Major research interests:
1. Nephrolithiasis: risk factors and prevention
2. Analgesic nephropathy
3. Mild chronic renal insufficiency: risk factors
4. Hypertension: risk factors and prevention
5. Gout: epidemiology
My research has examined the epidemiology of a variety of chronic diseases including nephrolithiasis, analgesic nephropathy, painful bladder syndrome/interstitial cystitis, hypertension, incontinence and hypertensive disorders of pregnancy. I have recently begun studying new areas, including shingles and psoriasis.
Nephrolithiasis: risk factors and prevention
I am studying the epidemiology of nephrolithiasis in three large, prospective cohort studies: Health Professionals Follow-up Study (n=51,000 men), Nursesâ€™ Health Study I (n=121,000 women) and Nursesâ€™ Health Study II (n=116,000 women). In particular, I am examining the role of dietary and non-dietary factors in kidney stone formation. We have also collected more than 4000 24-hour urine samples from participants. In addition, we are studying the role of oxalobacter formigenes and stone formation in a case-control study. The focus of this effort it to understand the etiology of stone formation and to develop new strategies to reduce stone recurrence.
Chronic kidney disease
I am studying risk factors for decline in renal function and chronic renal failure in the Nursesâ€™ Health Study I and Nursesâ€™ Health Study II, as well as in the Cholesterol and Recurrent Events (CARE) study. Using detailed questionnaires and by collecting blood and urine samples, the renal toxicity of different analgesics is being examined in NHS I and NHS II. I am also studying a variety of other risk factors for decline in renal function including genetic polymorphisms, dietary factors and biomarkers. Further, I am studying CKD as a risk factor for adverse outcomes such as cardiovascular disease.
Hypertension: risk factors and prevention
I have examined the association between birth weight and risk of adult hypertension and obesity in the three large cohorts previously described. Currently, I am studying the association between analgesic use and other novel risk factors, including uric acid and vitamin D, and the risk of subsequent hypertension in NHS I, NHS II and HPFS.
I am prospectively examining dietary and non-dietary risk factors for gout in the three large cohort studies. I am also examining gout as a risk factor for cardiovascular disease. We are also studying factors that influence the serum uric acid concentration.
My major teaching activities have centered on the MGH Clinical Research Programâ€™s Clinical Research Education Unit, the HMS PASTEUR program and the HSPH/BWH Program in Clinical Effectiveness.
Director, Clinical Research Education Unit
In 1997, I became the Director of the MGH Clinical Research Education Unit (CREU). The CREU develops educational programs, including courses, seminars and workshops, for investigators (MD and non-MD), clinical research coordinators, and the general clinical research community. Courses range from survey courses, such as Introduction to Clinical Investigation, to intense courses such as Design and Conduct of Clinical Trials. The educational programs are developed in collaboration with numerous departments at MGH. The number of registrants for these activities increased from ~600 in 1998 to over 2000 in 2002. I left this position in 2003 when I moved my appointment to BWH.
In 2000, I worked closely with Dr. Dennis Ausiello to establish the PASTEUR Program and assumed responsibility for the summer research program. This 8 week annual summer program introduces 15-25 first year HMS students to clinical reseach through a mentored research project and a weekly seminar series. In 2001, the PASTEUR Program was awarded a grant from the Doris Duke Foundation to establish year-long fellowships for second, third and fourth year HMS students. As a co-director of this program, I share responsibility for oversight of the medical students, through regular advisory sessions, the corrdination of mentor-student partnerships, review and approval of final projects, as well as curriculum development.