Thank you for your interest in Cleveland Clinic’s Nephrology and Hypertension Fellowship Program. As the Program Director, I am confident our innovative curriculum will provide you with an optimal training environment to be successful nephrologists in academia, clinical, and subspecialty training. We offer a two-year ACGME accredited training program with an opportunity for an American Society of Transplantation (AST) fellowship.
The fellowship had an incredible year in 2020. I am proud to announce that we expanded and successfully recruited an additional fellow for the class of 2022 and 2023 (5 first year fellows), maintained an AT HOME night float system, expanded our interventional nephrology experience, sponsored a fellow on a T32 Training grant, and began a clinical and research collaboration with the Louis Stokes Cleveland VA in July 1, 2020.
The Department of Nephrology and Hypertension has a rich legacy of excellence in patient care, clinical research and fellow education. Cleveland Clinic is ranked as one of the nation's top hospitals by U.S. News & World Report.
The nephrology fellowship is the foundation of our department. We pride ourselves in our ability to attract highly qualified, academically curious applicants who believe in the six core values of Cleveland Clinic; compassion, integrity, teamwork, quality, innovation, and service. One of the strengths of our program is the diverse population we serve. Cleveland Clinic is a 1,400 bed quaternary referral center which serves local, regional and international patients, allowing trainees to gain expertise in a wide spectrum of diseases.
The nephrology critical care experience is unparalleled, as our 250 ICU has one of the highest acuity scores in the nation. The Cleveland Clinic Transplant Center offers one of the most comprehensive programs in the world, and kidney transplant accounted for 266 transplants in 2020. Additionally, fellows have electives in our ambulatory subspecialty clinics - hypertension, glomerular, lupus, stone, transplantation, hemodialysis, and home therapy. Our department leverages this large clinical volume to build databases for epidemiological study in conjunction with NIH funded and nationally recognized research in Chronic Renal Insufficiency Cohort (CRIC), Kidney Precision Medicine Project (KPMP), Clinical Trials of Organ Transplantation (CTOT), APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO), Systolic Blood Pressure Intervention Trial (SPRINT), and the Chronic Kidney Disease Registry.
The strength of our fellowship education is the high quality, comprehensive, daily didactics delivered throughout the year. Fellow education and mentorship is a departmental effort provided by experienced staff members with varied subspecialty clinical experience and research expertise. Fellow involvement in our program evaluation committee allows us to continue to innovate our training program. First year fellows begin their training with a one month orientation, which includes introductory nephrology courses, hands-on experiences, simulation center curriculum, and shadowing second year fellows through all three of our on-site core inpatient rotations. We intentionally integrate ample scholarly activity and self-directed learning in between core rotations and limit weekend call to once a month.
Interested applicants who have completed a three year ACGME accredited Internal Medicine Residency should apply through the electronic application service (ERAS).
We believe our program offers unparalleled training that will allow you to reach your goal of developing into an outstanding nephrologist. Please review our website and contact us to learn more about our program.
Jonathan Taliercio, DO, FASN
Program Director, Nephrology and Hypertension Fellowship
Georges Nakhoul, MD, MEHPE, FASN
Associate Program Director, Nephrology and Hypertension Fellowship
Cleveland Clinic’s Nephrology and Hypertension Fellowship Program is a two-year ACGME training program which successfully recruits four fellows per class. The class of 2022 has expanded to 5 fellows. We offer two training tracks:
- Categorical Track - a traditional two year training program in Nephrology and Hypertension with an emphasis on development of clinical and research skills.
- Research Track - The Cleveland Clinic and partners has been awarded the U2C/TL1 grant by the National Institute of Health to cultivate young trainees and early career investigators to develop careers in research. During the first year of nephrology training, qualified fellows will have the opportunity to apply for an additional 2 years of scholarly activity.
- AST Transplant Fellowship - a one year fellowship accredited by American Society of Transplantation (AST). Applicants must have completed a two year ACGME general nephrology fellowship prior to acceptance into the program.
Cleveland Clinic is a quaternary referral center. Fellows have the unique opportunity to work with world-renowned experts on rare nephrological disorders, in addition, to serving residents of Northeast Ohio. The Department and Faculty are recognized for their expertise in research, acute kidney care, resistant hypertension, glomerulonephritis, transplantation, renal genetics, and stone disease.
The Nephrology and Hypertension Department has formed several collaborations with many disciplines to provide comprehensive medical care.
The Stone Clinic is composed of a multidisciplinary team of nephrologist and urologist specializing and investigating metabolic profiles, urine acidification testing, kidney stone prevention, and surgical treatment options.
The Glomerulonephritis (GN) Clinic and Lupus Clinic combines the expertise of a nephrologist, trained renal pathologists, and rheumatologist appointed to the Center for Vasculitis Care to diagnosis, treat, and enroll patients in clinical trials.
The Hypertension Clinic, designated as a Comprehensive Hypertension Center by the American Society of Hypertension, is staffed by certified hypertensive specialists to care for with resistant hypertension. The hypertension laboratory is equipped to diagnosis and treat patients with blood pressure disorders using remote monitoring, 24-hour ambulatory blood pressure measurements (ABPM), IV salt load, captopril testing, and noninvasive impedance cardiography to assess neurohumoral profiles and hemodynamic parameters.
The Renal Genetics Clinic, led by a medical geneticist and genetic counselors, offers patients the most advanced genetic testing to help diagnosis and treat patients with a rare conditions.
The trainees critical care experience is exceptional as the hospital boast one of the highest acuity scores in the nation with approximately 250 intensive care beds. Trainees develop expertise in caring for patients with acute kidney injury and other fluid and electrolyte s disturbances in various intensive care units (medical, cardiac, cardiovascular heart failure, liver, neurological, and surgical). Fellows will employ the full complement of renal replacement therapies (RRT) in conjunction with other life-supporting machines such as extracorporeal membrane oxygen support (ECMO), ventricular assist devices (VAD), and intra-aortic balloon pump (IABP).
