Award. Nearly 100% of the post- and pre-doctoral trainees on this grant have become independent researchers and outstanding teachers, or have filled positions of leadership in the field of nephrology, including at the US Food & Drug Administration.

A transplant fellowship was established in 2005 under the leadership of Dr. Randy Detwiler, who led the program through 2020. Dr. Edwin Fuller currently serves as program director. As of 2022, the program has trained 12 transplant nephrologists. The glomerular disease fellowship was established in 2009 under the leadership of Dr. Patrick Nachman. Dr. Koyal Jain has directed the program since 2020. The program has trained experts in glomerular since its inception, most of whom hold academic positions at prestigious institutions. Finally, the Division has trained 5 interventional nephrologists, 3 of whom serve as faculty members at UNC.


Division Chiefs

Louis G. Welt

1967 – 1972

Louis Welt founded the Division of Nephrology and was the first Chief of the Division. He was a pioneer in helping to establish the field of nephrology in academia. In 1968, he published “Approaches to a University Kidney Disease Program” with the US Department of Health, Education and Welfare (Public Health Service Publication, Issue 1816). In this publication, Dr. Welt describes a broad program that coordinates existing programs of research, education, and prevention “to improve the understanding of kidney disease and the care of patients who are ill with diseases of the genitourinary tract.” He wrote that the keystone is “the kidney center or nephrology unit, whose creation is made urgent by the dramatic developments in artificial organs and transplantation. Implementation of these developments demands a new organization and construction of new and specifically designed space.”

Dr. Welt also served as Chair of the University of North Carolina-Chapel Hill Department of Medicine from 1965 – 1972. He served as Chair of the Yale Department of Medicine from 1972 until his death in 1974. In 1963, Dr. Welt authored, with Dr. Maurice Strauss, the most comprehensive and authoritative text in nephrology at the time (Strauss and Welt’s Diseases of the Kidney). He helped found the American Society of Nephrology (1966) and went on to become one of its early presidents (1969 – 1970). The American Society of Nephrology (ASN) promotes expert patient care, advances medical research, educates the renal community, and informs policymakers about issues of importance to kidney doctors and their patients. The ASN is now composed of over 20,000 physicians and scientists from around the world.

Dr. Welt also worked for the National Institutes of Health, the National Aeronautics and Space Administration, the National Academy of Sciences, the American Medical Association, the National Kidney Foundation, the Association of Professors of Medicine, the Committee on National Medical Policy of the American Society for Clinical Investigation, the Association of American Physicians, and a host of other organizations and agencies.

Carl W. Gottschalk

Dr. Gottschalk’s first scientific interest was the study of butterflies, and the young lepidopterist discovered a new species (Strymon cecrops Gottschalki) when he was only 15 years old. He attended the University of Virginia Medical School and through the accelerated wartime program, he obtained his M.D. degree from Virginia in 1945.

Gottschalk never served as division chief, but he was an early leader in nephrology. He was professor of medicine and physiology at the University of North Carolina’s School of Medicine, 1952-1969, and Kenan Professor of Medicine and Physiology, 1969-1992. He served as chair of the Committee on Chronic Kidney Disease, sponsored by the United States Bureau of the Budget, which issued its influential Report of the Committee on Chronic Kidney Disease in 1967. He was also known for his Diseases of The Kidney, first published by Little Brown in 1988.

Gottschalk was named an American Heart Association Career Investigator and won the North Carolina Medal and the O. Max Gardner Award. In 1970, he received the Homer W. Smith Award from the New York Heart Association; in 1990, the A. N. Richards Award of the International Society of Nephrology; and, in April 1993, the first Robert W. Berliner Award for Excellence from the American Physiological Society. Gottschalk was president of the American Society of Nephrology (1974 – 1975) and a member of the National Academy of Sciences, the American Academy of Arts and Sciences, and the Institute of Medicine.

An avid bibliophile, Gottschalk donated his Robert Louis Stevenson collection to the Rare Book Collection of the Library of the University of North Carolina at Chapel Hill. His significant collection of rare books on the history of medicine, now known as the Carl W. Gottschalk Collection, came to the Rare Book Collection at UNC after his death in 1997.

William Brevard Blythe

1972 – 1993

William Blythe was born in Huntersville, North Carolina. He graduated from the University of North Carolina-Chapel Hill in 1948 at the age of 19. He served at Washington University School of Medicine and the Walter Reed Army Institute for Research, but devoted more than half a century to the University of North Carolina. He was appointed Division Chief of Nephrology in 1972 and received the Marion Covington Distinguished Professorship in Medicine. In 1982, he published a paper describing how the Bankers ponies of the North Carolina Outer Banks could survive without apparent access to anything other than salt water. His paper described his findings that fresh water was available to the ponies at the base of pawed vegetation.

In 2008, he co-authored “Bettering the Health of the People,” (with William W. McLendon, MD and Floyd W. Denny, Jr., MD), which chronicled the life and contributions of W. Reece Berryhill, MD. Dr. Berryhill was the founding dean from 1941 to 1964 of the M.D.-granting medical school at UNC-Chapel Hill. While celebrating the contributions of Dr. Berryhill, the work also addressed the unmet need in North Carolina for more doctors and hospitals, and for universal access to health care for all citizens, regardless of their ability to pay.

He embraced and lived the motto of the state of North Carolina, “Esse Quam Videri” (to be rather than to seem).

