Kamyar Kalantar-Zadeh

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Kamyar Kalantar-Zadeh
Born (1963-10-10) October 10, 1963 (age 60)
Alma mater University of Bonn, University of Erlangen-Nuremberg, University of California, Berkeley
Known for Reverse epidemiology, nutrition in Kidney disease, incremental dialysis
Scientific career
Fields Nephrology, dialysis, epidemiology, nutrition, internal medicine, pediatrics,
Institutions University of California, Irvine School of Medicine, Harbor–UCLA Medical Center, UCLA School of Public Health

Kamyar Kalantar-Zadeh (born October 1963) is a US American physician doing research in nephrology, kidney dialysis, nutrition, and epidemiology. He is best known as a specialist in kidney disease nutrition and chronic kidney disease and for his hypothesis about the longevity of individuals with chronic disease states, also known as reverse epidemiology including obesity paradox. According to this hypothesis, obesity or hypercholesterolemia may counterintuitively be protective and associated with greater survival in certain groups of people, such as elderly individuals, dialysis patients, or those with chronic disease states and wasting syndrome (cachexia), whereas normal to low body mass index or normal values of serum cholesterol may be detrimental and associated with worse mortality. Kalantar-Zadeh is also known for his expertise in kidney dialysis therapy, including incremental dialysis, as well as renal nutrition. He is the brother of Kourosh Kalantar-zadeh, who is an Australian scientist involved in research in the fields of materials sciences, nanotechnology, and transducers.

Contents

Education

Kalantar-Zadeh received his education in medicine from the University of Bochum and University of Bonn (Germany) and his M.D. degree from the University of Erlangen-Nuremberg (Germany). [1] In addition, he obtained a master's degree in public health (Master of Public Health, MPH) and a PhD in epidemiology from the University of California, Berkeley. [1] He is a practicing triple board certified physician specialist in internal medicine, pediatrics, and nephrology. [1] Kalantar-Zadeh completed his residency at the State University of New York and his nephrology fellowship at the University of California, San Francisco. [1]

Career

Kalantar-Zadeh is a professor of medicine at the David Geffen School of Medicine at UCLA and based at the Lundquist Institute for Biomedical Innovation at Harbor–UCLA Medical Center (2000-2012, and since 2023), where he worked with his former mentor Joel D. Kopple and served as the founding director of the Harold Simmons Center for Chronic Disease Research and Epidemiology. During 2012-2022 Kalantar-Zadeh was in the University of California, Irvine School of Medicine as a tenured professor of medicine, pediatrics, public health, and Nursing Sciences, and chief of Nephrology, [1] and the UC Irvine Medical Center. He also serves as a part-time staff physician at Tibor-Rubin VA Medical center in Long Beach, California, under the Veterans Health Administration. Kalantar-Zadeh has remained a professor of epidemiology at Fielding UCLA School of Public Health. [2]

Kalantar-Zadeh has authored or coauthored over 1,100 research articles and reviews, which have been cited nearly 100,000 times, giving him an h-index of >150. [3] In addition, Kalantar-Zadeh was editor-in-chief of the Journal of Renal Nutrition, and is an associate editor of the Journal of Cachexia, Sarcopenia and Muscle, [1] Clinical Journal of the American Society of Nephrology., [4] and Clinical Nutrition, and a member of the editorial boards of the Nephrology Dialysis Transplantation , Kidney International , American Journal of Kidney Diseases , Nutrients , and several other peer reviewed journals in Nephrology and Nutrition. Kalantar-Zadeh is the past president of the International Society of Renal Nutrition and Metabolism and the past chair of the international steering committee of the World Kidney Day, and current president of the National Forum of the ESRD Networks, the coalition of the 18 congressionally mandated End Stage Renal Disease Program network organizations since 1978.

Kalantar-Zadeh first proposed reverse epidemiology in articles in the journal Kidney International in 2003 [5] and in the Journal of the American College of Cardiology in 2004. [6] It is a contradiction to prevailing concepts of prevention of atherosclerosis and cardiovascular disease. In an interview with Nature Magazine in 2016, Kalantar-Zadeh stated that obesity is like “that guy who led you to prison, [but] becomes your friend in prison." [7]

Kalantar-Zadeh has also contributed extensively to the fields of dialysis and kidney disease nutrition including an invited review paper in the New England Journal of Medicine in 2017 on nutritional management of chronic kidney disease, in that he recommends low protein diet for conservative management of chronic kidney disease to delay dialysis initiation but high protein diet for dialysis patients without residual kidney function. [8] Kalantar-Zadeh has published extensively on chronic kidney disease and end-stage renal disease including kidney dialysis with focus on incremental transition to dialysis therapy with initially less frequent hemodialysis treatment. [9] Kalantar-Zadeh has first-authored three review and perspective articles in the New England Journal of Medicine including a 2013 case records paper on metabolic acidosis due to metformin toxicity, [10] a 2017 renal nutrition review paper., [11] and a 2020 perspective article on ensuring choice for people with kidney failure. [12] as well as a 2021 review paper in The Lancet on kidney preserving therapy in persons with chronic kidney disease. [13]

Related Research Articles

<span class="mw-page-title-main">Nephrology</span> Medical study concerned with the kidneys

Nephrology is a specialty for both adult internal medicine and pediatric medicine that concerns the study of the kidneys, specifically normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy. The word "renal" is an adjective meaning "relating to the kidneys", and its roots are French or late Latin. Whereas according to some opinions, "renal" and "nephro" should be replaced with "kidney" in scientific writings such as "kidney medicine" or "kidney replacement therapy", other experts have advocated preserving the use of renal and nephro as appropriate including in "nephrology" and "renal replacement therapy", respectively.