The Cleveland Clinic Kidney and Pancreas Transplant Center performed 266 transplants in 2020. General nephrology fellows and the third year transplant fellow care for patients as members of a fully integrated, multidisciplinary medical and surgical transplant team in the hospital and ambulatory clinic. Cleveland Clinic’s heart, liver, lung, intestine, and bone marrow programs provide comprehensive experience in managing renal related complications in other solid organ transplanted patients.
- Weekend Call
- Divided equally among all fellows and average one weekend per 5 weeks.
- Two fellows are assigned to call on the weekend; an ICU fellow and a nephrology/transplant consult floor fellow.
- Additional trainees help provide daytime coverage by seeing new consults and established patients.
- Night Float System/Weekday Call
- Fellows will participate in an AT-HOME night float system designed to improve trainee well-being and optimize fellow performance during regular scheduled work hours.
- Night float will occur in two week block intervals.
- First and second year fellows will have a total of 4 and 6 weeks respectively.
- The night float fellow will be responsible for addressing only urgent nephrological issues that arise beginning Monday night through Friday morning. Friday through Sunday night coverage will be provided by the weekend fellows.
History of the Department of Nephrology and Hypertension
Dr. Irvine Page arrives at Cleveland Clinic and uncovers the link between high blood pressure and heart disease. He isolates two key peptides in hypertension - angiotensin and serotonin.
Dr. Willem J. Kolff develops the first widely used artificial kidney using a shell of a washing machine at Cleveland Clinic.
Dr. Harriet Dustan and Eugene Poutasse originated renovascular surgery for the treatment of hypertension.
In1958, the new Department of Hypertension and Renal Disease was formed with Dr. David C. Humphrey as chairman. Dr. Humphrey served from 1958 to 1970.
Dr. Magnus O. Magnusson pioneered research in kidney preservation, lengthening the waiting time to find suitable transplant donors for recipients.
Cleveland Clinic performs its first cadaveric kidney transplant.
Dr. Willem Kolff develops the twin coil artificial kidney out of a peach can and 10 meters of cellophane. He is later named Head of Cleveland Clinic’s Department of Artificial Organs.
Cleveland Clinic performs peritoneal dialysis as a temporizing measure prior to hemodialysis.
Dr. William Braun establishes the histocompatibility laboratory for kidney transplantation.
Cleveland Clinic’s Board of Governors officially establishes the Department of Hypertension and Nephrology and appoints Dr. Ray Gifford chairman. He served in the role from 1970 to 1985 and again from 1991 to 1992.
Dr. Emmanuel Bravo established the Endocrine-Hypertension Research Lab to study pheochromocytoma and primary aldosteronism making the Cleveland Clinic the largest clinical center studying these complexes disease.
Dr. William Braun is appointed Chief of the Renal Transplantation Section at Cleveland Clinic, where the 450th kidney transplant is performed.
Dr. Phillip Hall heads the first glomerular filtration rate (GFR) test which is performed in Cleveland Clinic’s Renal Function Lab, and later becomes the gold standard for measuring renal function.
Cleveland Clinic is first in the United States to perform continuous dialysis therapy, in parallel with doctors in Germany.
Dr. Emil Paganini and Dr. Satoru Nakamoto (pictured) perform the first slow continuous ultrafiltration in the ICU.
Dr. Don Vidt was appointment chairman of the Department of Hypertension and Nephrology and led the department from 1985 to 1991.
Dr. Joe Nally joins the Cleveland Clinic and studies captopril renography to help diagnosis renovascular hypertension.
Dr. Vincent Dennis was appointment chairman of the Department of Nephrology and Hypertension. He served from 1992 to 2001. The department consisted of 14 members.
Cleveland Clinic participates in the Collaborative Study Group, formerly LNSG, investigates the use of ACE inhibitor (captopril) to treat type I diabetic nephropathy. The landmark trial revolutionizes the treatment of kidney disease.
Dr. Emil Paganini (pictured) and Dr. Charuhas Thakar develop the risk assessment score used to predict acute kidney injury in the ICU at Cleveland Clinic.
The Collaborative Study Group studied the effects of ARB inhibitor (irbesartan) on DM2 (IDNT Study) and publishes its results in the New England Journal of Medicine
|2010 to present
Dr. Jonathan Taliercio is the principle investigator for the NIH funded landmark study Chronic Renal Insufficiency Cohort Study (CRIC). He is also a co-investigator for the NIH funded Kidney Precision Medicine Project (KPMP). He was awarded the NIH funded CRIC-KPMP grant which helps integrate the funding of these 2 landmark studies in order to promote kidney health.
The Cleveland Clinic Lerner College of Medicine (CCLCM) was established between the Cleveland Clinic and the Case Western Reserve University (CWRU) with $100 million gift. The first call was enrollment in 2004. It is a five year tuition free program designed to develop physician researchers. In 2019, CCLM will move to its new Health Education Campus where medical, nursing, dental medicine and physician assistant students will engage in collaborative, interprofessional learning. Dr. Nally and Dr. Hall were instrumental in developing the highly regarded nephrology and hypertension problem based learning curriculum.
Cleveland Clinic’s publishes in Kidney International its initial results using a bioartificial kidney with a renal tubule assist device to treat acute renal failure patients in the ICU.
Dr. Martin Schreiber served as chairman of the Department of Nephrology and Hypertension from 2005 to 2012.
Dr. William Fissell is awarded a $3.2 million grant to develop the bioartificial kidney at Cleveland Clinic.
The Glickman Tower is completed and becomes the new home of the Glickman Urological and Kidney Institute, which includes the Department of Nephrology and Hypertension.
|2009 to present
Dr. Joseph Nally develops the Chronic Kidney Disease Registry which is an electronic medical record database used to study the epidemiological of CKD disease. The CKD registry has over 150,000 patients with CKD. There are over 25 publications to date dedicated to scientific links between CKD and cause of death.
The Cleveland Clinic was a participating site for the landmark NIH trial Systolic Blood Pressure Intervention Trial (SPRINT) Study. This study results had an instrumental role in changing blood pressure management guidelines to a more intensive strategy.
