Dr. Daniel Feig
Director | Professor
Dr. David Askenazi
Professor
Dr. Erica Bjornstad
Assistant Professor
Dr. Sahar Fathallah-Shaykh
Professor
Dr. Michael Seifert
Associate Professor
Dr. Tennille Webb
Assistant Professor
The UAB Division of Pediatric Nephrology leads research efforts in drug discovery and pharmacokinetics, as well as the assessment, progression and treatment of acute and chronic kidney disease in children.
David Askenazi, M.D., MSPH, is the director of the Pediatric and Infant Center for Acute Care Nephrology (PICAN). PICAN seeks to understand and improve outcomes in neonates and children who are at risk for abrupt kidney failure. Several ongoing projects highlight the ongoing mission. For example, PICAN pioneered the use of an adapted machine here at UAB and Children’s of Alabama to treat neonates and premature infants with kidney failure who were too small for hemodialysis. The team has published single-center and multi-center reports on the use of this therapy in neonates and small children. As a result of this work, children as small as 1 kg can now receive this lifesaving therapy. With the publication of these results, this technology is now being used at more than 10 major children’s hospitals across the country, including Cincinnati Children’s Hospital Medical Center, St. Louis Children’s Hospital, Children’s Hospital of Philadelphia and Seattle Children’s Hospital. To help disseminate our success to other institutions, Dr. Askenazi has launched the NICKS (Neonatal and Infants Course in Kidney Support). This two-day course, repeated three times annually instructions pediatric nephrologists and dialysis teams, including nurses, nurse practitioners, pharmacists and nutritionists, to provide optimal renal care for our smallest patients. During the pandemic, this has been given as a virtual course but will be back in person in January 2022.
Dr. Askenazi works with other faculty at UAB to develop the ZorroFlow, a novel external urine collection device for neonates. This device, which collects urine without the need for invasive catheterization, can reduce pain, procedural injury and risk of infection among infants in the neonatal intensive care unit. The development of this devices is now supported by funds from the NIH Small Business Innovation Research (SBIR) program.
Dr. Askenazi is the founder and chair of the Neonatal Kidney Cooperative, which studies the causes and outcomes of acute kidney injury in neonates.
Daniel Feig, M.D., leads the Childhood Hypertension Program, which has identified critical mechanisms involved in the development of adolescent onset essential hypertension, as well as the risk factors associated with hypertensive target organ damage. Previous clinical trials have demonstrated that elevated serum uric acid causes vascular damage and activation of the renin angiotensin system, resulting in high blood pressure that can be mitigated by uric acid-lowering therapy.
The SURPHER (Serum Uric acid Reduction to Prevent HypERtension) trial is an ongoing study to assess the effectiveness of uric acid reduction in lowering blood pressure in young adults. This study found that even mild hyperuricemia results in increased risk for hypertension and chronic kidney disease in patients with type 2 diabetes through vascular injury associated mechanisms. It has also shown that reduction of serum uric acid causes improvement in the function of the endothelium, the lining of blood vessels.
A new branch of research, in collaboration with faculty in the School of Public Health, is the evaluation of the impact of early life stress on the development of vascular dysfunction that leads to hypertension and renal disease.
Sahar Fathallah, M.D., serves as medical director of dialysis and is the site investigator for nearly a dozen nationwide studies aimed to improve the care of children with chronic kidney disease and those requiring dialysis. She works tirelessly to improve the care of children with renal disease.
Michael Seifert, M.D., M.S.C.I., investigates ways to improve long-term outcomes in children who receive kidney transplants. In a seminal study, he has demonstrated that early immunologic activation, seen on surveillance kidney transplant biopsies, predicts long-term complications even before changes in laboratory values. These findings will alter how many programs monitor children with kidney transplants. His current NIH-funded studies are aimed at identifying biomarkers of kidney transplant dysfunction and new therapeutic targets to mitigate late transplant failure. He is also the lead investigator for mechanistic studies on a newly funded multi-center trial, Advancing Transplant Outcomes in Children (ATOC) and a site principal investigator for a multi-national study aimed at reducing risk of recurrence of inflammatory kidney disease after transplantation.
