Nephrology

The Department of Nephrology of Renji Hospital was established in the 1970s and is one of the hospitals in China to have established a nephrology department at an early stage. In 1962–1963, an integrated Chinese and Western medicine ward was established within the internal medicine wards of Renji Hospital. It carried out integrated Chinese and Western medicine treatment for kidney diseases and renal insufficiency, with “conquering the incurable disease—uremia” as its principal direction. In 1976, the Department of Nephrology became an independent department. Under the leadership of successive department heads, Professors Chen Meifang, Zhang Qingyi, Qian Jiaqi, Ni Zhaohui, and Gu Leyi, it has now developed into a National Key Clinical Specialty, a Key Discipline of the Ministry of Education, one of the first batch of Ministry of Health Peritoneal Dialysis Training Centers, the Shanghai Sub-center of the National Clinical Research Center for Chronic Kidney Disease, the Shanghai Jiao Tong University Uremia Diagnosis and Treatment Center, the Shanghai Peritoneal Dialysis Research Center, the Asia-Pacific Peritoneal Dialysis Clinical College, and the first home dialysis training center in China. It also houses a Level III laboratory of the National Administration of Traditional Chinese Medicine—the Molecular Cell (Nephrology) Laboratory.

The Department of Nephrology currently provides outpatient and inpatient services at all three campuses—the East Campus, West Campus, and South Campus. It has a total of 72 specialty beds, 134 hemodialysis machines, and 16 CRRT machines. The discipline has a high-caliber academic echelon. Under the leadership of Director Ni Zhaohui and Director Gu Leyi, it currently has 49 physicians, including 11 professors/chief physicians and 8 associate professors/deputy chief physicians. The discipline is a training site for doctoral and master’s graduate students specializing in nephrology, with 4 doctoral supervisors and 5 master’s supervisors. Postgraduate educational qualifications cover 100% of the department, and more than 67% have doctoral-level qualifications. The discipline focuses on clinical and basic research aimed at delaying the progression of chronic kidney disease and carrying out integrated treatment of end-stage kidney disease. Its subspecialties include acute kidney injury, chronic kidney disease, the integrated Chinese and Western medicine prevention and treatment of kidney diseases, the treatment of critically ill kidney disease, hemodialysis, peritoneal dialysis, and kidney transplantation. Over the years, it has received extensive recognition and praise from patients.

The discipline’s objective is: “Leading domestically, advanced internationally, and first-class in Asia.” The discipline’s tenet is: “Patients first, quality as the foundation, developing the department through science and education, and striving to create a first-rate department.” The discipline’s direction is: “First-rate quality, first-rate service, first-rate management, and a first-rate environment.”

## I. Medical Care

The Department of Nephrology of Renji Hospital consists of the nephrology wards, nephrology outpatient clinics, the Hemodialysis Center, the Peritoneal Dialysis Center, the Molecular Cell (Nephrology) Laboratory, and the renal pathology room. It has 72 specialty beds, more than 6,000 inpatient visits annually, and more than 170,000 outpatient visits annually. In addition to specialist outpatient clinics every day, it also operates many disease-specific clinics, including clinics for lupus nephritis, refractory kidney disease, diabetic nephropathy, gout, chronic kidney disease, peritoneal dialysis follow-up, kidney transplant follow-up, urinary tract infections, tumor-associated kidney disease, and metabolism-related kidney disease, among others. It also operates expert clinics, special-needs senior expert clinics, and appointment clinics to meet the needs of patients at different levels.

Renal replacement therapy for end-stage kidney disease is also one of the distinctive features of the discipline. It holds a relatively high position domestically and also enjoys a certain reputation internationally. Beginning in 1996, it established the Sino-foreign cooperative medical institution, the “Renji NMC Hemodialysis Center.” The department currently has two units and three hemodialysis centers at the East, West, and South campuses. All of them use relatively advanced multifunctional blood purification machines, automated CRRT machines, and plasma exchange machines internationally, and the department began carrying out a series of new technologies in China. It can perform all types of blood purification treatment.

It is particularly skilled in performing dialysis for patients with highly difficult conditions, high-risk patients, emergency patients, and elderly patients. It uses single- or double-filter plasma exchange to treat various refractory kidney diseases, secondary kidney diseases—including severe lupus erythematosus—and rejection following kidney transplantation. The Dialysis Center not only emphasizes the quality of dialysis treatment, but also cares about patients’ psychological well-being and quality of life. It regularly conducts a rich variety of patient education and public-awareness activities.

For 15 consecutive years, the Department of Nephrology of Renji Hospital has been responsible for compiling Shanghai’s dialysis registry data. As the only such data from China, it was adopted by the United States Renal Data System (USRDS) and published worldwide. Peritoneal dialysis for the treatment of uremia is an especially important specialty of the department. It holds a relatively high position domestically and enjoys a high reputation internationally. Related research has received the Second Prize of the National Science and Technology Progress Award and many other scientific research awards. In 2012, it was selected and designated as a Ministry of Health Peritoneal Dialysis Training Center. There are currently more than 760 peritoneal dialysis patients under long-term follow-up and more than 530 hemodialysis patients.