Dr. Robert Heyka served as chairman of the Department of Nephrology and Hypertension from 2012 to 2021.
|2013 to present
Dr. James Simon is on the medical advisory committee for the Alport’s Syndrome Foundation. His expertise is in the diagnosis and management of Alport’s disease in females.
|2014 to present
Dr. Leal Herlitz joined the Cleveland Clinic as the Director of Medical Kidney Pathology and is the site pathologist for the NIH sponsored Kidney Precision Medicine Project. She has been instrumental in developing the nephrology fellowship pathology experience.
|2015 to present
Dr. George Thomas, who also served as the SPRINT principle investigator, was fundamental in establishing the department as a designated Comprehensive Hypertension Center by the American Society of Hypertension.
|2017 to present
Dr. John Sedor joins the Department of Nephrology and Hypertension as the director of research. He is a national leader in APOL1 research and is the principle investigator for the NIH funded Kidney Precision Medicine Project (KPMP). The KPMP mission is to create a kidney atlas, define disease subgroups, critical cells, pathways, and targets for novel therapy. He is Chair of KidneyX, a public private partnership to accelerate innovation, prevention and treatment of kidney disease.
|2017 to present
The Cleveland Clinic participates in two NIH funded multicenter trials; CureGN and NEPTUNE Study. Both studies are committed to the longitudinal study of podocytopathies, response to therapy, and disease progression, with the ultimate objective to cure glomerulonephropathy. Dr. John O’Toole serve as the principle investigator.
|2018 to present
Dr. Georges Nakhoul was awarded the William and Sandra Bennett Scholar grant from the American Society of Nephrology (ASN). This award is granted for those re-shaping the renal curriculum for the future. He is actively working on a virtual learning platform of the nephron.
|2019 to present
Dr. Emilio Poggio is awarded NIH funding for APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) Study. The prospective study is assessing the effects of renal-risk variants in the apolipoprotein gene. He also serves as the principle investigator for Clinical Trials in Organ Transplantation (CTOT).
2021 to present
Training and Curriculum
First Year Fellow Schedule
The fellowship begins with a popular four-week orientation program, followed by four-week modules. The first year is aimed at developing a strong fundamental in clinical inpatient nephrology. First year fellows will have eight inpatient experiences, rotating in each of the three core hospital services - general nephrology consults, renal transplant service, and intensive care nephrology teaching consults. The remainder of the year is comprised of two research modules and an ambulatory VA clinic module.
- Orientation (1 module)
- General Nephrology Consults (3 modules)
- Intensive Care Nephrology Teaching Consults (2 modules)
- Kidney Transplantation Service (Primary and Consultative)(3 Modules)
- At Home Night Float (1 module)
- Research (2 modules)
- Interventional Nephrology (2 weeks)
- VA Ambulatory Clinic (1 module)
- Outpatient In-center Hemodialysis and Home Therapies
- Longitudinal Ambulatory Clinic (1/2 day once a week)
Second Year Fellow Schedule
The second year of training is designed to hone ambulatory acumen and foster future career goals. Fellows will have approximately two rotations in one of the three core inpatient hospital experiences. Additional inpatient experiences include apheresis, renal pathology, kidney biopsy, and interventional nephrology. There are approximately seven research modules. Second year longitudinal experiences include kidney transplant clinic, ambulatory specialty clinic, and outpatient in-center hemodialysis and home dialysis therapies.
- General Nephrology Consults (1 module)
- Primary Transplant Service and Ambulatory Transplant Clinic (1)
- At Home Night Float (1.5 module)
- Research (7 modules)
- Kidney Biopsy (1 module)
- Apheresis (0.5 module)
- Renal Pathology Rotation (0.5 module)
- Longitudinal Ambulatory Clinic (1/2 day once a week)
- Outpatient In-center Hemodialysis and Home Therapies
- Kidney Genetic Clinic
- VA Ambulatory Clinic
- Ambulatory Specialty Clinic
- Interventional Nephrology
Descriptions of Rotations
General Nephrology Service Consults
The general nephrology service provides consultation to patients who reside on the regular nursing floors of Cleveland Clinic’s 1,400 bed quaternary referral center. This experience is revered by our department and fellows due to the wide spectrum of disease discovered. The fellow will gain expertise in diagnosing and managing hospitalized patients with acute kidney injury, advanced chronic kidney disease, electrolyte and acid-base disorders, vasculitis or other autoimmune disorders, podocytopathies, severe hypertension, pre-operative risk assessment, and peritoneal dialysis. Fellows develop leadership and team management skills while working with residents and medical students who also rotate on this service.
Intensive Care Nephrology Teaching Consults
The nephrology critical care experience is unparalleled, as our 250 ICU beds have one of the highest acuity scores in the nation. The department performed > 9,403 days of continuous renal replacement therapy (CRRT), > 11,051 intermittent hemodialysis sessions and 1,234 peritoneal dialysis sessions in 2020. The intensive care nephrology teaching consult service provides renal consultation to many multiple-disciplinary ICU units (cardiothoracic, cardiac, heart failure, medical, surgical, vascular, neurology). On this rotation, the fellow will gain competency in body fluid balance, electrolytes disturbances, and acid base disorders. The fellow will become proficient in the diagnoses and management of acute kidney injury in the ICU patient, including post-operative care and multi-organ failure disorders such as sepsis, cardiorenal, hepatorenal, and renal pulmonary disease. The fellow will also gain experience with various acute intermittent and continuous renal replacement therapies (CRRT) such as (CVVHD, CVVHF, CVVHDF, SCUF) and the use and limitations of peritoneal dialysis in the ICU patient. The trainee will learn how to seamlessly use dialysis modalities in conjunction with other lifesaving ancillary modalities such as ventricular assist devices (VAD) and extracorporeal membrane oxygenation (ECMO). The fellow will work directly with the nephrology staff, in addition to interacting with a variety of medical and anesthesiologist intensivists and surgeons.
