Nephrology Department I

| Basic overview |

The Department of Nephrology of Huashan Hospital, Fudan University, was founded in the 1960s by Professors Qiu Chuanlu and Lin Shantang. It is one of China’s pioneering nephrology institutions; one of the first national institutions authorized to confer doctoral degrees in nephrology; a key discipline of the Ministry of Education and a key discipline under the 211 Project; a National Health Commission clinical key specialty and a Chinese training base for nephrologists; one of the first Chinese International Nephrology Professional Doctor Training Bases recognized by the International Society of Nephrology (ISN); and a supervisory institution for the ISN International Sister Renal Centers.

The Department of Nephrology of Huashan Hospital follows the principle of department development: «What others do not have, we have; what others have, we excel in; what others excel in, we make new», and takes «providing patients with high-quality medical services» as its mission. It places particular emphasis on whole-course management of kidney disease—prevention, diagnosis and treatment, and rehabilitation—and on the joint prevention and treatment of kidney disease and other diseases. In 2023, the department was divided into Department of Nephrology I (Main Hospital) and Department of Nephrology II (Baoshan Campus). Department of Nephrology I at the Main Hospital comprises the Renal Ward, Blood Purification Center, Peritoneal Dialysis Center, Renal Pathology Center, Kidney Transplantation Center, Fudan University Institute of Nephrology, Shanghai AI-Assisted Medical Engineering Center, and other units. Its distinctive diagnostic and treatment strengths include renal immunotherapy and renal pathology, integrated whole-course management of kidney disease, blood purification and critical-care treatment, peritoneal dialysis, and internal-medicine management after kidney transplantation. It is nationally leading in the diagnosis and treatment of primary and secondary glomerular diseases—including IgA nephropathy, membranous nephropathy, minimal-change disease, focal segmental glomerulosclerosis, diabetic nephropathy, hypertensive nephropathy, lupus nephritis, ANCA-associated vasculitis, and anti-glomerular basement membrane disease—acute and chronic renal insufficiency and related complications, renal replacement therapy (hemodialysis, peritoneal dialysis, and kidney transplantation), and hemodialysis informatization. It also pioneered the application of a range of new blood-purification technologies in China and actively expanded their indications, making it one of the hospital’s core forces in treating difficult and critically ill patients.

| Clinical situation |

I. Full-process diagnosis and treatment of kidney disease

【Immunological nephrology and renal pathology】

Since its establishment, the Huashan Department of Nephrology has been committed to closely integrating the clinical diagnosis and treatment of kidney disease with renal pathology. In 1962, Professor Qiu Chuanlu, founder of the department and second Chair of the Chinese Society of Nephrology, was the first in China to perform renal needle biopsy. In 1996, the department established an independent renal pathology laboratory for pathological diagnosis. Since 2005, it has maintained a long-term cooperation framework with the Renal Pathology Center of Vanderbilt University in the United States and pioneered in China the establishment of internationally aligned standards for renal-pathology diagnosis and treatment, an efficient global platform for remote slide reading and consultation, and a professional team. Personalized molecular pathological diagnosis is performed according to clinical needs, and the department is at the leading national level in diagnosing complex and difficult renal pathology. In recent years, the Huashan Renal Pathology Center has completed more than 1,500 pathological diagnoses of renal biopsies from inside and outside the hospital each year, ranking among the leading institutions in Shanghai. Since 2014, Huashan Hospital has held the national continuing-education course «New Advances in Renal Pathology and Clinical Practice» every year, training nephrology and renal-pathology professionals from throughout China.

The Huashan Department of Nephrology has always adhered to the founding philosophy of inheritance and innovation. In IgA nephropathy, membranous nephropathy, minimal-change primary kidney disease, and secondary kidney diseases including diabetic nephropathy, lupus nephritis, hepatitis B-associated nephropathy, and tumor-associated nephropathy, it has developed precision diagnosis and treatment strategies centered on renal pathology. Drawing also on the strengths of other clinical specialties at Huashan Hospital, it provides patients with one-stop diagnostic and treatment services featuring multidisciplinary collaboration, standardization, and long-term disease-course management, thereby establishing distinctive clinical expertise.

