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 these people carry an enormous medical burden.  Patients with CKD suffer from the metabolic sequelae of poor kidney function, hypertension, progressive worsening of glomerular filtration rate (GFR), and from disproportionate cardiovascular diseases. Therefore, a large number of people can benefit from early recognition of CKD, improved understanding of the metabolic and cardiovascular responses to CKD, and by limiting 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 prospective trials in diabetic nephropathy, end-stage kidney disease, and in focal segmental glomerulosclerosis (FSGS.  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 faculty member (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.

• Frederick O'Connor Medical Consultants
• Raleigh Radiology

Representative Publications
Pun, PH; Herzog, CA; Middleton, JP. Improving ascertainment of sudden cardiac death in patients with end stage renal disease. Clinical Journal of the American Society of Nephrology. 2012;7:116-122. (2012) Abstract

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 International. 2011;80:868-878. (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 International. 2011;79:678-685. (2011) Abstract

Middleton, JP. Predisposition to arrhythmias: electrolytes, uremic fibrosis, other factors. Seminars in Dialysis. 2011;24:287-289. (2011) Abstract

Pun, PH; Lehrich, RW; Honeycutt, EF; Herzog, CA; Middleton, JP. Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. Kidney International. 2011;79:218-227. (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; AASK Study Investigators. CYP3A4 and CYP3A5 polymorphisms and blood pressure response to amlodipine among African-American men and women with early hypertensive renal disease. American Journal of Nephrology. 2010;31:95-103. (2010) Abstract

Middleton, JP; Pun, PH. Hypertension, chronic kidney disease, and the development of cardiovascular risk: a joint primacy. Kidney International. 2010;77:753-755. (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; AASK Study Investigators. G-protein-coupled receptor kinase 4 polymorphisms and blood pressure response to metoprolol among African Americans: sex-specificity and interactions. American Journal of Hypertension. 2009;22:332-338. (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 International. 2009;76:652-658. (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. Journal of the American Society of Nephrology. 2007;18:312-320. (2007) Abstract

Pun, PH; Lehrich, RW; Smith, SR; Middleton, JP. Predictors of survival after cardiac arrest in outpatient hemodialysis clinics. Clinical Journal of the American Society of Nephrology. 2007;2:491-500. (2007) Abstract

Winn, MP; Daskalakis, N; Spurney, RF; Middleton, JP. Unexpected role of TRPC6 channel in familial nephrotic syndrome: does it have clinical implications?. Journal of the American Society of Nephrology. 2006;17:378-387. (2006) Abstract

Wright, JT; 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; African American Study of Kidney Disease and Hypertension Study Group. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA: Journal of the American Medical Association. 2002;288:2421-2431. (2002) Abstract