Sagar Nigwekar, M.B.B.S.
Physician Investigator (Cl)
Renal Associates Monthly, Mass General Research Institute
Assistant Professor of Medicine
Harvard Medical School
Medicine-Nephrology, Massachusetts General Hospital
|MD Seth G. S. Medical College 1999|
CUA, a dermal arteriolar calcification disorder seen in dialysis patients, has significant morbidity associated with complicated wounds and non-remitting pain and 60-80% one-year mortality. During my nephrology training, I saw many CUA cases and was astounded by the unmet research needs in the CUA field linked to: 1) Unclear pathogenesis and risk factors, 2) Non-existence of circulating diagnostic biomarkers considering the risk of non-healing ulceration from skin biopsy (the current diagnostic gold-standard) and, 3) Absence of effective therapy.
I am interested in understanding the risk factors and pathobiology of CUA, and to develop and examine strategies to effectively diagnose and treat CUA. In addition, I aim to apply the knowledge gained from CUA research to investigate other forms of vascular calcifications in dialysis patients. Over 70% of dialysis patients have coronary artery, aortic or valvular calcifications, and recent literature attributes 50% of cardiovascular deaths in dialysis patients to vascular calcifications. Although, Virchow described the predisposition to vascular calcifications in kidney disease over a century ago, the biology of vascular calcification remains unclear and this limits development and evaluation of treatment interventions. I believe that CUA research will serve as a high-speed template to understand the biology of vascular calcification and accelerate the T2 translational research in this field.