【Integrated management of chronic kidney disease】

Professor Lin Shantang, lifelong Professor of Nephrology at Huashan Hospital and fifth Chair of the Chinese Society of Nephrology, began a series of studies on risk factors for chronic kidney disease progression as early as the 1980s. In the early 1990s, he was among the first in China to propose the new concept of «integrated» treatment for chronic kidney disease, emphasizing that metabolic disorders are the key to preventing and treating chronic kidney disease. The department has long been committed to innovative diagnosis and treatment of kidney disease and metabolic disorders, with particularly distinctive expertise in hypertension-related water and electrolyte disorders, glucose and lipid metabolism disorders, and mineral and bone metabolism abnormalities. It has established a precision diagnosis and treatment system and has received four provincial- or ministerial-level science and technology achievement awards.

In 2005, the Department of Nephrology, together with the Department of Nutrition and the Nursing Department, successively opened a renal-disease nutrition clinic and a hemodialysis nutrition clinic. It established multidisciplinary collaborative diagnosis-and-treatment standards and workflows and provided individualized nutrition education and nutritional therapy. These measures played an important role in slowing kidney-disease progression, correcting metabolic disorders, reducing cardiovascular events, and improving prognosis. The research findings and clinical experience have been cited in nutrition guidelines and expert consensuses in China and abroad, and the department was invited to participate in drafting or revising multiple guidelines, including the 2020 edition of the KDIGO international guideline on nutrition in CKD.

Since collaborating with the Department of General Surgery in 1999 to perform the first «total parathyroidectomy + forearm transplantation» in the Shanghai region for severe secondary hyperparathyroidism, the Huashan Department of Nephrology has pioneered the development of new clinical technologies and methods for chronic kidney disease–mineral and bone disorder (CKD-MBD), a common renal complication that is also a neglected, difficult interdisciplinary disease. It has established a CKD-MBD multidisciplinary collaborative diagnosis-and-treatment team and a high-level research platform, with academic influence leading in China and internationally. Since 2013, it has held the national continuing-education course «Huashan Forum: Multidisciplinary Prevention and Treatment of Chronic Kidney Disease–Mineral and Bone Abnormalities» every year, training professionals for medical institutions throughout China, disseminating CKD-MBD knowledge, and filling gaps in medical services.

Integrated chronic kidney disease management team

II. Renal replacement therapy

【High-quality management of blood purification】

The Huashan Blood Purification Unit was established in 1974 and is one of the earliest units in China to provide hemodialysis. For 50 years, it has been devoted to the continuous improvement and innovation of blood-purification technologies and pioneered a series of new technologies, including autologous arteriovenous fistula creation, ultrapure-water dialysis, citrate anticoagulation, continuous renal replacement therapy (CRRT), incremental-start hemodialysis, and independent hemodialysis. In 2008, it introduced the most advanced international hemodialysis information-management system and pioneered the establishment of a digital hemodialysis center, opening a new model of high-quality hemodialysis management. Since 2018, it has pioneered the research and development of artificial-intelligence products for hemodialysis in China and internationally. The Hemodialysis Center actively develops subspecialties. It has established multidisciplinary collaborative diagnosis-and-treatment standards for whole-course fistula management, CKD-MBD, hemodialysis nutrition, renal anemia, and cardiovascular and cerebrovascular complications; equipped a subspecialized hemodialysis nursing team; and established follow-up and patient-education systems. It is currently a supervising institution of the Shanghai Hemodialysis Quality Control Center and a practical training base for specialized hemodialysis nurses in Shanghai. The five-year survival rate of hemodialysis patients and complication control are at internationally leading levels. During the pandemic, the Huashan Hemodialysis Center ensured safe dialysis for patients through high-quality management. This work was published in early 2024 in Catalyst, a journal in the New England Journal of Medicine family, and became a landmark achievement in healthcare-management innovation in China. Since 2013, the Huashan Hemodialysis Center has held the national continuing-education course «Information Management of Hemodialysis» every year, actively disseminating new concepts and technologies in hemodialysis management and healthcare.

