John Paul Middleton, MD

Professor of Medicine
Campus mail 2424 Erwin Road, Suite 605, Durham, NC 27705
Phone (919) 660-6860
Email address j.p.middleton@duke.edu

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

Education and Training

  • Fellow in Nephrology, Medicine, Duke University, 1986 - 1989
  • Medical Resident, Medicine, University of Texas, Medical Branch at Galveston, 1983 - 1986
  • M.D., Virginia Commonwealth University, 1983

Publications

Esagian, Stepan M., Georgios A. Sideris, Muath Bishawi, Ioannis A. Ziogas, Ruediger W. Lehrich, John P. Middleton, Paul V. Suhocki, Theodore N. Pappas, and Konstantinos P. Economopoulos. “Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis.” J Nephrol 34, no. 5 (October 2021): 1681–96. https://doi.org/10.1007/s40620-020-00896-w.

PMID
33197001
Full Text

Srivastava, Anand, Xuan Cai, Jungwha Lee, Wei Li, Brett Larive, Cynthia Kendrick, Jennifer J. Gassman, et al. “Kidney Functional Magnetic Resonance Imaging and Change in eGFR in Individuals with CKD.” Clin J Am Soc Nephrol 15, no. 6 (June 8, 2020): 776–83. https://doi.org/10.2215/CJN.13201019.

PMID
32345747
Full Text

Raphael, Kalani L., Tamara Isakova, Joachim H. Ix, Dominic S. Raj, Myles Wolf, Linda F. Fried, Jennifer J. Gassman, et al. “A Randomized Trial Comparing the Safety, Adherence, and Pharmacodynamics Profiles of Two Doses of Sodium Bicarbonate in CKD: the BASE Pilot Trial.” J Am Soc Nephrol 31, no. 1 (January 2020): 161–74. https://doi.org/10.1681/ASN.2019030287.

PMID
31848294
Full Text

Ix, Joachim H., Tamara Isakova, Brett Larive, Kalani L. Raphael, Dominic S. Raj, Alfred K. Cheung, Stuart M. Sprague, et al. “Effects of Nicotinamide and Lanthanum Carbonate on Serum Phosphate and Fibroblast Growth Factor-23 in CKD: The COMBINE Trial.” J Am Soc Nephrol 30, no. 6 (June 2019): 1096–1108. https://doi.org/10.1681/ASN.2018101058.

PMID
31085679
Full Text

Edmonston, Daniel, Jessica D. Morris, and John P. Middleton. “Working Toward an Improved Understanding of Chronic Cardiorenal Syndrome Type 4.” Adv Chronic Kidney Dis 25, no. 5 (September 2018): 454–67. https://doi.org/10.1053/j.ackd.2018.08.010.

PMID
30309463
Full Text

Pun, Patrick H., Benjamin A. Goldstein, John A. Gallis, John P. Middleton, and Laura P. Svetkey. “Serum Potassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease.” Kidney Int Rep 2, no. 6 (November 2017): 1122–31. https://doi.org/10.1016/j.ekir.2017.07.001.

PMID
29270520
Full Text

Pun, Patrick H., Safa Abdalla, Geoffrey A. Block, Glenn M. Chertow, Ricardo Correa-Rotter, Bastian Dehmel, Tilman B. Drüeke, et al. “Cinacalcet, dialysate calcium concentration, and cardiovascular events in the EVOLVE trial.” Hemodial Int 20, no. 3 (July 2016): 421–31. https://doi.org/10.1111/hdi.12382.

PMID
26564024
Full Text

Suthar, Samantha Dias, and John P. Middleton. “Clinical Outcomes in Dialysis Patients: Prospects for Improvement with Aldosterone Receptor Antagonists.” Semin Dial 29, no. 1 (January 2016): 52–61. https://doi.org/10.1111/sdi.12421.

PMID
26242304
Full Text

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