Dr. Sylvia E. Rosas Addresses High Rate of Chronic Kidney Disease among Latinos with New Latino Kidney Clinic
Tuesday, December 10, 2013
According to the Center for Disease Control and Prevention (CDC), Hispanics are 1.5 times more likely to develop kidney failure than non-Hispanic whites. With diabetes serving as the leading cause of kidney failure, this makes diabetic nephropathy – kidney disease that is caused by diabetes complications and can lead to chronic kidney disease – an immense problem for Hispanics with diabetes. Joslin Diabetes Center is addressing the prevalence of chronic kidney disease (CKD) among Hispanic/Latino population with a new weekly Latino Kidney Clinic, led by Sylvia E. Rosas, M.D., MSCE, and a Nephrologist at Joslin.
“We are very fortunate to have recruited Dr. Rosas to Joslin,” said Dr. Robert C. Stanton, M.D., Chief of the Kidney and Hypertension Section at Joslin. “She greatly enhances our efforts to care for patients with diabetes and find new treatments for diabetic kidney disease as she is a very successful clinical researcher.”
Before coming to Joslin, Dr. Rosas worked as an Assistant Professor of Medicine at the University Of Pennsylvania Perelman School Of Medicine and as a physician at the Philadelphia Veterans Administration Medical Center. Both of these experiences helped Dr. Rosas build an impressive background treating and performing research in kidney disease, especially among patients with diabetes.
While at the University of Pennsylvania, Dr. Rosas performed clinical research in individuals with CKD. In particular, she was interested in vascular calcification, the hardening of arteries due to calcium deposits in the blood vessels. This calcification process can also occur in coronary arteries, known as coronary calcification, when the vessel wall thickens and develops a layer of plaque that frequently also includes calcium deposits, which restricts blood flow and can lead to a heart attack or stroke.
“We now understand that vascular calcification is a risk factor for cardiovascular events including death, and it’s not just the presence of, but the progression of these calcifications that is an important risk factor,” commented Dr. Rosas. “Vascular calcification can serve as a screening tool to see who’s at high risk for cardiovascular events such as heart attacks and stroke.”
Dr. Rosas will use these experiences in the new Latino Kidney Clinic where she will primarily treat patients with diabetic nephropathy. Patients with diabetic nephropathy commonly first present with proteinuria, or an abnormal amount of protein in urine. Over time their kidney function declines and may lead to the need for renal replacement therapies such as dialysis or transplantation.
According to Dr. Rosas, patients can slow down the progression of kidney disease by adequate blood pressure and diabetes control, as well as taking medications that can lower the protein in the urine. Patients in the clinic will work with Dr. Rosas and other clinicians towards these goals.
In addition to treating patients with CKD, Dr. Rosas hopes to use the clinic as a means of connecting with the population of Latino patients at Joslin.
“The Latino Kidney Clinic would like to be able to serve the community and I think as someone who speaks the language and understands the culture, this will be something that all patients will value,” said Dr. Rosas.
Dr. Rosas also plans to concentrate on CKD education. Specifically, she wants to teach her patients how to understand and deal with complex medical information regarding all aspects of their diabetes and its complications, including CKD and hypertension. She and others in the clinic will make use of Joslin’s expertise in nutrition and exercise by creating culturally-specific meal plans and exploring how fitness can impact patients’ overall wellbeing.
“I am interested in looking at exercise because this is something that Joslin is well-known for and I think it has not been examined in depth in patients with CKD,” said Dr. Rosas. “Joslin has a lot to offer and a lot of expertise with exercise, so I am going to try to integrate that into my research and clinical care.”
The main challenge facing this new clinic is that there is no cure for CKD; the only solution is to try to slow down the progression of kidney disease by controlling blood pressure, glucose levels, and complications from CKD and diabetes. Dr. Rosas is hopeful that the clinic will provide the opportunity to study new medications that may one day serve as a cure for CKD.
“There are some new medications that will work on different pathways to attempt to slow down the progression of kidney disease, we are hopeful that one will work out, but we are not there yet,” said Dr. Rosas. “Joslin is the ideal place for these medications to be tested because we are the premiere diabetes institution.”
Dr. Rosas looks forward to beginning her clinical and research endeavors at Joslin. Enrique Caballero, M.D. Director of the Latino Diabetes Initiative and Director of International Professional Education at Joslin, shares Dr. Rosas enthusiasm for what’s ahead.
“Dr. Rosas will lead the Latino Kidney Clinic [and] this is certainly a great addition to the services the Latino Diabetes Initiative has offered to the Latino population at Joslin for many years,” said Dr. Caballero. “CKD is a particularly frequent and challenging diabetes related complication in this population and we are delighted to welcome Dr. Rosas to Joslin to lead the efforts in this field!”
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