George Bakris, MD, a pioneer in hypertension, kidney disease research
A career spent researching hypertension has led Bakris into several other specialties.
Concerns about diabetes and kidney disease trends in the United States have defined the career of George L. Bakris, MD.
For more than three decades, Bakris has worked on the front lines of kidney disease, hypertension and diabetes research, and he has made crucial discoveries that have had a lasting effect on diabetes and hypertension therapy. Bakris specializes in kidney research, but has also crossed over into overlapping therapeutic areas like CVD and diabetes management.
“I am actually a board certified nephrologist and clinical hypertension specialist,” Bakris, a member of the Hypertension and Vascular Disease section of the Cardiology Today Editorial Board, said in an interview. “Our hypertension unit is nestled in with the diabetes center at the University of Chicago. I would say that 98% of the patients I see are obese, have diabetes, or have kidney disease — 100% have difficult-to-treat hypertension.”
Since Bakris’s primary specialty is in kidney disease, he spends time studying the hemodynamic effects of kidney disease as well as ethnic disparities in kidney disease development and progression. Problems with the kidneys, Bakris realized, also affect the vascular, cardiovascular and metabolic systems.
“I started out studying renal hemodynamic effects of contrast agents, and really looking at acute kidney injury,” said Bakris. “As times and my interests changed, I got more into diabetic kidney disease and the pathophysiology and therapeutics of trying to stop or slow progressive kidney disease. What I realized was that hypertension was an integral part of kidney disease, and it was almost impossible to divorce the two.”
During the next several years, Bakris conducted research into slowing or stopping kidney disease by controlling BP. One specialty and avenue of research overlapped into another and Bakris ended up conducting research in a number of specialties — specifically cardiovascular areas.
“I realized after getting into hypertension that a nice crossover existed not only between blood pressure control and progression of diabetic kidney disease, but also between blood pressure-lowering agents and progressive kidney disease,” said Bakris. “I have now come to the point where I am focused on vascular compliance and on atherosclerosis as it relates to blood pressure and kidney disease.”
Contributions to research
Bakris also has been responsible for a number of research observations and landmarks affecting the way diabetes and hypertension are treated in the United States. He ranks these as some of his proudest professional accomplishments.
“Our initial observation that differential reductions in proteinuria by different subclasses of calcium antagonists is associated with slowed progression of kidney disease and that this effect is not totally related to blood pressure reduction was an important one,” Bakris said. “Another is our observation of the interaction of endothelin and insulin, and its contribution to the progression of diabetic kidney disease.”
Bakris helped make both discoveries between 1989 and 1991. These observations were followed-up with subsequent research and further confirmation of these findings. Bakris said that he is proud to have contributed to this body of research on these subjects.
“Certainly, the proteinuria observation has been followed-up on and has weaved through my entire career,” said Bakris. “The endothelin research stopped by the mid 1990s, because it was clear then that, although there was a role for endothelin at a cellular level, using calcium channel blockers took care of a lot of the effects of endothelin, and there was not a lot interest in pursuing that further.”
Bakris is also responsible for getting practice-changing research about serum creatinine into treatment guidelines and regimens.
“A limited elevation of serum creatinine as a result of treating advanced kidney disease with ACE inhibitors or angiotensin receptor blockers does not equate to kidney injury. Moreover, if their BP is at goal, it indicates that those patients have a better prognosis for kidney outcomes than similar patients who don’t have elevations in serum creatinine,” Bakris said. “This is something that has gotten into the guidelines and has had major effect in terms of treatment regimen.”
Like many practitioners, Bakris has also become concerned about the rising levels of diabetes, obesity and hypertension among young people.
“I have addressed this in symposia, at conferences and on Capitol Hill,” said Bakris. “Physical education needs to be put back into schools, and all of the high-fat, high-glucose meals given to children need to be replaced. This must be a proactive effort, and I realize that it will take more money than has been available. In the end, the cost savings of prevention will be phenomenal.”
Academic career and hobbies
Bakris has spent his professional life in the Midwest, earning his bachelor’s degree in biology and psychology at Indiana University and master’s degree in human development at the University of Chicago. He graduated from the Chicago Medical School and completed residencies and fellowships at the University of Chicago, the Mayo Graduate School of Medicine. He is currently a professor of medicine and director of the Hypertensive Disease Union at the University of Chicago Pritzker School of Medicine.
Bakris has published more than 400 articles and books, and serves on the editorial boards of a number of publications and journals in addition to Cardiology Today, including Hypertension, Kidney International Journal of Clinical Hypertension, Journal of Human Hypertension, Hypertension, and the Journal of Nephrology. He is the editor of the American Journal of Nephrology.
When he is not immersed in his work, Bakris spends his downtime as an amateur musician and music enthusiast.
“I listen to a whole variety of music. I also play guitar, and I even used to play in a band and record. It is pretty much that and my job,” Bakris said. “I am one of those people who really enjoys what he does. I consider myself very fortunate in that respect.” – by Eric Raible