SFVA Division of Nephrology

About                        

Welcome to the San Francisco Veteran’s Affairs division of Nephrology! We are a group of eleven nephrologists, all with joint academic appointments at the University of California, San Francisco.

We are all deeply committed to providing the best possible nephrology care to Veterans and their families. We also have diverse academic interests including clinical research, basic science research and education. 

To view our overall Division website, please go here: UCSF NeprhologY Website

Patient Care

The Nephrology (Kidney) Section at the San Francisco VA Health Care System (SFVAHCS) offers outstanding comprehensive, personalized care to veterans with kidney disease, hypertension and electrolyte disorders.

Our specialists, are UCSF-affiliated faculty, provide expertise in the diagnosis and treatment of a variety of conditions that lead to chronic kidney disease including:

  • Hypertension
  • Acute Kidney Injury
  • Glomerular Disease
  • Vascular Disorders
  • Heart Failure
  • Tubulo-Interstitial Disease
  • Autoimmune Disorders
  • Drug Toxicity
  • Electrolyte Disorders
  • Urinary Obstruction and Recurrent kidney

Our team works closely with other specialty services at the SFVAHCS, including nutrition, endocrinology, rheumatology, cardiology, oncology, urology, vascular surgery and radiology to provide coordinated care plans for each patient and to offer specialized services, including kidney transplant care.

SFVAHCS Nephrology Clinics

The SFVA Nephrology Section provides services within the VISN21 network that extend from the San Francisco Bay area to the California-Oregon border and are in partnerships with other networks. We offer care through in-person clinics as well as e-consults and telehealth services.

General Renal Clinic

The clinic is staffed by nephrologists with expertise in various kidney disease conditions, including early to late stage chronic kidney disease, hypertension, kidney disease from a variety of causes, electrolyte disorders, and kidney stones.

When: Thursdays, 8 AM to 12 PM

Where: San Francisco VA Medical Center, Building 203, Ground Floor Module 1

Renal Transitions Clinic

The Renal Transitions Clinic provides care to patients with very advanced chronic kidney disease to support shared decision-making surrounding kidney replacement therapy. The clinic offers patient education on dialysis modality and offers an integrated approach to dialysis initiation working with vascular surgery and interventional radiology, to coordinate the patient’s advanced chronic kidney disease care. The clinic also offers palliative nephrology care. The clinic approaches patient care comprehensively with nephrology, nutrition, social work and kidney transplant evaluation programs working together to guide patients nearing end-stage kidney disease. The clinic also works with additional services as needed, such as

When: Wednesday 10:30AM to 4PM

Where: San Francisco VA Medical Center, Building 200, GB 17

 Kidney Transplant Clinic

The Kidney Transplant Evaluation Clinic guides patients through pre-transplant needs including anticipation and coordination of additional services and provides comprehensive post-transplant care.

We have an outstanding, close working relationship with our nearest VA kidney transplant center in Portland, Oregon, as well as with the University of California, San Francisco (UCSF) Kidney Transplant Program .

When: By appointment with transplant evaluation team

Where: San Francisco VA Medical Center, Building 200, GB17 or Building 203, Ground Floor Module 1

Dialysis Services

San Francisco VA Hemodialysis Service

The SFVA Medical Center provides outpatient hemodialysis to patients with end-stage kidney disease. The dialysis unit is staffed by dedicated, well-trained dialysis nurses and technicians. A team of nephrologists, dialysis staff, nutritionist and social work provide multidisciplinary coordinated care to comprehensively address the hemodialysis patient’s needs. We work closely with vascular surgery and interventional radiology to establish and maintain the patient’s vascular access for dialysis. In addition, the dialysis unit provides continuous renal replacement therapy for acutely ill patients admitted to the SFVA Intensive Care Unit.