<span class="mw-page-title-main">Kidney disease</span> Damage to or disease of a kidney

Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option.

<span class="mw-page-title-main">Chronic kidney disease</span> Medical condition

Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications can relate to hormonal dysfunction of the kidneys and include high blood pressure, bone disease, and anemia. Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization.

<span class="mw-page-title-main">Peritoneal dialysis</span> Type of dialysis

Peritoneal dialysis (PD) is a type of dialysis that uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure. Peritoneal dialysis has better outcomes than hemodialysis during the first couple of years. Other benefits include greater flexibility and better tolerability in those with significant heart disease.

<span class="mw-page-title-main">Metabolic acidosis</span> Medical condition

Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35. Acidemia and acidosis are not mutually exclusive – pH and hydrogen ion concentrations also depend on the coexistence of other acid-base disorders; therefore, pH levels in people with metabolic acidosis can range from low to high.

<span class="mw-page-title-main">High-protein diet</span> A diet high in protein

A high-protein diet is a diet in which 20% or more of the total daily calories come from protein. Many high protein diets are high in saturated fat and restrict intake of carbohydrates.

<span class="mw-page-title-main">Nephrectomy</span> Surgical removal of a kidney

A nephrectomy is the surgical removal of a kidney, performed to treat a number of kidney diseases including kidney cancer. It is also done to remove a normal healthy kidney from a living or deceased donor, which is part of a kidney transplant procedure.

Protein toxicity is the effect of the buildup of protein metabolic waste compounds, like urea, uric acid, ammonia, and creatinine. Protein toxicity has many causes, including urea cycle disorders, genetic mutations, excessive protein intake, and insufficient kidney function, such as chronic kidney disease and acute kidney injury. Symptoms of protein toxicity include unexplained vomiting and loss of appetite. Untreated protein toxicity can lead to serious complications such as seizures, encephalopathy, further kidney damage, and even death.

The Renal Support Network (RSN) is an American nonprofit, kidney patient-focused, kidney patient-run organization that works to benefit individuals affected by chronic kidney disease (CKD). RSN's mission is to help patients develop their personal coping skills, talents, and employability by educating and empowering them to take control of the course and management of the disease.

<span class="mw-page-title-main">Lori Hartwell</span>

Lori Hartwell is the Founder and President of the Renal Support Network, author of Chronically Happy: Joyful Living in Spite of Chronic Illness, and co-host of KidneyTalk, a biweekly webcast of issues of interest to those with Chronic Kidney Disease (CKD).

The obesity paradox is the finding in some studies of a lower mortality rate for overweight or obese people within certain subpopulations. The paradox has been observed in people with cardiovascular disease and cancer. Explanations for the paradox range from excess weight being protective to the statistical association being caused by methodological flaws such as confounding, detection bias, reverse causality, or selection bias.

Malnutrition–inflammation complex (syndrome) (MICS), also known as malnutrition–inflammation–cachexia syndrome, is a common condition in chronic disease states such as chronic kidney disease and chronic heart failure.

T. Alp Ikizler is a nephrologist, currently holding the Catherine McLaughlin Hakim chair in Medicine at Vanderbilt University School of Medicine, where he does clinical work and heads a research lab. Born in Istanbul, Turkey, he received his M.D. from the Istanbul University Faculty of Medicine.

<span class="mw-page-title-main">Carmine Zoccali</span>

Carmine Zoccali is an Italian nephrologist and a clinical investigator. He has contributed to research in several fields, most notably hypertension and cardiovascular complications in chronic kidney disease (CKD), CKD progression and clinical epidemiology of kidney diseases at large. He is known for his studies on cardiovascular risk in CKD and dialysis patients. He was among the earliest investigators that focused on the relevance of endothelial dysfunction and inflammation for the high risk of cardiovascular disease in these populations. In this research area, he was the first to link endogenous inhibitors of the nitric oxide system with death and cardiovascular disease. and the first to document a relationship between sympathetic over-activity and these outcomes Dr Zoccali is a practicing specialist in Nephrology, with a national qualification for the full professorship in Nephrology. He is also a specialist in hypertension, certified by the European Society of Hypertension (ESH).

