E-Kidney | october 2013

Doctor w/ clipboardNKF Research Spotlight:

Dr. Alex Chang studies the effects of phosphorus on early-stage CKD patients

It didn’t take long for Dr. Alex Chang, 31, to determine that he would pursue a career in nephrology. It was during his early years of medical school at Ohio State University that he became interested in the intricacies of the kidneys and the needs of kidney patients.

“I realized how important, yet underappreciated the kidneys are,” he said. “Nephrology is a complex field intimately linked with every organ system and that keeps me coming to work ready to learn more.”

It is that same passion that has driven his research. Dr. Chang focuses on ways to decrease the prevalence of chronic kidney disease and reduce its side effects through dietary interventions and lifestyle modifications. He is working on a new study, supported by the National Kidney Foundation’s Satellite Dialysis Clinical Investigator Grant, that is investigating the effects of phosphorus additives on patients who have early stage kidney disease.

“Patients who are on dialysis often have difficulty eliminating phosphorus, so they have to avoid consuming phosphorus additives,” Dr. Chang said. “But for people with early kidney disease, who can still excrete phosphorus, it is unknown if these additives could cause problems.”

Dr. Chang, who is a Clinical Investigator in Nephrology at Geisinger Health System, will conduct his research at Johns Hopkins University in the Prohealth Research Unit directed by Dr. Lawrence Appel.

The goal is to learn whether avoiding phosphorus additives decreases the cardiovascular risk in kidney patients. The study involves the recruitment of individuals who are classified as being in CKD stages 1 or 2. After obtaining a baseline phosphorus level, patients will undergo a period where they consume foods with phosphorus additives and another period where they consume foods without phosphorus additives. Researchers will then measure blood and urine searching for a hormone that is linked to increased cardiovascular risk.

“If we see an increase in this hormone (FGF-23), this would suggest that we should be counseling all kidney disease patients to avoid phosphorus additives,” said Dr. Chang.

Patients are currently being recruited for the study, and Dr. Chang and his team hope to publish results in mid-2015. After this study is completed, he will continue to examine new ways to combat kidney disease and its co-morbidities.

“There are so many exciting advances in dialysis and improvements in transplantation to look forward to, but I am actually hoping that we can refocus energy on low-hanging fruits,” he said. “To me, this means better understanding of diet and whether we can modify lifestyle behaviors to prevent or slow progression of kidney disease and increase the adherence rate to medications.”