Kidney Transplant Experience
Cleveland Clinic’s kidney transplant program was founded in 1963 and since that time more than 3,000 kidney transplants have been performed; approximately 160 per year. The Transplant rotation is the major venue for fellow’s exposure to hospitalized transplant patients. The kidney transplant experience is divided into two rotations.
- The Transplant Primary Service cares for kidney and pancreas transplant patients admitted to the transplant service. The service is composed of the surgical and medical transplant team. The medical team consists of a transplant nephrology staff, third year nephrology transplant fellow, and the general nephrology fellow. Patients on the service are those who are to receive a kidney and/or pancreas, or recent transplant recipients who are hospitalized for an allograft related complication such as rejection and infection. Fellows will round on them in the morning and gain competency in diagnosing and managing acute and chronic rejection, immunotherapy, infections, and malignancy including post-transplant lymphoproliferative disorder (PTLD). There are no additional call responsibilities associated with the primary service. General nephrology fellows are not responsible for admitting, discharging, or completing medical reconciliations. In the afternoon, the fellow will attend the ambulatory transplant clinics where they will have the opportunity to evaluate kidney donors and recipients, manage patients < 3 years out from transplant, address chronic immunosuppression medications, attend the pre-transplant evaluation clinic, transplant selection committee meetings, and transplant pathology rounds
- The Transplant Consult Service provides nephrological expertise for all inpatient kidney and/or pancreas transplant patients not on the Transplant Primary Service, other solid organ transplants (heart, lung, liver, intestine), and bone-marrow transplants. Fellows with gain the experience of managing immunosuppression medication and associated complications, evaluate for kidney transplant in hospitalized patients, and address other nephrological needs. Fellows have the opportunity to attend transplant selection committee meetings, and transplant pathology rounds. The Transplant Consult Service consist of the transplant nephrology staff, a general nephrology fellow, residents, and medical students.
Scholarly activity is vital for the fellow’s professional development. To foster investigation, 10 research modules are included in the 26-module fellowship. Fellows are paired with research mentors early in their training to help complete one mandatory research project and to work on additional projects to enhance their academic portfolio before graduation. First and second year fellows will present their work at the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) meetings, respectively. The program has monthly research conferences to provide guidance in determining feasibility, study design, analytics, and methodology. Fellows will have access to use several large nationally recognized registries such as CKD registry, Acute Kidney Injury Registry, and the UNOs transplant registry. Many on the nephrology staff serve as principle investigators of major NIH funded trials; Chronic Renal Insufficiency Cohort Study (CRIC), Kidney Precision Medicine Project (KPMP), Clinical Trials of Organ Transplantation (CTOT), and APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO), and Systolic Blood Pressure Intervention Trial (SPRINT). Please refer to the Research tab to see a complete description and listings of all the research being conducted in the nephrology department. Fellows who plan to pursue a career in research can apply for the Case Western Reserve University-Cleveland Clinic T32 clinical research fellowship grant, which supports one eligible position per year and offers the opportunity for two additional years of funded research.
Ambulatory Specialty Clinics
Fellows have the opportunity to work with leaders in the field of nephrology in several specialized clinics to tailor their expertise and future career interest. Available electives include:
- Stone Clinic
- Hypertension Clinic
- (Designated as a Comprehensive Hypertension Center by the American Society of Hypertension)
- Glomerulonephritis (GN) Clinic
- Lupus Clinic
- Kidney Transplant Clinic
Outpatient In-Center Hemodialysis and Home Therapies
This longitudinal experience allows fellows to gain competency in the care of an end stage renal disease patient in various outpatient setting such as in-center and nocturnal hemodialysis, home hemodialysis, and peritoneal dialysis. The experience is split into two components; in-center hemodialysis experience and home therapy dialysis (peritoneal dialysis and home hemodialysis). Expectations are different based on the level of training. Fellows will learn how to initiate and modify dialysis prescriptions based on adequacy, learn and adjust protocols for bone mineral disease and renal anemia, evaluate and manage medical complications associated with dialysis, access monitoring, evaluate PET testing, and participate in care plan meetings. Fellow will learn the responsibilities of the medical director such as water treatment, quality improvement, and other regulatory processes.
Longitudinal Ambulatory Clinic
Trainees have a half day a week of on-site clinic throughout the two-year fellowship. Fellows will learn the honor of being the patient’s doctor. Patients are scheduled with the fellow and view the fellow as their primary nephrologist. Consistent preceptors are paired with a fellow for six-month intervals providing guidance, education, and supervision of all clinical interactions.
VA Ambulatory Clinic and Quality Improvement Project
The VA rotation provides two experiences; a faculty supervised ambulatory clinic and an enriched quality improvement/research project (QI/RP). Fellows will have the privilege of managing veterans with a wide spectrum of renal pathology. Fellow’s with be expected to diagnosis and treat patients with CKD, hypertension, electrolyte and acid-base disorders and glomerulonephritis. Fellows will have the opportunity to work in a different healthcare delivery model and interact with other VA disciplines to help coordinate multidisciplinary care for their patients. The rotating fellow will be assigned 5 (1/2 day) outpatient nephrology clinics. The remaining time will be used for a longitudinal QI/RP to help promote scholarly activity.
Interventional Nephrology Experience
Fellows will learn from formally trained interventional nephrologists for the placement, exchange, or extraction of non-tunneled and tunneled lines using fluoroscopy and ultrasound. In 2020-21, we will continue to expand our interventional experience to include percutaneous endovascular procedures to manage dysfunctional arteriovenous fistulas or grafts, address, insertion of peritoneal dialysis catheters, ultrasonography of kidneys, and ultrasound-guided renal biopsy. We are proud to announce that the International Society of Nephrology (ISN) has recognized the Cleveland Clinic as an ISN Interventional Training Center. This peer reviewed designation requires training centers to demonstrate expertise in the field and meet a minimum threshold number of procedures.
Kidney Biopsy Rotation
This four-week rotation, completed in the second year of fellowship, allows hands on experience and competency in performing ultrasound guided percutaneous native and transplant kidney biopsies. In the first week, fellows will rotate with a radiologist to learn ultrasonography principles and practice knobology. In the remaining three weeks, the fellow will perform ultrasound guided percutaneous kidney transplant under the supervision of the radiologist.