Dr. Seifert leads the research efforts of a national quality improvement network [Improving Renal Outcomes Collaborative (IROC)] focused on reducing cardiovascular risk and rejection while improving quality of life for pediatric kidney transplant recipients. His efforts have resulted in the use of standardized protocols to control blood pressure and reduce late rejection in children with kidney transplants.
Tennille Webb, M.D., is collaborating with investigators in the Cardiac Intensive Care Unit to better understand the alterations in perfusion, cytokines and inflammation that lead to acute kidney injury in patients undergoing cardiac surgery. The goal of her program is to reduce complications, hospital time and morbidity and improve survival in these critically ill children.
Erica Bjornstad, M.D., Ph.D., M.P.H., continues her research and educational initiatives to improve kidney health worldwide, collaborating with UAB partners in Zambia and Malawi. She strives to understand the epidemiology and risk factors of acute kidney injury in low-resourced areas. Her early work in Malawi validated a bedside dipstick to triage trauma patients at risk for kidney injury. This approach will likely dramatically reduce morbidity in trauma victims.
She has launched an online educational case conference between UAB Pediatric Nephrology and several groups in Zambia and Malawi to provide collaboration, education and scholarship in the international nephrology community. The short-term goals of this program include supporting training for pediatric nephrology practitioners in Malawi and Zambia, countries with fewer than one practitioner per 10 million people (one and three pediatric nephrologists, respectively in each country).
During the pandemic, she has become a leader in national and international registries to understand the impact of COVID-19 on kidney injury in children and adults.
In addition to these programs, the Division of Pediatric Nephrology has a robust portfolio of quality improvement efforts. On a local level, we have projects that address two of the most severe complications of dialysis, anemia and hyperparathyroidism, and important aspects of renal transplantation, including immune suppression medication titration, management of opportunistic viral infections and pre-clinic planning to improve efficiency and medication adherence.
We are also involved in leadership of national quality improvement efforts.
IROC is a national consortium of 17 pediatric renal transplantation programs. Generous donations have allowed us to both participate and lead aspects of this program. We have automated data collection that is now monitoring over 30 benchmark issues. We have initiated intervention programs aimed at improving blood pressure (BP) control after transplant, which is critical for organ longevity, and standardization of immune suppression induction. Upcoming projects include standardization of post-transplant biopsy schedules and therapy of asymptomatic acute rejection episodes that may presage future graft dysfunction.
Michael Seifert, M.D., leads the IROC Research Committee and is on the governance board.
SCOPE is a collaborative of 78 pediatric nephrology programs to prevent infections in peritoneal and hemodialysis patients using large-scale collaboration to identify and disseminate effective interventions across pediatric care settings. In the past year, since we have joined SCOPE, our dialysis-associated infection rates have fallen over 25%. This represents substantial cost savings and prevention of numerous infection-related hospitalizations.
Sahar Fathallah, M.D., medical director of the Pediatric Renal Dialysis Unit, leads the local chapter.
NINJA is a collaboration between Children’s of Alabama and Cincinnati Children’s Hospital in which hospitalized patients receiving medications that can cause kidney injury are automatically identified by using the electronic medical record system and scheduled for dose adjustments and increased renal function surveillance. The rate of acute renal injury in inpatients has been decreased by more than 60%, resulting in substantially decreased morbidity across the hospital and reduced hospitalization duration. A very recent application of this program in the Neonatal Intensive Care Unit, a project only done at Children’s of Alabama, has nearly eliminated medication associated acute kidney injury in our most vulnerable premature infants. The NINJA program has been so successful that in 2018, it became the first new program added to the Solutions of Patient Safety consortium and instituted at 147 children’s hospitals worldwide.
David Askenazi, M.D., MPH, leads our site.
Am J Hematol. 2021 Feb 1. Hyperuricemia and Abnormal Nocturnal Dipping Impact Glomerular Filtration Rate in Patients with Sickle Cell Anemia. Jeffrey D Lebensburger, Inmaculada Aban, Lee M Hilliard, Daniel I Feig.