1993 – 2015

Ronald Falk graduated cum laude with a Bachelor of Arts degree from Dartmouth College. He received his MD degree and completed an internal medicine residency and clinical nephrology fellowship at the University of North Carolina-Chapel Hill. He served as Chief of the division from 1993 -2015 and has served as Chair of the UNC Department of Medicine since 2015. He co-founded the UNC Kidney Center and continues as its Co-Director.

Dr. Falk was honored with the inaugural Nan and Hugh Cullman Eminent Professorship in 2016. This endowed professorship was made possible through the Nan O. Cullman Fund for the UNC Kidney Center, an undesignated fund that is tied to research and highest need at the UNC Kidney Center. In 1994, he was appointed the Doc J. Thurston Distinguished Professor and was honored as the first Allen Brewster Distinguished Professor of Medicine in 2011. He was inducted into the American Society of Clinical Investigation in 1993 and into the American Clinical and Climatological Association in 2000, when he also received their Theodore E. Woodward Award. He was president of the American Society of Nephrology in 2012. In 2015, he earned National Institutes of Health honors for seminal work as a physician-scientist and delivered the National Institutes of Health Astute Clinician Lecture in 2016. He was honored by the New York Academy of Medicine in 2016 with the Edward N. Gibbs Lecture and Award in Nephrology, a lifetime achievement award. In 2017, he received the American Society of Nephrology John P. Peters Award in recognition of sustained research contributions to the discipline of nephrology, and his sustained achievements in one or more domains of academic medicine including clinical care, education, and leadership.

2015 – Present

Graduating summa cum laude from Boston University in 1985 and magna cum laude from that institution’s medical school in 1989, Dr. Hladik arrived at UNC for a medicine residency and then nephrology fellowship before joining as faculty as Assistant Professor of Medicine in 1996. In recognition of his accomplishments in and contributions to the intellectual advancement of the division and the School of Medicine, he was honored with the Doc J Thurston Distinguished Professorship in Nephrology in 2011. He is the embodiment of teaching excellence and has won countless teaching awards, including the Department of Medicine Recognition Award in 2005, the School of Medicine Spirit Award honoring faculty contributing most to the second year medical school class in 2006, the UNC School of Medicine Professor Award honoring the faculty member who most contributed to the medical education of the graduating class of 2008, the Sun Trust Teaching Award in 2008, and appointment as a Fellow in the UNC Academy of Educators in 2009.

Dr. Hladik was the Director of the Urinary Systems Course for undergraduate medical students from 1998 until 2015. From 2009 through 2020, he served as director of the subspecialty nephrology fellowship and grew the fellowship from 4 to 8 fellows. He served as Education Co-Director and Co-Editor of the Nephrology Self-Assessment Program for the American Society of Nephrology 2015-2019 and the Director of Education for Maintenance of Certification from 2013 – 2015. He co-created the Kidney Self-Assessment Program, along with his colleagues, Dr. Melanie Hoenig from Harvard, in 2015, and served as its inaugural director from 2015-2017. This program is a key educational activity for board preparation for nephrology fellows and practicing nephrologists. He developed and served as course director for the nephrology portion of the UNC Physician Assistant Program Course (PA 720, Clinical Medicine II) from 2016 – 2018. From 2010 – 2013, he served on the American Society of Nephrology Workforce Committee to develop the ASN Renal Educator Listserv in collaboration with Melanie Hoenig, MD (Harvard). A community of educators was created through the establishment of a traditional listserv for preclinical course leaders throughout the US in kidney physiology and pathophysiology to facilitate resource sharing, mentorship, and support with the targeted goal of increasing interest in nephrology among US medical students.

2020 – Present

Dr. Flythe was appointed Vice chief of the Division of Nephrology and Hypertension in 2020. She earned her Bachelor of Arts degree in 1999 from Duke University and graduated medical school in 2006 at UNC. She completed a medicine residency in 2009 at the Oregon Health and Science University and earned her Master’s in Public Health from Harvard School of Public Health in 2013. Before joining our faculty in 2014, she completed a nephrology fellowship at Brigham & Women’s Hospital and Massachusetts General Hospital.

Since her appointment at UNC, Dr. Flythe has continuously demonstrated institutional leadership. In January of 2017, she was appointed Medical Director of UNC Hospitals Dialysis Services. She also serves on the UNC Hospitals Dialysis Quality Assessment and Performance Improvement and Governance Committee (since 2014), and served on the Department of Medicine Value-Based Care Committee 2016-2019. She was invited to participate in the UNC School of Medicine Program in Leadership Development program (2018-19). Her leadership extends beyond UNC as exemplified by her service on the Board of Directors of the Kidney Health Initiative (a partnership between the American Society of Nephrology and U.S. Food and Drug Administration), the Executive Committee of Kidney Disease Improving Global Outcomes (KDIGO), and as chairperson of numerous American Society of Nephrology, National Kidney Foundation, and Centers for Medicare and Medicaid Services workgroups, education programs, and technical expert panels. In formal recognition of her numerous contributions and accomplishments to the kidney community, Dr. Flythe has received many notable awards. She received the Shaul G. Massry Distinguished Lecture Award from the National Kidney Foundation in 2022. She received the American Society of Clinical Investigation Young Physician-Scientist Award in 2018 and was inducted as a full member in 2021. She also received the James W. Woods Junior Faculty Award from the UNC School of Medicine in 2018.