Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
With three kids under age two, Steven Brunelli has discovered that the best way to help his scientist wife and attend to his own work is to take their newest family member, two-month-old insomniac ,Tyler, to the lab at night.
In the wee hours, Brunelli bounces his boy on his knee while analyzing data and explaining his passion to uncover why dialysis patients have such a high incidence of cardiovascular diseaseâ€”10 to 30-fold higher than the general population. "I'm disappointed in him," quips Brunelli, 33. "He's not very good at statistics." That's o.k., his dad has more than enough knowledge and dedication for the both of them.
Brunelli grew up in West Philadelphia with a probation officer father whom he recalls, “told me I wanted to be a doctor when I was very young. Not being very imaginative, I became a doctor.” Dialysis patients should be grateful. “Doing research that will improve the life expectancy and health of people on dialysis is my life’s work!” says Brunelli, Instructor of Renal, Electrolyte and Hypertension at the University of Pennsylvania. “That’s what this NKF grant is allowing me to do.”
Brunelli is focusing on the relationship between cardiovascular disease (CVD) and blood pressure fluctuations, which are far more frequent and dramatic in their ups and downs in dialysis patients than in others. More than half of dialysis patients die from (CVD), which includes heart attacks and strokes. That risk goes down dramatically after kidney transplant when blood pressure becomes less volatile. “I have come to believe that there is something about dialysis that is causing this burden of cardiovascular disease,” says Brunelli.
Using data from more than 10,000 patients who started dialysis between 2004 and 2005, he already has completed a study of long-term blood pressure fluctuations, those that occur over days to weeks. Now, he will begin to analyze these same factors for minute-to-minute fluctuations that occur during dialysis treatments. "If they have committed themselves to undergoing dialysis 12–15 hours a week, which is no picnic," says Brunelli, "then I can certainly commit myself to making their burden lighter!"
For a copy of NKF’s 2008 Report and Research Directory, e-mail firstname.lastname@example.org.