Department of Nephrology

The Department of Nephrology was established in 1979 as a new discipline in China, founded by Professor Bi Zengqi, becoming one of the earliest nephrology departments in the country. In 1980, a renal laboratory and hemodialysis unit were established. In the early 1990s, a group of young scholars returned from overseas, injecting new vitality and development opportunities into clinical nephrology, education, and research. In 1993, the nephrology specialty group at Peking Union Medical College Hospital was restructured into the Department of Nephrology, along with the establishment of the Blood Purification Center. By the late 1990s, several doctoral and master's graduates completed postdoctoral training or further studies in the United States, Europe, Australia, and Japan, enhancing the vitality of the department. After nearly 30 years of hard work, the nephrology department has gradually developed into a modern kidney disease diagnosis and treatment center, including outpatient services, inpatient wards, a blood purification (including peritoneal dialysis) center, and a renal laboratory.

Over the years, under the direct leadership of the Ministry of Health, the department has accomplished significant work in high-level health care, foreign patient treatment, and overseas medical consultations.

The strict physician rotation training system and three-level ward rounds at Peking Union Medical College Hospital, along with the solid internal medicine foundation of physicians at all levels and strong interdisciplinary collaboration, give the department a unique advantage in managing complex cases and rescuing critically ill patients, earning unanimous recognition in the industry.

The talent hierarchy of the department and the academic positions of its personnel.

Throughout nearly thirty years of development, three generations of department leaders have dedicated significant effort.

The Department of Nephrology at Peking Union Medical College Hospital has a highly educated (90% of attending physicians and associate professors hold doctoral degrees) and young professional team. Currently, there are 3 professors, 2 doctoral supervisors, and 10 associate professors, all of whom have received rigorous research or clinical fellowship training abroad and are capable of leading related teams in clinical and research work upon returning to China, with several serving as master's supervisors. There are 5 attending physicians, all of whom have undergone strict clinical training in internal medicine at Peking Union Medical College Hospital and are capable of handling daily clinical and teaching responsibilities independently. The department boasts a top-notch team of graduate supervisors and a high-level technical backbone in specialized laboratories. Colleagues who have trained at Peking Union Medical College Hospital are now key personnel in local hospitals, with several physicians becoming standing committee members or committee members of the Chinese Society of Nephrology.

The Department of Nephrology consists of outpatient services, inpatient wards, hemodialysis center, peritoneal dialysis center, and laboratories, with specialties including glomerular diseases, tubulointerstitial diseases, hypertension and water-salt metabolism, non-dialysis treatment of chronic renal failure, hemodialysis, peritoneal dialysis, and kidney transplantation. The outpatient volume is nearly 40,000 visits per year, with 52 inpatient beds (32 in the East Campus and 20 in the West Campus). Each year, nearly 1,000 patients are hospitalized and undergo renal biopsy.

As part of Peking Union Medical College Hospital, a national center for the research and treatment of difficult diseases, many patients face complex and severe conditions from across the country. The department demonstrates a solid internal medicine foundation and strong interdisciplinary collaboration in managing complex cases and rescuing critically ill patients, enjoying a high reputation domestically. This is closely linked to the hospital's comprehensive three-level ward round system, the system of resident physicians, interns, and attending physicians conducting rounds and lectures, and the rotation training system for resident and attending physicians.

Professors Huang Qingyuan and Su Ying from the Department of Nephrology have both studied renal pathology in the United States for a year. This work is currently led by Associate Professor Li Hang, with the participation of a physician specializing in laboratory pathology. The department holds weekly clinical-pathological case discussions, and in recent years, the quality of pathological diagnoses has continuously improved, placing the diagnostic level at the forefront in the country.

Since 1997, a comprehensive clinical database for difficult cases, a renal pathology database, and associated serum, urine specimen, and DNA banks have been established, playing an increasingly important foundational role in improving clinical diagnosis and treatment levels and clinical research.

In recent years, the department has placed greater emphasis on collaboration with sister departments to enhance the prevention and treatment of critical illnesses. Collaborating with the laboratory department, we have applied the latest international RIFLE criteria to analyze all 89,778 serum creatinine (Scr) data from hospitalized patients, obtaining epidemiological data on the incidence of acquired acute renal failure (ARF) in a large comprehensive hospital, aiming to reduce the occurrence of severe ARF and improve AKI prognosis. Additionally, we have collaborated with the radiology, microbiology, respiratory, and infectious disease departments to establish a warning mechanism for patients with glomerulonephritis receiving immunosuppressive therapy, monitoring the relationship between PC infections, respiratory failure, lymphocyte counts, and T lymphocyte subpopulation functions, enabling timely detection and prevention of life-threatening severe infections due to immunosuppression, placing us at a leading position in the country.

In the 1970s, the initial work on blood purification and peritoneal dialysis began, playing an important role in the treatment of critically ill patients. Since the establishment of the Blood Purification and Peritoneal Dialysis Center in 1999, it has developed in a standardized manner, establishing a high-quality integrated dialysis system for end-stage renal disease, with patient long-term survival rates and quality of life ranking among the best in the country. The incidence of peritonitis is 1 in 68 patients per month, leading the country.