The Department of Nephrology has long adhered to research integrating Chinese and Western medicine and uses both Chinese and Western medical methods for diagnosis. It has achieved good therapeutic results in the treatment of chronic kidney disease, chronic renal insufficiency, and uremia. Its clinical specialty is the treatment of various difficult and critical kidney diseases, including primary and secondary kidney diseases such as lupus nephritis, diabetic nephropathy, and renal hypertension. A series of studies on the prevention and treatment of chronic kidney disease and diabetic nephropathy with Huangqi (Astragalus) received the China Association of Integrative Medicine Science and Technology Progress Award and the Shanghai Integrative Medicine Science and Technology Progress Award.

## II. Research

The discipline has a Level III laboratory of the National Administration of Traditional Chinese Medicine—the Molecular Cell (Nephrology) Laboratory. Over the past five years, it has led and undertaken more than ten national-level research projects, including key special projects of the Ministry of Science and Technology and projects of the National Natural Science Foundation of China, as well as multiple provincial- and ministerial-level projects. It has published nearly 200 papers in various journals, more than 100 of which have been indexed by SCI.

Its research achievements have received numerous awards, including the Second Prize of the National Science and Technology Progress Award, the Second Prize of the Shanghai Science and Technology Progress Award, the First Prize of the China Association of Integrative Medicine Science and Technology Award, the Third Prize of the Huaxia Medical Science and Technology Award, the Second and Third Prizes of the Shanghai Medical Science and Technology Award, and the Second Prize of the Shanghai Integrative Medicine Science and Technology Award. It has also obtained multiple national invention patents.

The department participated in compiling the Ministry of Health’s *Blood Purification Standard Operating Guidelines, 2021 Edition* and the *Standard Operating Guidelines for Peritoneal Dialysis*, among others. It also participated in compiling multiple diagnostic and treatment standards and guidelines for kidney diseases.

It served as chief editor of the monographs *Clinical Therapeutics*, *Clinical Nephrology Volume*, *Dietary Therapy for Kidney Disease*, *Handbook of Internal Medicine Outpatient Clinics*, and *Strategies for the Diagnosis and Treatment of Kidney Diseases*, among others. It served as deputy editor-in-chief of *Standard Operating Specifications for Peritoneal Dialysis*. It also participated in compiling the monographs *Theory and Practice of Internal Medicine*, *Practical Internal Medicine*, *Chinese Internal Medicine*, *Clinical Therapeutics*, *Practical Nephrology* (1st Edition), *Nutrition—Kidney Disease Section*, *The Merck Manual—17th Edition*, *Practical Critical Care Treatment*, *Nephrology*, *Chinese Medical Encyclopedia (Nephrology Volume)*, and *Chinese Dietary Therapy*, among others.

## III. Teaching

Over the past approximately 10 years, the Department of Nephrology has trained a total of 52 doctoral graduate students, 55 master’s students, and 1 postdoctoral fellow. A large number of physicians from Shanghai and from 30 provinces, municipalities, and autonomous regions across the country have come to the department for further training. To date, it has trained more than 100 physicians receiving further training in nephrology.

It served as chief editor of the national higher-education “13th Five-Year Plan” medical organ–system integration planning textbook *Urinary System*, as well as *Complex Diseases of the Urinary System*, among others. Since 1997, it has continuously held 23 editions of the national-level continuing education program course *Fundamentals and Clinical Practice of Peritoneal Dialysis*, training more than 2,000 peritoneal dialysis professionals for the country. In 2003, it was approved by the Ministry of Health as one of the first batch of national continuing medical education training bases.

The department is responsible for the clinical and preclinical teaching of eight-year, seven-year, and five-year medical university undergraduates—including Chinese- and English-language classes—as well as junior college students and physicians receiving further training. It has received the “Baosteel Teaching Award,” and many members have received the university-level and hospital-level title of “Excellent Teacher.”

The department has been recognized as:

- A National Key Clinical Specialty of the Ministry of Health - A Level III Laboratory of the National Administration of Chinese Medicine - One of the first batch of Ministry of Health Peritoneal Dialysis Training Demonstration Centers - The Asia-Pacific Peritoneal Dialysis Clinical College - The Shanghai Jiao Tong University Uremia Diagnosis and Treatment Center - A Key Specialty of Shanghai Jiao Tong University School of Medicine - A Demonstration Ward of Shanghai Jiao Tong University School of Medicine - An Excellent Teaching Team of Shanghai Jiao Tong University School of Medicine

## Major Milestones of the Department of Nephrology

**April 24, 1970:** Renji Hospital successfully performed its first hemodialysis.

**February 1974:** The first TX-23 dialysate supply device and plate-type dialyzer in China were successfully trial-manufactured.

**1975:** The first hollow-fiber dialyzer in China was successfully developed and received the Shanghai Municipal Health Bureau Science and Technology Progress Award.

**Early 1980s:** The Department of Nephrology began regular hemodialysis treatment.

**1987:** Shanghai’s first successful case of using plasma exchange to treat rejection of a transplanted kidney was performed.

**June 1996:** The Renji-Nianmeisi (Renji-NMC) Hemodialysis Center was established. In 1998, it was renamed the Renji-FMC Hemodialysis Center.

