- Staff Clinician, Kidney Disease Section, NIDDK, NIH, 2002-present
- Medical Officer, Kidney Disease Section, NIDDK, NIH, 1991-2002
- Expert Consultant in Nephrology, NIH Georgetown University Hospital, 1980-1991
- Nephrology Fellow, Georgetown University Hospital, 1978-1980
- Junior and Senior Assistant Medical Resident, Georgetown University Hospital, 1975-1978
- Surgical Intern and Junior Assistant Resident, Columbia Presbyterian Hospital and Georgetown University Hospital, 1973-1975
- M.D., College of Physicians and Surgeons, Columbia University, 1973
The ultimate goal is to better understand the pathogenesis of these immune mediated kidney diseases so that immunosuppressive therapy can be targeted and thereby optimize efficacy and minimize toxicity.
We study the natural history, pathogenesis, prognosis, and treatment of immune mediated kidney diseases. Our studies have focused on the efficacy and toxicity of immunosuppressive treatment regimens for proliferative lupus nephritis, membranous lupus nephropathy, and idiopathic membranous nephropathy. We have completed prospective randomized clinical trials of immunosuppressive drug therapies for proliferative lupus nephritis and membranous lupus nephropathy. A prospective clinical study of combination rituximab and cyclosporine therapy for idiopathic membranous nephropathy is in progress.
Applying our Research
Patients with immune mediated kidney diseases are at increased risk for life-threatening (and life-altering) complications, including chronic kidney failure, cardiovascular and cerebrovascular disease, as well as thromboembolic events. While non-immunosuppressive therapies are available that reduce the risk of these complications to some degree, it is widely recognized that patients benefit most when they achieve a remission of the kidney disease, either spontaneously or from treatments that suppress their abnormally active immune system.
Need for Further Study
To optimize the treatment of immune mediated kidney diseases, additional studies are needed to further define the pathogenesis of these conditions and to develop novel treatment strategies that target the underlying immunologic abnormalities.
- Membranous nephropathy: Pilot study of a novel regimen combining cyclosporine and Rituximab.
- Waldman M, Beck LH Jr, Braun M, Wilkins K, Balow JE, Austin HA 3rd.
- Kidney Int Rep (2016 Jul) 1:73-84. Abstract/Full Text
- A Clinical Service to Support the Return of Secondary Genomic Findings in Human Research.
- Darnell AJ, Austin H, Bluemke DA, Cannon RO 3rd, Fischbeck K, Gahl W, Goldman D, Grady C, Greene MH, Holland SM, Hull SC, Porter FD, Resnik D, Rubinstein WS, Biesecker LG.
- Am J Hum Genet (2016 Mar 3) 98:435-441. Abstract/Full Text
Research in Plain Language
Normally, the immune system protects the body from harm. This harm can be due to infection, cancer, or other diseases. We study kidney diseases that occur when a patient’s immune system becomes over-active and injures their own kidneys. The goal is to suppress the over-active immune system cautiously in order to treat the kidney disease effectively and minimize the risk of complications, such as infection.