Where: San Francisco VA Medical Center, Building 200, 3rd Floor

Contact: 415-221-4810, extension 22034

Home Peritoneal Dialysis Service

The SFVA Medical Center provides home peritoneal dialysis to patients with end-stage kidney disease, including patient and caregiver training for home peritoneal dialysis. Eligible individuals for the program work with a team of nephrologists, peritoneal dialysis specialty trained nursing staff, nutritionist and social work to provide multidisciplinary coordinated care to comprehensively address the peritoneal dialysis patient’s needs. Individuals are typically followed in our Renal Transitions Clinic [EMM8] until the need for dialysis arises. The team works very closely with surgery and interventional radiology for catheter placement. Comprehensive peritoneal dialysis training includes one week of intensive one-on-one training.

When: Wednesday am and pm clinic, training by appointment

Where: San Francisco VA Medical Center, Building 200, GB17

Additional Access to Nephrology Care

We offer the same outstanding outpatient clinical service at our community-based outpatient clinics (CBOCs).  The Nephrology Section is also proud to participate in the Veterans Health Administration Telehealth Services through the provision of monthly video teleconference appointments. We offer electronic consultation and video teleconference (VTEL) for eligible veterans who live remotely from San Francisco. We provide electronic consultation (e-consult) for providers who may need aid in patient management but may not necessarily require a full patient visit. These e-consults may be placed via the computerized patient record system (CPRS). In addition, outpatient face-to-face clinical service will be provided at the Eureka and Santa Rosa clinics. Referrals for these consultation programs may be made by your primary care provider. The following is a list of community-based clinics eligible for both e-consult and VTEL consultation.  

  • Eureka
  • Santa Rosa
  • Clearlake
  • Ukiah
  • San Bruno (e-consult)

Faculty

Education                

The San Francisco VA (SFVA) is one of three primary teaching sites for the University of California, San Francisco (UCSF) Nephrology Fellowship. Each month, two fellows rotate on our clinical rotation services.

One fellow works closely with the inpatient consult attending to care for patients requiring inpatient nephrology consultation. The other fellow is responsible for supervising the care of outpatients that receive renal replacement therapy from our dialysis unit. UCSF fellows and UCSF internal medicine residents also provide care to veterans in our renal clinic under our supervision.

Every member of our faculty is dedicated to education. Several of us have completed rigorous advanced training in medical education, scholarship and leadership through the UCSF Teaching Scholars Program. Selected faculty have also competed successfully for funding both for education related activities including education innovations and mentorship.

Learn more about the Nephrology fellowship here: Nephrology Fellowship

Research

SFVA Nephrology faculty members are leaders in the field of kidney disease research.

Our faculty members serve in editorial roles in top journals and are members of working groups for major ongoing studies. Dr. Lovett is a member of the prestigious American Society for Clinical Investigation. Our work is supported by many competitive grants from both the National Institutes of Health and other sources.

The San Francisco VA also houses the Kidney Health Research Collaborative (KHRC) which is joint investment by SFVA and UCSF. The KHRC is an innovation hub dedicated to improving kidney health worldwide through research and mentorship. Our faculty serve in key roles at the KHRC including Dr. Peralta who is Executive Director and Co-founder of the KHRC, and Dr. Estrella and Dr. Johansen who are both Core Investigators.

Our senior faculty are committed to maintaining a culture of supportive mentorship and have each mentored many successful trainees and junior faculty members. Dr Johansen is also the recipient of a highly competitive mentoring grant (NIH K24). Members of our faculty (Drs Lovett and Johansen) have chaired the UCSF Nephrology T32 committee for the last 12 years.  We are deeply proud of our senior fellows and junior faculty and their success in both dissemination of their work and in obtaining competitive funding awards.

Faculty who devote a substantial portion of their time to research include Cynthia Delgado, Ruth Dubin, Michelle Estrella, Vasantha Jotwani, David Lovett and Carmen Peralta.

Helpful Links

Kidney Health Research CollaborativeKHRC door

UCSF Nephrology Fellowship

TED style talk about research mentorship in academic medicine by Carmen Peralta, SFVA Nephrology faculty member and Executive Director of the KHRC