Specialty: Adult Nephrology
Practice: Nephrology Associates of Westchester (affiliated with Boston Children’s Health Physicians)
Hospital: Westchester Medical Center
On one hand, as program director of Westchester Medical Center’s (WMC) nephrology fellowship, Maureen Brogan, MD, takes on some of the most critically ill patients and most complex nephrology cases across New York State. On the other hand, as director of WMC’s Renal Clinic, Brogan is focused on “ordinary” nephrology tasks, such as preventing the progression of kidney disease, controlling blood pressure, and treating kidney stones for Westchester’s most underserved populations. “I love working on complex cases, and, with two helicopter landings, two trauma ICUs, and a burn unit, we are taking on the sickest patients and the most complicated nephrology cases from around the state,” Brogan says. “But I’m also passionate about the work I do in the clinic, caring for people without insurance, for people coming from other countries, who don’t necessarily speak English, and people from group homes with cognitive problems.” Brogan’s clinic is equipped with iPads capable of translating any language, and she believes it’s vital, not just to talk but to listen to her patients. “I work hard to teach this to my fellows,” she says.
What can we do to detect kidney problems before they become fatal?
Many kidney diseases are asymptomatic, so people don’t know they have it until the very end. Certain diseases run in the family, so it’s important to know your family history. If you are 30 or older, see your doctor and have your kidney function tested, blood pressure checked, and your urine checked for protein, because we know that one in two adults who are 30 to 64 years old are going to get kidney disease. If your kidney function comes back abnormal, or you have protein in your urine, see a nephrologist.
What advice do you give your patients about protecting their renal health?
Beyond food and diet, know what’s in your medicine. If you are taking herbal medicine, know where they are coming from because herbal medications can be laced with heavy metals. Limit NSAIDS [Aleve, Advil], which can cause kidney problems. So can some antibiotics and a lot of these new antacids called proton-pump inhibitors [PPIs].
What recent changes in the field of nephrology are you most excited about?
I am really excited about some new patient-education platforms. There are more and more tools available for patients to educate themselves about kidney health. For example, you can go to the Centers for Disease Control website or the National Kidney Foundation website and educate yourself about your own risk.
Can spin classes cause kidney damage?
Yes. I’m writing a paper on this and calling it “Freebie Rhabdo.” People get free spin-class coupons, take classes where they burn hundreds of calories quickly, and afterward, they can barely walk for the next few days. They can get something called rhabdomyolysis, which happens when muscles break down in the quadriceps and gluteus maximus, which then leak an enzyme that can cause kidney failure. We saw six cases of spin-related exertional rhabdo at Westchester Medical Center in the last year. One of the patients was just 32 years old and was only on the bike for 15 minutes, which led to high muscle enzyme elevation and hospitalization to prevent kidney disease.