Currently, the Blood Purification Center is managed by Associate Professor Sun Yang, who is also the Secretary-General of the Quality Management Committee of the Chinese Medical Association Hospital Management Society and the Vice Chairman of the Dialysis Treatment Group of the Beijing Biomedical Engineering Society. The Blood Purification Center and Peritoneal Dialysis Center are equipped with 63 advanced hemodialysis machines, 1 artificial liver treatment machine, 2 plasma exchange machines, 4 bedside blood filtration machines, and 4 peritoneal dialysis machines. A comprehensive online urea nitrogen monitoring system, volume monitoring system, cartridge sodium dialysis system, and hemodialysis computer monitoring system have been established, enabling the implementation of all new and specialized blood purification treatment projects in the country, such as CRRT, immunoadsorption, bilirubin adsorption therapy, and molecular adsorption recirculation system (artificial liver MARS). Among these, the CRRT (Continuous Renal Replacement Therapy) for critically ill patients is a crucial part of the hospital's rescue system for critically ill patients, available 24/7 in all wards. Following the 5.12 earthquake in Sichuan, the department was tasked by the Ministry of Health and the Beijing Municipal Health Bureau, with 4 doctors and nurses rushing to the front lines to participate in the rescue of patients with crush syndrome and acute renal failure, receiving high praise from all parties.

The Department of Nephrology is one of the earliest departments to perform kidney transplants, currently having a relatively stable team for long-term follow-up. In 2002, the Department of Nephrology, in collaboration with the Urology and Pediatrics departments, established a comprehensive kidney disease center integrating clinical, research, education, and public awareness. The establishment of this center facilitates early diagnosis and treatment of kidney diseases and prevention of chronic renal insufficiency, allowing patients to receive integrated treatment and services for non-dialysis and replacement therapies (including hemodialysis, peritoneal dialysis, and kidney transplantation). In recent years, closer cooperation has been developed in pediatric renal pathology, screening for adult Fabry disease, and familial kidney transplants.

After more than 40 years of accumulation and innovative development, the Department of Nephrology enjoys a high reputation in domestic clinical research on kidney diseases. In the early 1980s, it was the first to develop essential amino acid preparations for renal failure and explored the significance of integrated traditional Chinese and Western medicine in non-dialysis treatment of chronic renal failure, leading the country in immunopathological and clinical research on lupus nephritis. Since the 1990s, the department has undertaken several national key projects funded by the Ministry of Health and the Ministry of Education, including the 'Research on Domestic CAPD Dialysis Bags and Dialysate' and 'Series Studies on the Immunosuppressive Effects of Tripterygium Wilfordii on Transplant Immunity, Peripheral Blood T Cells, and Renal Mesangial Cells'.

The developing renal pathology laboratory has advanced imaging acquisition and processing systems, capable of independently completing routine light microscopy and special staining, electron microscopy (immunoelectron microscopy), immunofluorescence, immunodouble staining, and in situ hybridization techniques; while completing routine clinical experiments, it also provides high-quality technical support for 10-20 doctoral and master's students annually in areas such as experimental zoology, pathology, general biochemistry, cellular immunology, molecular biology, and radioimmunology, expanding the clinical and basic research of the discipline from gross pathology to protein function and molecular levels. This has facilitated the successful completion and development of national key projects such as 'Diagnosis and Treatment of Early Diabetic Nephropathy' and 'Research on Lipid Metabolism in Kidney Diseases'. Among these, the non-lipid-lowering renal protective effects of statins and the series of studies on lipid metabolism and kidney diseases are at the leading level in the country, winning the first prize for scientific papers at Peking Union Medical College Hospital in 2003. Research on drugs (especially traditional Chinese medicine Aristolochic acid) that promote transdifferentiation, apoptosis, and interstitial fibrosis of renal tubular epithelial cells is among the earliest, most systematic, and in-depth in the country.