Am J Transplant. 2021 Jan 16. COVID-19 in pediatric kidney transplantation: The Improving Renal Outcomes Collaborative. Charles Varnell Jr, Lyndsay A Harshman, Laurie Smith, Chunyan Liu, Shiran Chen, Samhar Al-Akash, Gina-Marie Barletta, Craig Belsha, Paul Brakeman, Abanti Chaudhuri, Paul Fadakar, Rouba Garro, Caroline Gluck, Jens Goebel, David Kershaw, Debora Matossian, Corina Nailescu, Hiren P Patel, Cozumel Pruette, Saritha Ranabothu, Nancy Rodig, Jodi Smith, Judith Sebestyen VanSickle, Patricia Weng, Lara Danziger-Isakov, David K Hooper, Michael Seifert.
Blood Purif. 2021 Jan 18;1-10. Acute Kidney Injury, Fluid Overload, and Renal Replacement Therapy Differ by Underlying Diagnosis in Neonatal Extracorporeal Support and Impact Mortality Disparately. Heidi J Murphy, Jason Gien, Rashmi Sahay, Eileen King, David T Selewski, Brian C Bridges, David S Cooper, Geoffrey M Fleming, Matthew L Paden, Michael Zappitelli, Katja M Gist, Rajit K Basu, Jennifer G Jetton, David Askenazi.
CJASN. 16(3):446-448. Preliminary assessment of acute kidney injury in critically ill children associated with SARS-CoV2 infection: A multi-center, cross-sectional analysis. Bjornstad EC, Krallman KA, Askenazi D, Zappitelli M, Goldstein SL, Basu RK, on behalf of SPARC investigators.
Clin Nephrology. doi: 10.5414/CN110455. Conversion to permanent vascular access is associated with improved markers of hemodialysis efficacy in children: Pediatric Nephrology Research Consortium Study. Onder AM, Flynn JT, Ansari MAY, Deng F, DeFreitas M, Katsoufis C, Grinsell MM, Patterson L, Jetton J, Fahallath-Shaykh S, et al.
J Am Soc Nephrol. 2021 May 26;ASN.2020111665. Long-term Kidney Outcomes Following Childhood Acute Kidney Injury Receiving Dialysis: A Population-based Cohort Study. Cal Robinson, Nivethika Jeyakumar, Bin Luo, Ron Wald, Amit Garg, Danielle Nash, Eric McArthur, Jason Greenberg, David Askenazi, Cherry Mammen, Lehana Thabane, Stuart Goldstein, Rulan Parekh, Michael Zappitelli, Rahul Chanchlani.
J Pediatr Intensive Care. Urine quantification following furosemide for severe acute kidney injury prediction in critically ill children. Gist KM, Penk J, Wald EL, Kitzmiller L, Webb TN, Krallman K, et al.
J Perinatology. 41(2):185-195. Improving the quality of neonatal acute kidney injury care: neonatal-specific response to the 22nd Acute Disease Quality Initiative (ADQI) conference. Harer MW, Selewski DT, Kashani K, Basu RK, Gist KM, Jetton JG, Sutherland SM, Zappitelli M, Goldstein SL, Mottes TA, Askenazi DJ.
JAMA Netw Open. 2021 Apr 1;4(4):e213917. Trends in Blood Pressure and Hypertension Among US Children and Adolescents, 1999-2018. Shakia T Hardy, Swati Sakhuja, Byron C Jaeger, Elaine M Urbina, Shakira F Suglia, Daniel I Feig, Paul Muntner.
Pediatr Crit Care Med. 2021 May 10. Coronavirus Disease 2019-Associated PICU Admissions: A Report From the Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study Registry. Sandeep Tripathi 1, Katja M Gist, Erica C Bjornstad, Rahul Kashyap, Karen Boman, Kathleen Chiotos, Varsha P Gharpure, Heda Dapul, Imran A Sayed, Joshua Kuehne, Julia A Heneghan, Manoj Gupta, Paras B Khandhar, Shina Menon, Neha Gupta, Vishakha K Kumar, Lynn Retford, Jerry Zimmerman, Utpal S Bhalala, Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group.