This two week rotation in the Department of Hematology-Oncology occurs during the second year of fellowship. The trainee will gain expertise in transfusion medicine while working closing with apheresis staff. Educational objectives of the experience is to apply the American Society for Apheresis (ASFA) guidelines to various hematological and nephrological disease. The fellow will develop competency in identifying the indications, mechanics, complications, and prescribing of apheresis.
Renal Pathology Rotation
The Cleveland Clinic is an international reference laboratory that received over 2,500 renal biopsies from all over the world in 2019. The nephrology fellow has the opportunity to shadow a renal pathologist for a two-week rotation in their second year. The goal of this rotation is to consolidate the fellow’s renal pathology experience. The trainee will learn how to processes a kidney biopsy, apply standard stains, and use ancillary diagnostic techniques such as immunofluorescence and electron microscopy. Fellows are expected to become increasingly proficient at light microscopy and recognizing pathologic findings in native and transplant biopsies, such as diabetic nephropathy, podocytopathies, renal vasculitis, interstitial nephritis, and rejection. Trainees should be able to integrate clinical information with pathological findings to render an accurate diagnosis of commonly encountered medical renal disease.
Kidney Genetic Clinic
The Renal Genetic Clinic is an elective for fellows who would like additional exposure to both pediatric and adult patients with chromosomal and monogenic disorders. The Cleveland Clinic Genetic Clinic has experienced a 7 fold increase in patient volume since 2019. Fellows will collaborate with our nephrologist and medical geneticist, and medical counselors to help diagnoses and manage patients who have rare genetic diseases such as ADPKD, ARPKD, ADTKD, nephronophthisis, Alport syndrome, Fabry disease, Batter and Gitelman syndrome, aHUS, and Dent disease.
Cleveland Clinic Nephrology and Hypertension Fellowship Program has a two year revolving core conference series. There are a variety of hour-long conferences to meet all educational goals to foster expertise in the field of nephrology and hypertension. This curriculum offers a blend of traditional didactics, multi-disciplinary case conferences, and problem-based learning. Additional offerings include morbidity and mortality, quality improvement, practice management, healthcare finance, and transplant conference.
|Day of Week||Rounds/Lecture|
|Monday||Case Management Conference
Monthly Renal Pathology Conference
|Tuesday||Core Curriculum Conference
Monthly Renal Pathology Slide Review
|Wednesday||Nephrology Grand Rounds|
|Thursday||Problem-based Learning (PBL)
Home Therapy and Hemodialysis Lecture Series
Monthly Board Review
|Friday||Monthly Journal Club
Case Management Conference
This weekly conference addresses diagnostic or management dilemmas in nephrology and hypertension. Actual cases are presented by the staff who highlight teaching points through guiding questions. The fellow will present a short 30-minute literature review. Interactive discussion about the intricacies of the case and current standards of care are exchanged between attendees.
Monthly Renal Pathology Conference
Cleveland Clinic is an international reference laboratory that receives over 1,300 renal biopsies from across the world in 2018. Every month, the renal pathologist will select interesting teaching cases and present the biopsy images to the department. The pathologist will present a didactic on each case presented. Diagnostic and therapeutic management considerations are discussed between staff and fellows.
Core Curriculum Conference
This two-year rotating traditional didactic focuses on educating fellows on the full spectrum of nephrology and hypertension. Topics include renal physiology, fluid and electrolytes disorders, glomerular disease, hypertension, hereditary disease, transplantation, acute kidney injury, chronic kidney disease, and stone disease. Distinguished faculty from the Glickman Urological and Kidney Institute and other departments present on various areas of expertise.
Monthly Renal Pathology Slide Review
This monthly hands on experience enables the fellow to navigate and examine native and transplant kidney biopsy using a multi-headed microscope with a renal pathologist. Fellows will also learn how to read patterns of immunofluorescence and electron microscopy findings. Trainees will be able to integrate clinical information with histological features to render an accurate diagnosis for common medical diseases.
Nephrology Grand Rounds
Fellow’s will give one grand rounds per year. The fellows is expected to identify an area of interest for self-discovery, undertake an extensive literature search, and present the topic in an organized, concise forum to peers and staff.
Problem-based Learning (PBL)
Fellows are presented with medical cases which are partnered with Tuesday’s core curriculum conference. Case-based scenarios engage trainees to use problem-solving and team participation skills in acid-base disorders, electrolytes disturbances, hypertension, apheresis, and toxicology.
Home Therapy and Hemodialysis Lecture Series
This lectures series combines the fundamentals concepts and physiological principles of peritoneal dialysis, home hemodialysis, and hemodialysis modalities. Fellows learn about urea kinetic modeling, dialysis adequacy, prescription writing, dialysis apparatus, water treatment, medical director responsibilities, access management, and complications of dialysis.
Monthly Board Review Conference
This staff run board review conference uses current nephrology and hypertension questions and answers to help with board preparation. For more than ten years, the department has had a 100% pass rate for the American Board of Internal Medicine (ABIM) Certification Exam in Nephrology and Hypertension.
This monthly conference exposes fellows to important current research in nephrology and hypertension and gives them the experience to critically appraise published literature.
Biostatistics Club Conference
This monthly conference introduces fellows to the basics of medical statistics, study design, and research methodology to help augment journal club and other scholarly endeavors.
This monthly conference focuses on promoting fellow research and supporting their efforts in completing a research study. Fellows will be mentored in project resources, feasibility, development, execution, and manuscript writing with the goal of publication. Fellows will present their work at the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) clinical meetings.
This three session conference exposes the fellow to basic financial principles of healthcare. The goal of the conference is to help the fellow appreciate different practice models, current healthcare regulation, organizational structure, and financial impacts. This conference is led by staff with Master’s in Business Administration (MBA) degrees in healthcare.
