John Paul Middleton, MD

Associate 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

Edmonston, D, Morris, JD, and Middleton, JP. "Working Toward an Improved Understanding of Chronic Cardiorenal Syndrome Type 4." Advances in Chronic Kidney Disease 25, no. 5 (September 2018): 454-467. (Review)

PMID
30309463
Full Text

Pun, PH, and Middleton, JP. "Dialysate Potassium, Dialysate Magnesium, and Hemodialysis Risk." Journal of the American Society of Nephrology : JASN 28, no. 12 (December 2017): 3441-3451. (Review)

PMID
28993507
Full Text

Pun, PH, Goldstein, BA, Gallis, JA, Middleton, JP, and Svetkey, LP. "Serum Potassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease." Kidney International Reports 2, no. 6 (November 2017): 1122-1131.

PMID
29270520
Full Text

Middleton, JP, and Wolf, M. "Second Chances to Improve ESRD Outcomes With a Second-Generation Calcimimetic." JAMA 317, no. 2 (January 2017): 139-141.

PMID
28097342
Full Text

Pun, PH, Abdalla, S, Block, GA, Chertow, GM, Correa-Rotter, R, Dehmel, B, Drüeke, TB, Floege, J, Goodman, WG, Herzog, CA, London, GM, Mahaffey, KW, Moe, SM, Parfrey, PS, Wheeler, DC, and Middleton, JP. "Cinacalcet, dialysate calcium concentration, and cardiovascular events in the EVOLVE trial." Hemodialysis international. International Symposium on Home Hemodialysis 20, no. 3 (July 2016): 421-431.

PMID
26564024
Full Text

Suthar, SD, and Middleton, JP. "Clinical Outcomes in Dialysis Patients: Prospects for Improvement with Aldosterone Receptor Antagonists." Seminars in dialysis 29, no. 1 (January 2016): 52-61. (Review)

PMID
26242304
Full Text

Van Buren, PN, Lewis, JB, Dwyer, JP, Greene, T, Middleton, J, Sika, M, Umanath, K, Abraham, JD, Arfeen, SS, Bowline, IG, Chernin, G, Fadem, SZ, Goral, S, Koury, M, Sinsakul, MV, Weiner, DE, and Collaborative Study Group, . "The Phosphate Binder Ferric Citrate and Mineral Metabolism and Inflammatory Markers in Maintenance Dialysis Patients: Results From Prespecified Analyses of a Randomized Clinical Trial." American journal of kidney diseases : the official journal of the National Kidney Foundation 66, no. 3 (September 2015): 479-488.

PMID
25958079
Full Text

Moe, SM, Chertow, GM, Parfrey, PS, Kubo, Y, Block, GA, Correa-Rotter, R, Drüeke, TB, Herzog, CA, London, GM, Mahaffey, KW, Wheeler, DC, Stolina, M, Dehmel, B, Goodman, WG, Floege, J, and Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial Investigators*, . "Cinacalcet, Fibroblast Growth Factor-23, and Cardiovascular Disease in Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial." Circulation 132, no. 1 (July 2015): 27-39.

PMID
26059012
Full Text

Pun, PH, Hellkamp, AS, Sanders, GD, Middleton, JP, Hammill, SC, Al-Khalidi, HR, Curtis, LH, Fonarow, GC, and Al-Khatib, SM. "Primary prevention implantable cardioverter defibrillators in end-stage kidney disease patients on dialysis: a matched cohort study." Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 30, no. 5 (May 2015): 829-835.

PMID
25404241
Full Text

Middleton, JP, and Patel, UD. "The need for collaboration to improve cardiovascular outcomes in patients with CKD." Advances in chronic kidney disease 21, no. 6 (November 2014): 456-459.

PMID
25443570
Full Text

Pages