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Dr. Jessica Stahl, MD, MS
Assistant Professor, Division of Nephrology and Hypertension
University of North Carolina
What was your main motivation for pursuing a field in nephrology?
Personally, I have a background in mental health and was interested in working in a field with patients and families who are dealing with chronic medical issues. There are obviously many other specialties that take care of patients with chronic diseases, but I find the kidney especially interesting. In nephrology, I have the opportunity to work with children and their families in many different settings, from regular doctor’s office visits to intensive care in the hospital. I get to perform kidney biopsies and to run dialysis. The day-to-day variety is a lot of fun.
What are the primary differences between kidney diseases found in adolescents compared to adults?
In adolescents and younger children compared to adults, we see more kidney disease related to CAKUT, which stands for Congenital Anomalies of the Kidneys and Urinary Tract. CAKUT is used to refer to a number of different conditions that occur when some portion of the kidney or urinary tract develops abnormally during pregnancy. There are types of kidney disease caused by genetic mutations, or by activation of the immune system that tend to first show up in childhood. Some kidney diseases that we used to think of as mostly adult problems, like kidney disease due to obesity or diabetes, that we are now seeing more commonly in children. On the other hand, we also have improved how we take care of pediatric kidney disease a lot over the past few decades so that our adult nephrology counterparts are taking care of patients who had pediatric kidney disease and have now grown up.
How do the symptoms of acute kidney diseases vary from those of chronic ones?
It depends. If your kidneys have a mild injury, for example, if you got sick and dehydrated, but then started drinking again, you may recover and never notice that you had an injury. With severe acute kidney injury, your kidneys may stop making urine, which also means being unable to filter out ‘waste’ minerals and electrolytes and water from your bloodstream. Build up of those wastes and water can cause high blood pressure, swelling, headaches, and just feeling sick until your kidneys recover. Those same symptoms can happen with chronic kidney disease as it gets more advanced, but tend to occur slowly over time. In children with chronic kidney disease, you might notice slow growth, low appetite, and low energy.
Has there been any discoveries regarding nephrology in the last few years that have shaped the field of research?
There is a lot of excitement about gene testing to identify specific kidney diseases which moves us one step closer to using technologies like CRISPR and gene editing. Microfabrication techniques have also moved us toward making a “kidney on a chip” which can be used to test drugs and medications, and also to study how the kidney responds to different conditions - one of my friends recently sent her kidney on a chip into space!
Has the COVID-19 Pandemic affected your career in any way? If so, how?
I actually officially started my career in the pandemic, which was interesting! Fortunately, I work with a wonderful group of people and they’ve been great at introducing me to my new hospital and clinic. I certainly do a lot more patient visits on telemedicine/online than I used to. Connecting with other nephrologists is also different without meeting at conferences, but it’s been nice to see a lot of our research and learning meetings continue online.