Pediatr Nephrol. 2021 Jan 18. Urinary neutrophil gelatinase-associated lipocalin rules out nephrotoxic acute kidney injury in children. Stuart L Goldstein, Kelli A Krallman, Alexandra Schmerge, Lynn Dill, Bradley Gerhardt, Praneeta Chodaparavu, Abigail Radomsky, Cassie Kirby, David J Askenazi.
Pediatr. 2021 Jan 20;S0022-3476(21)00065-2. The Impact of Erythropoietin on Short and Long-term Kidney-Related Outcomes in Extremely Low Gestational Age Neonates. Results of a Multi-center Double-Blind Placebo-Controlled Randomized Clinical Trial. David J Askenazi, Patrick J Heagerty, Robert H Schmicker, Patrick Brophy, Sandra E Juul , Stuart L Goldstein, Sangeeta Hingorani, PENUT Trial Consortium.
Pediatric Transplantation. Feb; 25(1):e13811. Promoting cardiovascular health post-transplant through early diagnosis and adequate management of hypertension and dyslipidemia. Charnaya O, Seifert M.
Resuscitation. 2021 Jan 12;S0300-9572(21)00001-0. Acute kidney injury after in-hospital cardiac arrest. Kenneth E Mah, Jeffrey A Alten, Timothy T Cornell, David T Selewski, David Askenazi, Julie C Fitzgerald, Alexis Topjian, Kent Page, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler.
Semin Dial. 2021 Apr 28. doi: 10.1111/sdi.12978. Kidney support therapy in the pediatric patient: Unique considerations for a unique population. David Askenazi, Rajit K Basu.
Semin Fetal Neonatal Med. 2021 Jun 12;101261. Fluid management, electrolytes imbalance and renal management in neonates with neonatal encephalopathy treated with hypothermia. Jeffrey L Segar, Valerie Y-L Chock, Matthew W Harer, David T Selewski, David J Askenazi, Newborn Brain Society Guidelines and Publications Committee.
Transplant Direct. 2021 Jan 26;7(2):e663. Impact of Subclinical Borderline Inflammation on Kidney Transplant Outcomes. Michael E Seifert, Gaurav Agarwal, Miriam Bernard, Ellen Kasik, S Sikandar Raza, Huma Fatima , Robert S Gaston, Vera Hauptfeld-Dolejsek, Bruce A Julian, Clifton E Kew, Vineeta Kumar, Shikha Mehta, Song Ong, Frida Rosenblum, Graham Towns, Roslyn B Mannon.
David Askenazi, M.D.
Erica Bjornstad, M.D.
Sahar Fathallah, M.D.
Daniel Feig, M.D., Ph.D.
Michael Seifert, M.D., M.P.H.
Tennille Webb, M.D.
The UAB Pediatric Nephrology Fellowship Program has been fully accredited for over 20 years. Our program combines an interdisciplinary experience in clinical training and collaborative research opportunities to train the next generation of academic pediatric nephrologists. The first year of fellowship concentrates on clinical training, offering fellows exposure to a variety of patient experiences with intensive research training in the second and third years.
Our available research collaborations across UAB encompass basic science and adult and pediatric nephrology. Fellows have access to additional program training resources at the O’Brien Center, the UAB Comprehensive Transplant Institute, Health Disparities Research Center, and the Pediatric and Infant Center for Acute Nephrology (PICAN), along with the possibility of obtaining a master’s in public health.
2021–2022 Fellows
Lindsey Gordon, D.O.
First-Year Fellow
Residency: University of Tennessee, Chattanooga
Kyle Deville, M.D.
Second-Year Fellow
Residency: University of Alabama at Birmingham
Priyanka Ameta, M.D.
Third-Year Fellow
Residency: University of Florida, Pensacola
Program Directors
Daniel Feig, M.D.
Program Director
Michael Seifert, M.D.
Associate Program Director
Program Coordinator
Meagan Reagan