**1997:** CRRT was used for the first time to successfully treat a patient with multiple organ failure following cardiac surgery.

**1998:** The department became an affiliated institution of the Shanghai Municipal Health Bureau Hemodialysis Quality Control Center, with Professor Qian Jiaqi serving as director of the Hemodialysis Quality Control Center.

**2001:** The Hemodialysis Center of Renji Hospital’s East Campus was established, with 30 hemodialysis machines. In 2012, the number increased to 60.

**2002:** The department took the lead in China in carrying out online monitoring methods for BVM, BPM, BTM, and online Kt/V, greatly improving patients’ dialysis experience and treatment outcomes.

**February 2006:** The Shanghai Peritoneal Dialysis Research Center was established.

**June 2006:** *Related Research on Effectively Improving the Survival Rate of Peritoneal Dialysis Patients* received the First Prize of the Shanghai Medical Science and Technology Award.

**October 2006:** The Shanghai Dialysis Registry Network was established. It was adopted and published by the USRDS system as the only data from mainland China, achieving a “zero” breakthrough in the inclusion of dialysis registry data for Chinese uremia patients by an internationally authoritative institution.

**November 2006:** *A Series of Studies on Improving the Survival Rate of Peritoneal Dialysis Patients* received the First Prize of the Shanghai Science and Technology Progress Award.

**December 2006:** *A Series of Studies on the Prevention and Treatment of Chronic Kidney Disease with Huangqi* received the Second Prize of the Science and Technology Award of the Chinese Association of Integrative Medicine.

**January 2007:** *Clinical and Basic Research on Improving the Prognosis of Uremia Patients through Peritoneal Dialysis* received the First Prize of the Science and Technology Progress Award of Chinese Universities.

**December 2007:** *Basic and Clinical Research on Improving the Survival Rate of Peritoneal Dialysis Patients* received the Second Prize of the National Science and Technology Progress Award.

**May 12, 2008:** Head Nurse Wang Yongmei and Head Nurse Jiang Rong successively went to the front line of the Wenchuan earthquake relief effort, carrying out a series of rescue treatments, including CRRT and long-duration hemodialysis.

**June 2009:** *A Series of Studies on the Prevention and Treatment of Diabetic Nephropathy with Huangqi* received the Second Prize of the Shanghai Integrative Medicine Science and Technology Progress Award.

**September 2010:** *Standardized Treatment for Improving Peritoneal Dialysis Survival* received the Shanghai Medical Science and Technology Award (Achievement Promotion).

**2012:** The Hemodialysis Center of Renji Hospital’s South Campus was established, with 42 hemodialysis machines.

**December 2012:** *Mechanisms of Action and Translational Application of Huangqi in the Prevention and Treatment of Kidney Diseases* received the Second Prize of the Shanghai Integrative Medicine Science and Technology Award.

**June 2013:** The Hemodialysis Center of Renji Hospital’s South Campus was established.

**December 2013:** *Pathogenesis of Renal Fibrosis and the Translational Application of Huangqi Intervention* received the First Prize of the Science and Technology Award of the Chinese Association of Integrative Medicine.

**December 2014:** *Pathogenesis of Renal Fibrosis and the Translational Application of Integrated Chinese and Western Medicine Intervention* received the Third Prize of the Huaxia Medical Science and Technology Award.

**July 2015:** *Mechanisms of Renal Fibrosis and the Translational Application of Biomarkers* received the Second Prize of the Shanghai Medical Science and Technology Award.

**2017:** Renovation of the Hemodialysis Center of Renji Hospital’s West Campus was completed, with 32 hemodialysis machines.

**2017:** The department began to be responsible for the Sanda student course *Fundamentals and Nursing of Blood Purification*, training application-oriented undergraduates in blood purification.

**October 18, 2018:** Renji’s first home hemodialysis training center in China was officially unveiled.

**April 27, 2020:** China’s first patient to complete home hemodialysis training underwent hemodialysis treatment at home, achieving a “zero” breakthrough in home hemodialysis in China.

**February 19, 2020:** Seven doctors and nurses from the Department of Nephrology joined the members of Shanghai’s eighth medical team sent to assist Hubei and went to Wuhan Leishenshan Hospital, where they used CRRT and hemodialysis technology to treat critically ill COVID-19 patients.

**2020:** The department was designated a practical training base for specialized blood purification nurses by the Chinese Nursing Association.

**May 2021:** *Mechanisms of Podocyte Injury Repair and Determination of Efficacy and Prognosis in IgA Nephropathy* received the Third Prize of the Shanghai Medical Science and Technology Award.

**March 12, 2022:** The Hemodialysis Center of Renji Hospital opened an “Emergency Hemodialysis Room” to receive hemodialysis patients from areas under lockdown and control.

**March 18, 2022:** Renji Hospital’s East Campus entered closed-loop management. Patients at the East Campus Hemodialysis Center continued their regular hemodialysis, taking the lead in achieving “the hospital closed, but the hemodialysis room did not.”

**2022:** The department was designated a National Blood Purification Standard Demonstration Training Center.