‘Engineers Of The Kidneys’ Pioneer Valley Nephrology Battles ‘Epidemic’ Of Kidney Disease

Dr. Jonathan Slater tells the childen in his neighborhood that he’s an “engineer of the kidneys.” 

The 1998 founder of Pioneer Valley Nephrology measures kidney function, investigates the causes of kidney failure and hypertension and works to slow the progression of kidney disease.

Slater, who graduated summa cum laude from the University of Connecticut and completed his nephrology fellowship at the University of Colorado, is one of only two physicians in Western Mass. board certified by the American Society of Hypertension. The other is Dr. Balaji Padmanabhan, who came to Holyoke to practice with Slater in August of 2000, following his nephrology fellowship at Brookdale University Hospital and Medical Center in New York. Both are designated as “specialists in clinical hypertension” and are board certified in Internal Medicine and Nephrology. Slater, Padmanabhan and Dr. Krishnan Babu, who joined the practice three years ago after completing his nephrology fellowship at Long Island College Hospital, are offering comprehensive care for chronic kidney disease and hypertension, utilizing state-of-the-art technology to meet every patient’s individual needs.

In their office at 10 Hospital Dr., the three physicians treat patients referred to them by their primary care practitioners when the kidneys are functioning at less than 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}. Patients with kidney disease may not have any symptoms until their kidney function is below 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, said Slater. Early detection of kidney disease and aggressive, protective treatment is the key in delaying and possibly arresting the progression to End-Stage Kidney Disease (ESRD) — when the kidneys are functioning at less than 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and require dialysis or a kidney transplant.

“Kidney disease is growing in epidemic proportions. There are presently 20 million people in the United States alone with some degree of kidney disease and more than 300,000 on dialysis,” said Slater, who estimated that 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Pioneer Valley Nephrology’s work is with patients suffering from chronic kidney disease, undergoing dialysis or who have had a kidney transplantation; 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} suffering from severe hypertension; and 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} suffering from other kidney malfunctions, including kidney stones, electrolyte abnormalities, proteinuria (excess protein in the urine), or polycystic kidney disease.

Hypertension, or high blood pressure, is one of the major causes of kidney failure and heart disease, said Padmanabhan, known affectionately by his patients as “Dr. Pad.”

Many patients have an artificial elevation of their blood pressure in the doctor’s office, which is termed as “White-Coat Hypertension.” To more accurately monitor high blood pressure, Padmanabhan, Slater and Babu are utilizing an innovative 24-hour, ambulatory digital blood pressure cuff that patients wear on their upper arm.

A computer registers their blood pressure every 15 minutes, giving highly accurate results without interrupting a person’s normal daily schedule. “These cuffs are the gold standard for knowing what a person’s blood pressure really is,” he said. Having an accurate reading allows physicians to better prescribe blood pressure lowering medications, including “anti-angiotensin II type” blood pressure medications, which selectively protect the kidneys.

Slater and Padmanabhan founded the Springfield Dialysis Unit in July of 2003. It provides state-of-the-art, in-center hemodialysis along with a premier home peritoneal dialysis program. The physicians are in the process of offering home-based hemodialysis treatments including daily home dialysis and nocturnal dialysis (night time dialysis), which make life a lot easier for patients accustomed to visiting the dialysis clinic three times a week.

“The next step will be to open a dialysis unit right here in Holyoke, which we’re also actively pursuing,” said Slater. “We try to do everything we can to improve the efficiency of the kidneys, to make them last longer, to slow the progression of kidney disease. Anything we can do to make patients’ lives easier and more comfortable, is our goal.”

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