Physicians

Department / Division
Medicine / Medicine-Nephrology

Address
2424 Erwin Road, Suite 605
Durham, NC 27705

Appointment Telephone
919-668-7630

Office Telephone
919-660-6860

Fax Telephone
919-684-4476

Training

• MD, Medical College of Virginia (Virginia Commonwealth University School of Medicine), 1983

Residency

• Internal Medicine, University of Texas Medical Branch, 1986

Fellowship

• Nephrology, Duke University Medical Center, 1989

Clinical Interests
Hypertension, general nephrology, progressive renal diseases, ESRD

Research Interests
I. More than 20 million people in the United States have chronic kidney disease (CKD), and they carry the burden of metabolic consequences of CKD, hypertension, progressive worsening of glomerular filtration rate (GFR), and inordinate risk of cardiovascular disease.  Therefore, a large number of people can benefit by recognition of CKD, by improved understanding of the metabolic and cardiovascular responses to CKD, and by efforts to reduce the progressive decline of GFR.

II. Current research efforts aim to improve understanding of the association among traditional and novel cardiovascular risks and kidney disease.  Ultimately the goal of the ongoing research will be to improve the management of the unique cardiovascular complications that occur in the patients with chronic kidney disease and to reduce the risk of developing advanced CKD.

III. Clinical trials underway at Duke include EVOLVE (Evaluation of Cincalcet Therapy to Lower Cardiovascular Events), SHARP (The Study of Heart and Renal Protection), and a prospective trial in diabetic nephropathy.  In addition, Dr. Middleton serves on the Steering Committee for the NIH Clinical Trial in Focal Segmental Glomerulosclerosis (FSGS). Dr. Middleton and his group is also performing retrospective trials with large clinical databases to determine etiology of and outcomes from sudden cardiac arrest in patients with advanced CKD.

IV. Recent studies have helped identify interventions to reduce progression of hypertensive nephrosclerosis and diabetic nephropathy.  The research group has also determined exposures that augment the cardiovascular risk of chronic kidney disease, including CKD that is maintained on hemodialysis.  

V. Key words: chronic kidney disease CKD), hypertension, glomerular disease, progression of chronic kidney disease (CKD), cardiovascular complications of chronic kidney disease (CKD), hemodialysis, cardiovascular risk

Industry Relationships and Collaborations (What's this?)

This physician (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.

• Merck & Co. USA (not assoc'd with Merck KGaA)
• Mitsubishi Pharmaceuticals
• Raleigh Radiology

Representative Publications
Gipson DS, Trachtman H, Kaskel FJ, Greene TH, Radeva MK, Gassman JJ, Moxey-Mims MM, Hogg RJ, Watkins SL, Fine RN, Hogan SL, Middleton JP, Vehaskari VM, Flynn PA, Powell LM, Vento SM, McMahan JL, Siegel N, D'Agati VD, Friedman AL. Clinical trial of focal segmental glomerulosclerosis in children and young adults. Kidney Int. 2011 Oct;80(8):868-78. (2011) Abstract

Gipson DS, Trachtman H, Kaskel FJ, Radeva MK, Gassman J, Greene TH, Moxey-Mims MM, Hogg RJ, Watkins SL, Fine RN, Middleton JP, Vehaskari VM, Hogan SL, Vento S, Flynn PA, Powell LM, McMahan JL, Siegel N, Friedman AL. Clinical trials treating focal segmental glomerulosclerosis should measure patient quality of life. Kidney Int. 2011 Mar;79(6):678-85. (2011) Abstract

Middleton JP. Predisposition to arrhythmias: electrolytes, uremic fibrosis, other factors. Semin Dial. 2011 May-Jun;24(3):287-9. (2011) Abstract

Pun PH, Herzog CA, Middleton JP. Improving Ascertainment of Sudden Cardiac Death in Patients with End Stage Renal Disease. Clin J Am Soc Nephrol. 2011 Nov 10. (2011) Abstract

Pun PH, Lehrich RW, Honeycutt EF, Herzog CA, Middleton JP. Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. Kidney Int. 2011 Jan;79(2):218-27. (2011) Abstract

Bhatnagar V, Garcia EP, O'Connor DT, Brophy VH, Alcaraz J, Richard E, Bakris GL, Middleton JP, Norris KC, Wright J, Hiremath L, Contreras G, Appel LJ, Lipkowitz MS, . CYP3A4 and CYP3A5 polymorphisms and blood pressure response to amlodipine among African-American men and women with early hypertensive renal disease. Am J Nephrol. 2010;31(2):95-103. (2010) Abstract

Middleton JP, Pun PH. Hypertension, chronic kidney disease, and the development of cardiovascular risk: a joint primacy. Kidney Int. 2010 May;77(9):753-5. (2010) Abstract

Bhatnagar V, O'Connor DT, Brophy VH, Schork NJ, Richard E, Salem RM, Nievergelt CM, Bakris GL, Middleton JP, Norris KC, Wright J, Hiremath L, Contreras G, Appel LJ, Lipkowitz MS, . G-protein-coupled receptor kinase 4 polymorphisms and blood pressure response to metoprolol among African Americans: sex-specificity and interactions. Am J Hypertens. 2009 Mar;22(3):332-8. (2009) Abstract

Pun PH, Smarz TR, Honeycutt EF, Shaw LK, Al-Khatib SM, Middleton JP. Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease. Kidney Int. 2009 Sep;76(6):652-8. (2009) Abstract

Lehrich RW, Pun PH, Tanenbaum ND, Smith SR, Middleton JP. Automated external defibrillators and survival from cardiac arrest in the outpatient hemodialysis clinic. J Am Soc Nephrol. 2007 Jan;18(1):312-20. (2007) Abstract

Pun PH, Lehrich RW, Smith SR, Middleton JP. Predictors of survival after cardiac arrest in outpatient hemodialysis clinics. Clin J Am Soc Nephrol. 2007 May;2(3):491-500. (2007) Abstract

Winn MP, Daskalakis N, Spurney RF, Middleton JP. Unexpected role of TRPC6 channel in familial nephrotic syndrome: does it have clinical implications? J Am Soc Nephrol. 2006 Feb;17(2):378-87. (2006) Abstract

Wright JT Jr, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, Cheek D, Douglas-Baltimore JG, Gassman J, Glassock R, Hebert L, Jamerson K, Lewis J, Phillips RA, Toto RD, Middleton JP, Rostand SG, . Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002 Nov 20;288(19):2421-31. (2002) Abstract

Fitz JG, Sostman AH, Middleton JP: Regulation of cation channels in liver cells by intracellular calcium and protein kinase C. Am. J. Physiol. 266:G677-G684, 1994. (1994)

Middleton JP, Kahn W, Collinsworth G, Hannun Y, Medford R: Heterogeneous regulation of Na+?K+ ATPAse in renal epithelial cells by protein kinase C. J.Biol. Chem. 268:15958-15964, 1993. (1993)

Middleton JP, Mangel AW, Bassavappa S, Fitz, G: Nucleotide receptors regulate membrane ion transport in renal epithelial cells. Am. J. Physiol. 264:F867-F873, 1993. (1993)

Middleton JP, Raymond JR, Whorton AR, Dennis VW: Short-term regulation of Na+/K+ ATPAse by recombinant human 5-HT1A receptor expressed in HeLa cells. J. Clin. Invest. 86:1799-1805, 1990. (1990)