In recent years, the Department of Nephrology has strengthened research investment and output based on existing advantageous projects, including studies on the mechanisms of diabetic tubulointerstitial lesions (funded by the Ministry of Science and Technology), the role of COX2 and nNOS in the regulation of renin in juxtaglomerular apparatus (funded by the National Natural Science Foundation), clinical and basic research on contrast-induced nephropathy and ischemic kidney disease (funded by the Ministry of Health), and series studies on the roles of oxidative stress, VEGF, and MCP-1 in the phenotypic changes of renal tubular epithelial cells (funded by the National Natural Science Foundation and Beijing Natural Science Foundation), as well as research on accelerated atherosclerosis of small renal vessels in lupus nephritis patients (funded by the internal fund of Peking Union Medical College Hospital). These projects have been successfully completed and concluded. Additionally, the 'Early Diagnosis and Intervention of Kidney Damage in Metabolic Syndrome' and 'Optimizing and Integrating Promotion of Early Diagnosis of CKD' have received funding from the National Health Department (4.19 million) and Beijing Science and Technology Commission (2.92 million), respectively, and are among the key ongoing projects. Furthermore, a group of young researchers returning from internationally renowned laboratories has significantly enriched the research team. Since 2006, young scholars have received multiple national and various levels of funding, including two National Natural Science Foundation projects, the Ministry of Personnel's Returnee Startup Fund, the Ministry of Science and Technology's Joint Fund for Basic and Clinical Research, and the Ministry of Science and Technology's Basic Platform Fund (three projects), covering various fields such as the regulatory mechanisms of angiotensin and renin, the interactions of COX2 and AngII in glomerulonephritis, and the molecular mechanisms of podocyte apoptosis in diabetic nephropathy, as well as basic and clinical research on hepatitis B-related nephritis and rapamycin nephropathy. Currently, the department's research on lipid metabolism-related kidney damage and the mechanisms of renal fibrosis involving phenotypic changes (transdifferentiation) of tubular cells remain at the forefront in the country, with multiple oral presentations at the Asia-Pacific Nephrology Annual Conference.

As a national clinical trial institution for new drugs, the Department of Nephrology has undertaken the organization and leadership of nationwide multicenter clinical validation of various erythropoietin applications in kidney diseases, leading and participating in clinical validation work for drugs such as EPO, low molecular weight heparin, cyclosporine A, FK506, methylprednisolone, mycophenolate mofetil, intravenous iron agents, compound keto acid, epoetin, ultrapure water, and dextrose peritoneal dialysis fluid. Among these, the 'Development and Clinical Research of Erythropoietin' won the second prize for national scientific and technological progress in 1998, with multiple validation projects currently underway.

As information and interaction become the most frequently used terms of this era, the Department of Nephrology has maintained close academic connections with peers at home and abroad as a catalyst for the discipline's development, establishing long-term collaborative relationships and postdoctoral training connections with institutions such as Columbia University College of Physicians and Surgeons, the Royal College of Physicians in London, the National Institute of Diabetes and Digestive and Kidney Diseases in the USA, Utah State University College of Medicine, and the University of Melbourne Medical School in Australia. Currently, the department is engaged in over 10 research projects funded by the National Natural Science Foundation, the Ministry of Personnel, the Ministry of Health, the Ministry of Science and Technology, Beijing Municipality, the Academy of Medical Sciences, and the hospital. The department has long undertaken multiple national key research projects, publishing hundreds of academic papers in international mainstream nephrology journals and authoritative domestic magazines.

As one of the earliest clinical medical schools in China to align with international standards, the Department of Nephrology at Peking Union Medical College has long been responsible for teaching diagnosis and internal medicine to eight-year undergraduate students, nursing students, and adult education students. It serves as a clinical training and internship base for Peking Union Medical College. Since 2006, it has become one of the first national residency training bases and secondary discipline training bases, participating in the revision of the Ministry of Health's specialty physician training syllabus, annually undertaking training for over 30 resident physicians and 5-10 specialty physicians. The unique residency rotation and training system at Peking Union Medical College Hospital has produced a large number of outstanding talents with solid foundational skills in nephrology, while also providing an important clinical training base for rotating clinical research graduate students. In clinical training, there is a strong emphasis on the 'three basics' while particularly valuing the cultivation of clinical thinking and learning abilities, encouraging proactive learning and work styles, and actively guiding resident physicians to participate in clinical research activities. In continuing education, the department organizes and teaches advanced nephrology seminars, providing specialized training for visiting physicians from across the country and cultivating a large number of key personnel for grassroots hospitals, with several physicians becoming local or national academic committee members.

The annual national advanced nephrology seminar, which began in 2007, combines expert lectures with clinical case discussions, directly sharing Peking Union Medical College's rich clinical experience accumulated over the years with participants, attracting hundreds of physicians of various levels each year. Additionally, the department co-hosts the China Blood Purification Summit Forum, which attracts over a thousand participants annually for exchanges and discussions on blood purification, reflecting Peking Union Medical College Hospital's influence and appeal in medical education and research. Each year, the department selects 1-2 master's and doctoral students to engage in research training at top international academic research institutions in the UK, USA, and Australia, maintaining close research exchanges to ensure the department's academic and teaching standards remain aligned with international advanced levels, adhering to Peking Union Medical College's tradition of rigorous and precise medical education.

The Department of Nephrology at Peking Union Medical College Hospital will carry forward the glorious past of Peking Union Medical College, upholding the fine tradition of diligence, precision, and dedication. However, in the face of the rapid development of peer institutions across the country, the department remains relatively weak in research, particularly in basic research. Therefore, it has begun to establish more collaborative relationships with various overseas research institutions and important domestic laboratories, attracting international or regional talents and academic leaders, motivating the department's research personnel to strive for excellence, and responding to the goal of building Peking Union Medical College Hospital into a nationally renowned, first-class hospital, working diligently towards better inheritance and development in all aspects of medical education and research.