Meet ASN’s New President: Sharon M. Moe

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Sharon M. Moe, MD, FASN, FACP, FAHA, began her term as ASN President November 10, 2013. Dr. Moe is Director of the Division of Nephrology at Indiana University School of Medicine, as well as the Stuart A. Kleit Professor of Medicine and an Adjunct Professor of Anatomy & Cell Biology. She is also Section Chief of Nephrology at the Roudebush Veterans Administration Medical Center in Indianapolis.

Dr. Moe received her medical degree from the University of Illinois College of Medicine at Chicago and completed her residency in the Department of Internal Medicine at Loyola University Medical Center in Maywood, IL. She was a clinical fellow and a research fellow at the University of Chicago. At Indiana University Dr. Moe chaired the Department of Medicine Clinical Trials Program from 1997 to 2007 and was the Assistant and then Associate Dean for Research Support from 2001 to 2005. She then became the Vice Chair for Research in the Department of Medicine from February 2005 to June 2011. In 2011 she became the Director of the Division of Nephrology at Indiana University.

In addition to serving on ASN Council for the past 5 years, Dr. Moe served on the ASN Postgraduate Education, Program, and Nominating Committees as well as the Media Relations Task Force. She has served as co-director of the society’s Annual Meeting Professional Development Symposium, as a speaker at the society’s Board Review Course and Update, and as an abstract reviewer and session coordinator.

Dr. Moe, what are your areas of research study?

I study the relationship of kidney disease, vascular calcification, bone, and disorders of mineral metabolism (CKD-MBD). Work in our lab has used in vivo, ex vivo, and in vitro techniques to investigate the pathophysiology of arterial medial calcification and the relationship between calcification and bone. We are now investigating this pathway using a naturally occurring rat model of CKD-MBD to understand how therapies for bone alter cardiovascular disease and how cardiovascular disease is altered by drugs we use to treat bone and mineral disorders. We are also interested in how the dietary source of phosphate alters bioavailability and how this alters CKD-MBD.

Why did you become a nephrologist?

Nephrology offers a little bit of everything. Patients with kidney disease offer complex challenges; each patient is a little bit different. I chose nephrology because taking care of otherwise healthy patients didn’t seem to offer as much professional satisfaction or intellectual stimulation. Nephrologists take physiology to the bedside; not every specialty has that connection, and I was also interested in opportunities to pursue my research and administrative interests.

Fewer students are choosing nephrology. Can ASN make a difference?

While ASN is making a difference, workforce concerns remain a problem for nephrologists. We haven’t done a good enough job “marketing” the joys of nephrology; we don’t convey to students the range of careers available, the range of patients nephrologists take care of, and the real difference kidney professionals make to their patients’ lives.

In medical school, students may most often see patients with kidney disease in the emergency room or late in their disease course. They don’t get a full picture of the wide spectrum of practice, or of how energizing and motivating our work can be—as an example, I have a patient who came to me to start dialysis 15 years ago, and together we have managed his care so that he still hasn’t had to start dialysis. And we fail to emphasize the miraculous nature of dialysis itself—while undergoing dialysis is tough, without dialysis, patients would die.

In 2011, ASN established the ASN Workforce Committee and this group is very active. This year ASN launched a very successful program to introduce medical students to renal physiology and connect them with nephrology mentors, as well as a program to involve patients in community screenings. The ASN Foundation for Kidney Research is helping young faculty achieve independent careers. However, we have to focus more on building diversity within the ranks of kidney professionals, supporting the entire care team, creating more flexibility for those who want to work part time or job share, and making sure that students understand how much nephrology offers to those who want to make a real difference in health care.

You have selected health disparities as a focus of your presidential term. Why?

In the United States, nephrologists see a disproportionately high number of patients who are African American, Hispanic, and Native American. We don’t understand enough about the reasons for this. ASN is uniquely positioned to give voice to all types of patients with kidney disease, and the society has committed a number of resources to advancing care for vulnerable populations, and to the basic and clinical research that will help us really understand the underlying causes of these disparities.

If funding for kidney disease research remains low, these disparities will continue. As ASN President I will work with our policy team to make sure U.S. lawmakers and other policymakers understand the full impact of kidney disease and just how much they can contribute to reducing health disparities. We also need to work with other research organizations and foundations to help us lessen the disparities.

You have spoken before about the need for more proactive approaches to chronic disease care. Would you elaborate on that?

Professionals who take care of patients with chronic disease experience the joy of providing real continuity of care and making huge positive differences in the lives of their patients. But a challenge for all chronic disease care involves balancing ongoing care of patients with active efforts to prevent disease. This is especially true in an area like nephrology, where kidney disease may go undiagnosed for quite a while.

We must really advance our ability to detect and prevent kidney disease. This requires raising awareness among the general population and other medical professionals, and funding innovative research that will help us detect kidney disease at earlier stages.

There has been so much emphasis on dialysis despite the fact that the therapy affects a small proportion of our patients. While truly life-saving, dialysis does not provide patients with an ideal quality of life. I am certain all nephrologists have seen patients who were told they had kidney disease 10 years ago, but never sought care because they were so afraid of dialysis and did not believe there was anything that could be done to prevent progression. And many of these patients have family members on dialysis. In my personal experience fear fuels denial, and denial limits access to care and compliance with care.

I believe the concept that over 20 million Americans have kidney disease needs to be heard loud and clear and needs to come from all kidney organizations and patients alike. The corollary is that if we don’t slow progression we will have increased costs. These costs are to patient quality of life, disruption to families, and costs to the health care system. The Kidney Health Initiative is energizing the innovation needed to find therapies to slow progression, but our message to patients and Congress has to be equally energizing. Nephrologists need to send a common message of what we can do to slow progression, that preemptive transplant is ideal, and that early diagnosis is key. This positive thinking will empower patients to take care of themselves and stand up for more research to ensure that care is optimized.