Georges Nakhoul, MD
Associate Director, Nephrology and Hypertension Fellowship Program
- Amir Alamir, MD
- Nuzhat Ashai, MD
- Joshua Augustine, MD
- Juan Calle, MD
- Diana Deitzer, DO
- Sevag Demirjian, MD
- Christi Dhayanandhan, MD
- Richard Fatica, MD
- Crystal Gadegbeku, MD
- Robert Heyka, MD
- Leal Herlitz, MD
- Anne Huml, MD
- Roulan Abu Hweij, MD
- Daniel Kahn, DO
- Cassandra Kovach, MD
- Rhyan Maditz, DO
- Jerin Mathew, MD
- Ali Mehdi, MD
- Matthew McGuire, MD
- Joseph Nally, MD
- Saul Nurko, MD
- John O’Toole, MD
- Emilio Poggio, MD
- Laura Provenzano, MD
- Hernon Rincon, MD
- Jesse Schold, PhD
- John Sedor, MD
- Roman Shingarev, MD
- James Simon, MD
- Brian Stephany, MD
- George Thomas, MD
- Tushar Vachharajani, MD
- Xiangling Wang, MD, PhD
- Leslie Wong, MD
- Ziad Zaky, MD
Class of 2022
|Hanny Sawaf - Chief Nephrology Fellow
Medical School: Saba University School of Medicine
Residency: TriHealth-Good Samaritan Hospital
Awards/Honors: IM Chief Medical Resident, ASN Award Recipient, Multiple time University of Kansas CLAS Honor Roll/Honor Roll member, Speaks Arabic
Medical School: American University of Beirut
Residency: Saint Louis University School of Medicine
Awards/Honors: 1st Place Award for Best "Senior Resident Grand Round" at Saint Louis University (2020). Resident of the month (10/2017). Graduated with distinction B.S Biology (2003). Distinction: Medicine II (2007)-American University of Beirut.
|Xin Yee Tan
Medical School: Palacky University Olomouc, Czech Republic
Residency: Lincoln Medical Center, NY
Awards/Honors: IM Chief Medical Resident, 2021 ASN NTSD Work Group,Speaks Mandarin, Cantonese, Malay.
Class of 2023
Medical School: Jagiellonian Universiy Medical College, Krakow, Poland
Residency: Quinnipiac University St. Vincent's Medical Center. Bridgeport, CT
Awards/Honors: Categorical Intern of the Year (2019). Junior Resident of the Year (2020). St. Louise de Marillac Resident of the Year Award (2020).PGY3 Chief Medical Resident (2020-2021). ASN STARS Recipient (2020). Multi-Disciplinary Conference Presentation Commendation Award (2020). St. Vincent's Science Symposium 1st Place Case Vignette Presentation (2021). Arsenal FC Supporter. Speaks Polish. Cześć! Canadian.
Medical School: Hawassa University, Sidama, Ethiopia
Residency: Mercy Hospital and Medical Center, Chicago, USA
Awards/Honors: Best Graduate in Extracurricular Activities, Hawassa University, Best General Practitioner. Top fourth Research paper presenter at Mercy Hospital
|Liza Cholin - 3rd Year Nephrology Research Fellow
Medical School: University of Toledo College of Medicine
Residency: University of Louisville
Nephrology and Hypertension Fellowship: Cleveland Clinic
Awards/Honors: T32 NIH recipient, former Chief Nephrology Fellow. Speaks Bulgarian
|Yuliya Sharakova||2019-2021||Premier Renal Care, OH|
|Mohamed Hassanein||2019-2021||University of Mississippi, MS|
|Rahul Kumar||2018-2020||Nephrology/Critical Care: Wellstar Health System, Georgia|
|Roulan Abu Hweij||2018-2020||Cleveland Clinic, OH|
|Rhyan Maditz||2018-2020||Cleveland Clinic, OH|
|Ali Mehdi||2018-2020||Cleveland Clinic, OH|
|Bushra Syed||2017-2020||University of Mississippi, MS|
|Anum Malik||2017-2019||Cleveland VA, OH|
|Rami Azem||2017-2019||Azem Inc, OH|
|Tarek Ashour||2017-2019||Cleveland Clinic, OH|
|Rebecca Blonsky||2016-2018||Marshfield Hospital, WI|
|Samir Brahmbhatt||2016-2018||Nephrology Associates, OH|
|Gayatri Nair||2016-2018||North Shore University Hospital, NY|
|Adedeji (DJ) Sodeinde||2016-2018||North Coast Nephrology, OH|
|Yvonne El Kassis||2015-2017||University of Pennsylvania|
|Arani Nanavati||2015-2017||Iowa Kidney Physicians PC, IA|
|Arjun Sekar||2015-2017||Associates in Kidney Care, IA|
|Masaaki Yamada||2015-2017||University of Iowa/Iowa VA|
|Taran Kaur||2014-2016||UC Health, OH|
|Minesh Rajpal||2014-2016||Southwest Kidney Institute, AZ|
|Reejis Stephen||2014-2016||Southwest Kidney Institute, AZ|
|Saurabh Dasgupta||2014-2016||Mdics At Calvert Llc, MD|
Nephrology and Hypertension Fellowship Program Application Process
Cleveland Clinic’s nephrology fellowship participates in the National Resident Matching Program (NRMP). Applications are only accepted through the Electronic Residency Application Service (ERAS). All applicants must complete a three year ACGME Internal Medicine Residency Program. We welcome trainees on J1 and H1 visas.