Blood-purification medical and nursing team

【High-quality peritoneal dialysis】

In 1962, under the leadership of Professor Qiu Chuanlu, the specialty pioneered peritoneal-dialysis treatment in China. In 2005, the Huashan Hospital Peritoneal Dialysis Center was established. It has now formed a disease-specific peritoneal-dialysis MDT management team comprising dedicated peritoneal-dialysis physicians, specialist peritoneal-dialysis nurses, dietitians, social workers, and clinical pharmacists. The center has established standardized whole-course management procedures covering pre-dialysis assessment, peritoneal-dialysis catheter placement and perioperative management, peritoneal-dialysis assessment, and prevention and treatment of peritoneal-dialysis complications. Through diverse models including disease-specific clinics, home visits, and online follow-up, it provides systematic, professional long-term education and follow-up. Quality-control indicators include a peritoneal-dialysis dropout rate below 10%, an average peritoneal-dialysis treatment duration maintained at 72–106 months, and a peritoneal-dialysis infection rate maintained at 85–100 patient-months/episode. The treatment level and quality of life of peritoneal-dialysis patients rank among the leading levels in China and Shanghai. Every year, the department holds the course «New Advances in Peritoneal-Dialysis Nursing and Patient Education and Management», training many outstanding peritoneal-dialysis nursing professionals for other provinces and cities.

Peritoneal-dialysis medical and nursing team

【Distinctive internal-medicine management of kidney transplantation】

The Huashan Department of Nephrology worked with the Department of Urology and pioneered kidney transplantation in the 1970s, established a Kidney Transplantation Center, and created China’s only closely coordinated medical–surgical kidney-transplantation MDT workflow aligned with international standards. It was among the first group of national pilot institutions for donation after circulatory death (DCD). After patients with uremia undergo kidney-transplant surgery at Huashan Hospital, a specialized treatment team from the Department of Nephrology provides systematic internal-medicine treatment and education. After discharge, patients receive long-term follow-up at the department’s transplant specialty clinic, and the department maintains a patient cohort, database, and specimen-management system. Over the past decades, it has established and improved clinical-management standards for transplanted-kidney assessment, diagnosis and treatment of acute and chronic rejection, prevention of post-transplant infections, prevention of cardiovascular events, and monitoring for recurrent nephritis. It has formulated indications and procedures for pathological biopsy of the transplanted kidney and applied new technologies such as special blood-purification treatment for refractory rejection, significantly improving the long-term survival of transplant recipients and establishing distinctive clinical expertise.

Multidisciplinary kidney-transplantation management team

III. Treatment of difficult and critically ill patients

The Huashan Department of Nephrology actively expands the indications for blood purification and provides special blood-purification treatments including extracorporeal carbon-dioxide removal (ECCO2), plasma exchange, plasma diafiltration (PDF), lipid apheresis, and immunoadsorption. In treating difficult and critically ill patients, especially those with sepsis, COVID-19 pneumonia, liver failure, and central nervous system diseases, it has accumulated extensive clinical experience and is a core force in the hospital’s treatment of such patients. In recent years, together with the Medical Affairs Department, it pioneered in China the establishment of the Huashan Hospital CRRT Quality Control Management Committee. The committee includes the Nursing Department, Department of Critical Care Medicine, Department of Infectious Diseases, Department of Emergency Medicine, Department of Information, and multiple other disciplines. It focuses on training high-level CRRT professionals and improving CRRT quality-control management capacity, pioneered the implementation in China of a new CRRT management concept based on multidisciplinary collaboration, and achieved major breakthroughs in disciplinary integration, precision quality control, and efficient operation of blood-purification management for critically ill patients.

