UH Geauga Medical Center Nephrologist Lives Out Childhood Dream

UH Clinical Update | April 2023

Not many 6-year-old girls declare that they want to grow up to be a nephrologist. But not many have had the background and experiences of Nissreen Elfadawy, MD – now a nephrologist on the medical staff at UH Geauga Medical Center.

“Starting when I was 6 years old, when anyone asked me what I wanted to be, I always said not just a doctor, but a kidney doctor,” Dr. Elfadawy says.

Nissreen Elfadawy,MD

Experiences Spark Interest

As a child growing up in the small township of Mansoura in the Delta region of Egypt, young Nissreen would tag along with her father as he visited dialysis wards. He was not a physician, but instead supervised and managed the dialysis units. Dr. Elfadawy says she also became interested in the field though interactions with nephrologists in Mansoura township, which is internationally known for high-quality kidney care.

After graduating from medical school at Alexandria University, Dr. Elfadawy continued in her single-minded journey to become a nephrologist. She earned a master’s degree in dialysis, writing her master’s thesis on how better to understand and manage the problem of blood pressure drop during dialysis sessions. She completed a residency in internal medicine in Egypt. But still she wanted to learn more. Deciding to relocate to Cleveland, she completed a urology research fellowship at Cleveland Clinic, as well as a transplant nephrology fellowship. Still wanting to further her education and training, Dr. Elfadawy arrived at UH, completing residency training in internal medicine and fellowship training in nephrology in 2019.

And when the time came to choose where she would launch her career, it wasn’t a close call, she says.

“I did my residency, my fellowship, everything, here,” she says. “I really can’t see myself outside of UH.  My husband is the same. He's UH-grown and -produced. We feel like UH is our home.”

Measurable Impact

In her short time at UH Geauga, Dr. Elfadawy has lent her nephrology expertise to several different initiatives benefiting both patients and the UH system, says Marlea Miano, MD, the hospital’s Chief Medical Officer. For one, Dr. Elfadawy helped develop a protocol for residents and primary care providers for when to remove a Foley catheter, serving as the contact point when opinions differ among physicians.

“This has led to a reduction in “Foley catheter days” – which has led to a significant reduction in catheter-associated urinary tract infections (CAUTI),” Dr. Miano says. “UH Geauga has been CAUTI-free since August 2020.”

In addition, Dr. Elfadawy has helped spearhead a new hospital-based program in peritoneal dialysis at UH Geauga – a crucial addition to the hospital’s services. Peritoneal dialysis is less taxing on the body, and government payors prefer it because of its lower cost.

“We identified a dedicated team of nurses to receive very intense training, and we made sure that every shift of the day, we have one or two trainers or nurses for peritoneal dialysis,” Dr. Elfadawy says. “In a very short time, just three to six months, we established our PD program.”

This new program also means fewer transfers to Main Campus, she says, preserving capacity there for those who are most seriously ill.

“Our goal here as a community hospital is trying to help the busy downtown Main Campus and keep our patients close to home,” she says. “So now we are taking care of those patients efficiently.”

Dr. Elfadawy has also launched an onco-nephrology clinic at UH Geauga – the only one of its kind outside of Main Campus. And she’s an active consultant with UH’s growing Hospital@Home program – and its only current nephrologist.

Given the breadth of these accomplishments, it’s no surprise that Dr. Elfadawy has received a “Dinner with the Doc” honor from UH CEO Cliff A. Megerian, MD, FACS, Jane and Henry Meyer Chief Executive Officer Distinguished Chair.

Accolades and Plans

Next up for Dr. Elfadawy is the imminent publication of new international guidelines on management of BK virus nephropathy in the context of kidney transplantation, on which she is a co-author. She was one of just 35 nephrologists around the world who were invited by The Transplantation Society to meet last March in Switzerland to develop these needed guidelines.

“This is a prestigious invitation to acknowledge her numerous publications and previous training in this field,” Dr. Miano says

Dr. Elfadawy says she’s gratified at the impact work like this can have.

“We wrote the guidelines that will help all the physicians in the world to treat this kind of virus,” she says. “That’s amazing to think about.”

And closer to home at UH Geauga, she’s hoping to launch yet another new service – a mini-clinic for people who’ve had kidney transplants. She feels strongly about locating these services out in the community.

“Sometimes it's very, very burdensome on patients to drive to Main Campus,” she says. “Sometimes they even forgo a needed appointment. So if I can offer this service to the population here in the community, I think that would be ideal.”