For additional information about our Nephrology and Hypertension Fellowship Program, please contact:
Nephrology and Hypertension Fellowship Program
Cleveland Clinic Department of Nephrology and Hypertension
9500 Euclid Avenue / Q7
Cleveland, OH 44195
Email: [email protected]
All applicants to the Nephrology fellowship program are required to register with the (NRMP) and require the following:
- A completed ERAS common application form
- A minimum of three letters of recommendation, one from your internal medicine program director
- USMLE or COMLEX transcript – Step 1,2,3, and clinical skills (CS)
- ECFMG (for foreign medical school graduates)
- Personal statement
- June 23, 2021: ERAS Access opens for Programs
- July 7, 2021: Candidates begin submitting applications
- July 21, 2021: Programs begin reviewing applications. All interviews will be conducted virtually
- August 25, 2021: Match Opens
- September 29, 2021: Ranking Opens
- November 17, 2021: Ranking Closes
- December 1, 2021: Match Day
Transplant Fellowship Application Process
Cleveland Clinic’s Nephrology and Hypertension Fellowship Program also offers a one year fellowship by the American Society of Transplantation (AST) for all interested applicants who have completed a two year ACGME general nephrology fellowship. Interested candidates should contact Brian Stephany, MD at 216.444.5382 or at [email protected].
The following are active NIH funded studies.
- COPE-AKI: Caring for OutPatiEnts after Acute Kidney Injury (COPE-AKI), Dr. J. Sedor, Dr.S. Demirjian, Dr. A. Huml
Summary: Acute kidney injury (AKI) is associated with high morbidity, risk of chronic kidney disease (CKD), end-stage kidney disease (ESKD), cardiovascular disease, and mortality. There is limited evidence to inform recommendations for processes of care or therapeutic interventions targeting progression of kidney disease and the associated morbidity and mortality in AKI survivors. Cleveland Clinic is 1 of 3 Clinical Centers that will develop and test interventions that aim to reduce morbidity compared with usual care in Stage 2 and 3 AKI survivors.
- CRIC/Chronic Renal Insufficiency Cohort Study, Dr. J.Taliercio
Summary: The Chronic Renal Insufficiency Cohort (CRIC) Study is a longitudinal observational study of 5,500 CKD patients originally aimed to study novel predictors of CKD progression and to elucidate the risk and manifestations of cardiovascular disease.The study has become a national resource for investigation of a broad spectrum of CKD-related topics, promoting many young investigators, and fostered international collaborations focused on understanding the global burden of CKD.
- Treg Adoptive Therapy in Subclinical Inflammation in Kidney Transplantation (CTOT-21), Dr. E. Poggio
Summary: This is a randomized open-label trial to determine the safety and efficacy of a single dose of autologous polyTregs or darTregs in renal transplant recipients with SCI in the 3-7 months post-transplant allograft biopsy compared to control patients treated with CNI-based immunosuppression.
- Regulatory T cell Modulation in Kidney Transplantation with Biologic Blockade of Dual Effector Pathways, CD28 and IL-6 (CTOT-24), Dr. E. Poggio
Summary: This is a multi-center, open-label, pilot, single arm trial that is looking to enroll 10 living donor renal transplant recipients to evaluate the safety of lulizumab pegol (BMS 931699) as a novel immunosuppressive regimen using anti-thymocyte globulin (rabbit) (ATG), steroids, Nulojix (belataceot), Actemra (tocilizumab) and Zortress (everolimus).
- Kidney Precision Medicine Project (KPMP), Dr. J. O'Toole
Summary: The Kidney Precision Medicine Project (KPMP) is a prospective cohort study, whose goal is to use deep molecular phenotypes of kidney biopsies, along with longitudinally collected clinical phenotypic data, in order to develop new disease ontologies, classification systems, and treatments for acute kidney injury (AKI) and chronic kidney disease (CKD).
- APOL 1 Studies in Kidney Transplant (ASK-CCC) and APOL1 Long-term Kidney Transplantation Outcomes Network, Dr. E. Poggio
Summary: This study is being done in an attempt to improve outcomes after kidney transplantation and to improve the safety of living kidney donation based upon variation in the apolipoprotein L1 gene (APOL1)
The following study is currently enrolling:
- Validation of genomic immune-phenotyping profiles in peripheral blood gene signatures to predict risk of kidney transplant rejection, Dr. J. Augustine
Summary: The aim of the clinical study is to validate the prognostic and/or diagnostic performance characteristics of the mRNA transcriptomic immune-phenotyping signatures of the Verici Dx sequencing assay-generated expression profiles with algorithm-generated risk scores in transplant recipients
- Illuminate –A Phase 3 Study to Evaluate the Efficacy and Safety of Lumasiran in Children and Adults with Primary Hyperoxaluria Type 1, Dr. J. Calle
Summary: This is a multicenter, multinational Phase 3 study designed to evaluate the efficacy and safety of lumasiran in patients with PH1 ≥ 6 years of age with relatively preserved renal function.
- A phase 3 trial of the efficacy and safety of bardoxolone methyl in patients with autosomal dominant polycystic kidney disease, Dr. R. Fatica
Summary: This international, multi-center, randomized, double-blind, placebo-controlled Phase 3 trial will study the safety, tolerability, and efficacy of bardoxolone methyl in qualified patients with ADPKD.
- Halting Myocardial Fibrosis with Kidney Transplantation (Hy-Fi), Dr. A. Huml
Summary: This study aims to measure the amount of cardiac fibrosis and stiffness before and after kidney transplantation using a blood tests and cardiac MRI.
- A Randomized, double blind, placebo controlled study to evaluate the efficacy and safety of Nefecon in patients with primary IgA nephropathy at risk of progressing to end-stage renal disease, Dr. J. Sedor
Summary: Seeks to evaluate the use of Nefecon (formulation of budesonide) in patients with primary IgA nephropathy who are at risk for progression to end stage renal disease.
