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Rachel B Fissell M.D. M.S.

Department: Medicine

Biography

I trained in Internal Medicine at the University of Maryland, and completed a Nephrology Fellowship at the University of Michigan, and a Masters degree in Biostatistics and Clinical Trial Design at the University of Michigan.

The goals of my research are to improve survival and quality of life for patients with End Stage Renal Disease.   My training and background are in epidemiology, statistics, and clinical trial design, particularly in the hemodialysis population.  My contributions in the past have involved sampling large data sets such as the Dialysis Outcomes and Practice Patterns Study, the United States Renal Data System, and the Scientific Registry of Transplant Recipients, to test for associations between patient characteristics and practice patterns, and patient outcomes. 

Over the past 5 years, my clinical focus has been hemodialysis, and specifically in-center nocturnal hemodialysis.  I have worked with teams at both the Cleveland Clinic and Vanderbilt to add nocturnal shifts to existing daytime programs; we put patients on for 8 hours, 3 nights a week.  My research now focuses on the benefits to patients of longer, more extended treatments.  In-center nocturnal hemodialysis seems to allow patients to normalize their sleep wake cycle, liberalize their diet and still maintain normal serum phosphorus levels, and have slower ultrafiltration rates with overall greater fluid removal.  Our team is studying patient factors that are associated with long term patient success with the nocturnal modality.  I am also interested in the physiology of longer versus shorter treatments, and whether extending treatment times can modify inflammation, which has been associated with morbidity and mortality in the dialysis population.  Finally, I am interested in learning more about using metrics other than small solute clearance to measure dialysis adequacy. 

 

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