Symptom targeted intervention (STI) is a clinical program being used in medical settings to help patients who struggle with symptoms of depression or anxiety or adherence to treatment plans but who are not interested in receiving outpatient mental health treatment. STI is an individualized therapeutic model and clinical program that teaches patients brief, effective ways to cope with difficult thoughts, feelings, and behaviors using evidence-based interventions. Its individualized engagement process employs techniques from solution-focused therapy, using a Rogerian, patient-centered philosophy. This engagement process ensures that even challenging, at-risk, and non-adherent patients are able to participate.

Sucroferric oxyhydroxide, sold under the brand name Velphoro, is a non-calcium, iron-based phosphate binder used for the control of serum phosphorus levels in adults with chronic kidney disease (CKD) on haemodialysis (HD) or peritoneal dialysis (PD). It is used in form of chewable tablets.

Vlado Perkovic is an Australian renal physician and researcher who is the Provost at the University of New South Wales, Sydney, having previously been Dean of Medicine & Health at that University between 2019 and 2023.

A renal diet is a diet aimed at keeping levels of fluids, electrolytes, and minerals balanced in the body in individuals with chronic kidney disease or who are on dialysis. Dietary changes may include the restriction of fluid intake, protein, and electrolytes including sodium, phosphorus, and potassium. Calories may also be supplemented if the individual is losing weight undesirably.

<span class="mw-page-title-main">Andrew S. Levey</span> American nephrologist (born 1950)

Andrew S. Levey is an American nephrologist who transformed chronic kidney disease (CKD) clinical practice, research, and public health by developing equations to estimate glomerular filtration rate (GFR), and leading the global standardization of CKD definition and staging.

Peter Stenvinkel is a Swedish nephrologist and academic. He is a senior lecturer at Karolinska University Hospital and a professor of nephrology at Karolinska Institutet.

References

  1. 1 2 3 4 5 6 "Kamyar Kalantar-Zadeh, M.D., M.P.H., Ph.D." Homepage Division of Nephrology and Hypertension. UC Irvine Medical Center. Retrieved 2014-01-04.
  2. ↑ "Kamyar Kalantar-Zadeh, MD, MPH, PhD". Homepage UCLA School of Public Health. UCLA Fielding SPH. Retrieved 2014-01-03.
  3. ↑ "K. Kalantar-Zadeh". Google Scholar . Retrieved 2018-12-24.
  4. ↑ "Nephrology Dialysis Transplantation | Editorial Board". Oxford Journals. Oxford University Press. Archived from the original on 2005-12-18. Retrieved 2011-11-26.
  5. ↑ Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD (March 2003). "Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients" (PDF). Kidney Int. 63 (3): 793–808. doi: 10.1046/j.1523-1755.2003.00803.x . PMID   12631061. S2CID   25515189.
  6. ↑ Kalantar-Zadeh K, Block G, Horwich T, Fonarow GC (April 2004). "Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure". J. Am. Coll. Cardiol. 43 (8): 1439–44. doi: 10.1016/j.jacc.2003.11.039 . PMID   15093881. S2CID   46581648.
  7. ↑ Gupta S (Sep 14, 2016). "Obesity: The fat advantage". Nature. 537 (7620): S100–S102–101. Bibcode:2016Natur.537S.100G. doi: 10.1038/537S100a . PMID   27626776.
  8. ↑ Kalantar-Zadeh K, Fouque D (Nov 2, 2017). "Nutritional management of chronic kidney disease". N. Engl. J. Med. 377 (18): 1765–1776. doi:10.1056/NEJMra1700312. PMID   29091561. S2CID   27499763.
  9. ↑ Kalantar-Zadeh K, Unruh M, Zager PG, et al. (Aug 2013). "Twice-weekly and incremental hemodialysis treatment for initiation of kidney replacement therapy". Am J Kidney Dis. 64 (2): 181–186. doi:10.1053/j.ajkd.2014.04.019. PMC   4111970 . PMID   24840669.
  10. ↑ Kalantar-Zadeh K, Uppot RN, Lewandrowski KB (July 25, 2013). "Case 23-2013 — A 54-Year-Old Woman with Abdominal Pain, Vomiting, and Confusion". N. Engl. J. Med. 369 (4): 374–82. doi:10.1056/NEJMcpc1208154. PMID   23841704.
  11. ↑ Kalantar-Zadeh K, Fouque D (Nov 2, 2017). "Nutritional management of chronic kidney disease". N. Engl. J. Med. 377 (18): 1765–1776. doi:10.1056/NEJMra1700312. PMID   29091561. S2CID   27499763.
  12. ↑ Kalantar-Zadeh K, Wightman A, Liao S (Jul 9, 2020). "Ensuring Choice for People with Kidney Failure — Dialysis, Supportive Care, and Hope". N. Engl. J. Med. 383 (2): 99–101. doi:10.1056/NEJMp2001794. PMID   32640129. S2CID   220435659.
  13. ↑ Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V (Jun 24, 2021). "Chronic Kidney Disease" (PDF). Lancet. 397 (10293): 001–017. doi:10.1016/S0140-6736(21)00519-5. PMID   34175022. S2CID   235631509.
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