Multidisciplinary CRRT quality-control management team

| Teaching and training |

As one of the first institutions authorized by the Ministry of Education to confer doctoral degrees, a Chinese training base for nephrologists, and one of the first Chinese International Nephrology Professional Doctor Training Bases recognized by the International Society of Nephrology (ISN), Department of Nephrology I is also the ISN Interventional Nephrology Training Center, the only one in China. It currently has four doctoral supervisors and four master’s supervisors and has received honors including Outstanding Supervising Physician for Standardized Resident Training in Shanghai, Outstanding Supervisor of Fudan University, and Outstanding Clinical Teacher of Fudan University. It has trained more than 130 postdoctoral fellows and doctoral students and more than 120 master’s students, including Outstanding Graduates of Shanghai and recipients of Shanghai awards for outstanding postgraduate theses. These graduates have become the backbone of nephrology in China and abroad. More than 30 now serve as academic leaders at tertiary Grade A hospitals in China, and more than 10 serve as attending physicians and principal investigators at renowned medical and academic institutions including Massachusetts General Hospital, Emory University, and Vanderbilt University in the United States.

| Research |

The Department of Nephrology of Huashan Hospital, Fudan University, is the institution from which the Chairs of the Nephrology Branch of the Chinese Medical Association have served two terms and the Chairs of the Nephrology Branch of the Shanghai Medical Association have served three terms. In 2004, the department led the establishment of the Fudan University Institute of Nephrology, with Professor Lin Shantang as its director. In 2016, Huashan Hospital, Fudan University, established the National Clinical Research Center for Geriatric Diseases, Fudan University’s first national clinical medical research platform and the only national clinical research center for geriatric diseases in East China. Professor Chen Jing serves as Deputy Director and Director of the Office of the center and also leads the area of «Kidney Aging and Prevention and Treatment of Geriatric Comorbidities». In 2020, with support from funding for the development of high-level local universities in Shanghai, Fudan University established the Joint Laboratory of Geriatric Medicine and Health. Professor Chen Jing serves as Deputy Director and Director of the Office of the laboratory and is responsible for research on kidney aging and age-related diseases.

The department leads more than 100 national and provincial/ministerial-level projects, including the National Key Research and Development Program, special projects of the National Program on Key Basic Research and Development (973 Program projects), major projects of the National Natural Science Foundation of China, key projects of the National Natural Science Foundation of China, and key international cooperation projects of the National Natural Science Foundation of China. It has led and participated in a series of international and domestic multicenter clinical studies, published hundreds of papers in leading international journals (N Engl J Med, J Clin Invest, J Am Soc Nephrol, Kidney Int, and others), and received more than 10 provincial- or ministerial-level science and technology achievement awards.

| Expert team |

Professor Lin Shantang, a founder of the discipline, served as a Council member of the International Society of Nephrology and received numerous international honors, including the International Distinguished Contribution Award and the Pioneer Award, making major contributions to bringing Chinese nephrology to the world. Professor Hao Chuanming, the academic leader, currently serves as a member of the Nominating Committee of the American Society of Nephrology, a member of the Best Clinical Practice Recommendations Committee of the Asian Pacific Society of Nephrology, a member of the Editorial Board for Renal Physiology of the American Journal of Physiology, and Chair of the Renal Professional Committee of the Chinese Society of Physiological Sciences. Professor Chen Jing, Director of Department of Nephrology I, currently serves as an expert of the ISN-Dialysis Working Group, a member of the Nephrology Branch of the Chinese Medical Association, and Deputy Chair of the Nephrology Branch of the Shanghai Medical Association.

Under the leadership of Director Chen Jing, Department of Nephrology I currently has 32 employees, including 17 with senior professional titles; 92% hold doctoral degrees, and more than 50% have studied or trained at renowned universities abroad. There are also four full-time technicians. Seventy percent of the staff have led more than 100 scientific research projects at provincial/ministerial level or above. The team has received dozens of talent-program appointments and honors, including the Ministry of Education New Century Excellent Talents Program, Shanghai Medical Leading Talents, Shanghai Outstanding Academic Leaders, the Hundred Talents Program, the Outstanding Academic Leaders Program, Shuguang Scholars, Medical Garden New Stars, the Chenguang Program, Outstanding Young Medical Talents, the Shanghai Science and Technology Qimingxing Program, and the Yangfan Program. It has thus formed a highly educated talent echelon and technical team with strong clinical and research capabilities, aligned with national medical standards and modern development trends.

Talent echelon of Department of Nephrology I.