- A multicenter international randomized parallel group double blind placebo controlled clinical trial of EMP Agliflozin once daily to assess cardio-renal outcomes in patients with chronic kidney disease, Dr. J. Sedor/ Dr. G. Thomas/Dr. J Taliercio
Summary: This randomized trial will compare empagliflozin 10 mg once daily versus matching placebo, given on top of standard of care, in around 5000 participants with established CKD, with or without diagnosed diabetes mellitus, who are being treated (where tolerated) with an appropriate dose of a renin-angiotensin system inhibitor
- A phase 2A multiple ascending, placebo-controlled study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of GFB-887, a TRPC5 channel inhibitor, in patients with diabetic nephropathy, focal segmental glomerulosclerosis, and treatment-resistant minimal change disease., Dr. J. Sedor
Summary: Seeks to develop a subtype-selective and potent transient receptor potential Canonical–5 (TRPC5) channel inhibitor, GFB-887, which offers the potential for targeted disease-modifying therapy for patients with diabetic nephropathy (DN), focal segmental Glomerulosclerosis (FSGS), and treatment-resistant minimal change disease (TR-MCD)
- A multi-center, randomized, double bind, placebo-controlled, parallel group, phase III study to evaluate the efficacy and safety of LNP023 in primary IgA nephropathy patients, Dr. J. O'Toole/Sedor
Summary: The study is designed as a multicenter, randomized, double-blind, placebo controlled study to demonstrate the superiority of LNP023 at a dose of 200 mg b.i.d. compared to placebo on top of maximally tolerated ACEi or ARB on reduction of proteinuria and slowing renal disease progression in primary IgAN patients
- A randomized, treatment open-label, dose- blinded parallel group, three arm, proof of concept clinical trial to investigate the efficacy and safety of LNP023 compared with rituximab in the treatment of subjects with idiopathic membranous nephropathy., Dr. J. Sedor
Summary: The purpose of this study is to ascertain the efficacy, safety, tolerability and pharmacokinetics of LNP023 over a 24-week treatment period compared with rituximab in subjects with MN.
- Precision medicine proof of concept trial for TNF inhibition in FSGS and treatment resistant minimal change disease, Dr. J. Sedor
Summary: This is a proof of concept, multi-center, open label, clinical trial to test the hypothesis that FSGS and treatment resistant MCD patients with up-regulation of the intra-renal tumor necrosis factor (TNF) pathway can be identified through gene expression profiling and urine biomarkers MCP1/Cr and TIMP1/Cr.
- An extended access program to assess long term safety of bardoxolone methyl in patients with chronic kidney disease, Dr. J. Simon
Summary: This extended access study will assess the long-term safety and tolerability of bardoxolone methyl in qualified patients with chronic kidney disease (CKD) who previously participated in a qualifying, clinical study with bardoxolone methyl.
- A phase 2, 12 week, adaptive, open label, sequential cohort trial to evaluate the efficacy, safety, tolerability and pharmacokinetics of PF-06730512 following multiple doses in adult subjects with focal segmental glomerulosclerosis (FSGS), Dr. J. Taliercio
Summary: The purpose of this Phase 2 adaptive study is to evaluate the efficacy, safety, tolerability and pharmacokinetics of PF-06730512 following multiple intravenous administrations in adult subjects with FSGS, the primary intention is to obtain an early indication of efficacy.
- A phase 3, randomized, double blinded, placebo controlled, multicenter study to evaluate the efficacy and safety of ravulizumab in adult participants who have thrombotic microangiopathy associated with a trigger, Dr. J. Taliercio
Summary: The objective of this study is to investigate the efficacy and safety of ravulizumab administered by intravenous (IV) infusion compared to placebo in adult participants with TMA associated with a range of triggers (hypertension, autoimmune, drug induced, solid organ transplant)
- Intercomex cFDNA-HLA-MMDx study, Dr. Z. Zaky
Summary: The study will compare DD-cfDNA, DSA, and MMDx in 300 prospectively collected biopsies for clinical indications, and validate that with 900 blood samples from American, European, Asian, and Australian centers, to calibrate the cf-DNA (Natera Inc.) levels against the MMDx biopsy diagnoses of T cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR, and its stages), and acute and chronic injury, and examine adjustments for DSA positivity.
- dd-cfDNA to Detect Rejection in HCV NAT+ Renal Allograft Recipients, Dr. Z. Zaky
Summary: The study will measure the performance of Natera’s Kidney transplant dd-cfDNA assay (Prospera) in recipients of HCV NAT+ kidney transplants in differentiating rejection from non-rejection using a 1% dd-cfDNA cut off
- Use of dd-cfDNA in multi-organ transplant rejection detection (MOTR), Dr. Z. Zaky
Summary: Seeks to better understand the ability of dd-cfDNA to detect rejection in multi-organ transplant patients
- Evaluation of patient outcomes from the kidney allograft outcomes Allosure registry (KOAR), Dr. Z. Zaky
Summary: The primary efficacy objective is to test the hypothesis that a strategy of monitoring for rejection using AlloSure results in a reduction in the number of renal biopsies performed when compared to a strategy of clinical care without the use of AlloSure.
- Evaluation of patient outcomes from the kidney allograft outcomes allosure registry: Outcomes of Kidney Care on renal allografts (OKRA), Dr. Z. Zaky
Summary: The primary efficacy objective is to test the hypothesis that a strategy of monitoring for rejection using AlloSure results in a reduction in the number of renal biopsies performed when compared to a strategy of clinical care without the use of AlloSure.
- TruGraf Long-term clinical Outcomes Study, Dr. Z. Zaky
Summary: This study is a prospective, multi-center, observational study. The goal is to evaluate post- transplant clinical outcomes in recipients of kidney transplants who are undergoing TruGraf and TRAC monitoring
- The Prospera Kidney Transplant Active Rejection Assessment Registry (Proactive), Dr. R. Fatica
Summary: Registry study using donor derived cell free DNA assay in kidney transplant recipients to predict presence of acute rejection. Patients are treated according to standard post-transplant care path protocols, with concomitant cell free DNA measures. The study will measure Natera’s cell free DNA product’s efficacy in predicting acute rejection. Study participant recruitment is ongoing.
The following study is in the start-up phase (not currently open):
- APOL 1 Pre-Eclampsia, Dr. J.O-Toole
Learn more about our nephrology and hypertension research.
Living in Cleveland
Cleveland, an ethnically diverse mid-sized city located on Lake Erie, features a host of cultural and recreational attractions. Cleveland Clinic is located near the University Circle area, which is the major cultural center in Cleveland. This area also features the Cleveland Orchestra, the Cleveland Museum of Art, several other museums, and Case Western Reserve University. Downtown Cleveland is approximately 2 miles from the Cleveland Clinic campus.