Nephrology at Shanghai First People's Hospital | CMCS

Expert Kidney Disease Care at One of Shanghai's Premier Academic Medical Centers

The Department of Nephrology at Shanghai First People's Hospital — affiliated with Shanghai Jiao Tong University School of Medicine — is one of Shanghai's most distinguished nephrology centers, with a national reputation for excellence in glomerular disease, chronic kidney disease, acute kidney injury, dialysis, kidney transplantation, and the management of complex renal conditions. With a comprehensive dialysis program and a kidney transplantation service, the department combines outstanding clinical expertise with a world-class research program, offering international patients access to some of China's most eminent nephrologists. China Medical Concierge Shanghai (CMCS) provides seamless end-to-end coordination for international patients throughout their renal care journey.

About the Department

The nephrology department is a national key clinical specialty operating dedicated nephrology inpatient wards, a hemodialysis center, a peritoneal dialysis program, a kidney biopsy service, a kidney transplantation program, a CKD clinic, a glomerular disease clinic, a hypertension and renovascular disease clinic, and works in close collaboration with urology, cardiology, endocrinology, rheumatology, and transplant surgery through a fully integrated multidisciplinary team.

Glomerular Disease

Primary Glomerulonephritis

• IgA Nephropathy (IgAN) — Optimized supportive care (RAS blockade, SGLT2 inhibitors, fish oil); sparsentan (dual endothelin/angiotensin receptor antagonist — PROTECT trial); budesonide targeted-release (Nefecon/Tarpeyo) for high-risk IgAN; iptacopan (complement factor B inhibitor) for IgAN; systemic corticosteroids for selected patients; one of Shanghai's most experienced IgAN programs
• Membranous Nephropathy (MN) — PLA2R antibody testing; THSD7A testing; rituximab for PLA2R-positive MN (MENTOR trial); cyclophosphamide + corticosteroids (Ponticelli); tacrolimus + corticosteroids; obinutuzumab for rituximab-resistant MN; inebilizumab
• Focal Segmental Glomerulosclerosis (FSGS) — Corticosteroids; calcineurin inhibitors (tacrolimus, cyclosporine); mycophenolate; sparsentan for FSGS (DUPLEX trial); voclosporin; LNP023 (iptacopan) for C3G and FSGS
• Minimal Change Disease (MCD) — Corticosteroids; tacrolimus for frequently relapsing/steroid-dependent MCD; rituximab for refractory MCD; voclosporin
• Membranoproliferative GN & C3 Glomerulopathy — Complement pathway evaluation; iptacopan for C3G; avacopan; eculizumab for dense deposit disease; mycophenolate + corticosteroids

Secondary Glomerulonephritis

• Lupus Nephritis (LN) — Mycophenolate + hydroxychloroquine + corticosteroids; voclosporin + mycophenolate + corticosteroids (AURORA 1 trial); belimumab + standard of care (BLISS-LN trial); obinutuzumab for refractory LN; anifrolumab; low-dose corticosteroid protocols; one of Shanghai's most experienced lupus nephritis programs
• ANCA-Associated Vasculitis (AAV) — Rituximab + corticosteroids (RAVE trial); cyclophosphamide + corticosteroids; avacopan (complement C5a receptor inhibitor — ADVOCATE trial) replacing high-dose corticosteroids; rituximab maintenance; avacopan for remission maintenance
• Anti-GBM Disease (Goodpasture's) — Plasmapheresis; cyclophosphamide + corticosteroids; rituximab for refractory cases; dialysis support
• Diabetic Nephropathy — SGLT2 inhibitors (dapagliflozin — DAPA-CKD; empagliflozin — EMPA-KIDNEY); finerenone (Kerendia — FIDELIO-DKD, FIGARO-DKD); RAS blockade; semaglutide for CKD with T2DM (FLOW trial); coordination with endocrinology
• Amyloidosis Nephropathy — AL amyloidosis: daratumumab + VCd; ATTR amyloidosis: tafamidis; eplontersen; patisiran; coordination with hematology and cardiology

Chronic Kidney Disease (CKD)

• CKD Management — RAS blockade (ACE inhibitors, ARBs); SGLT2 inhibitors for CKD with or without diabetes; finerenone for CKD with T2DM; blood pressure control; proteinuria reduction; anemia management (ESA, HIF-PHI — roxadustat, daprodustat); CKD-MBD management (phosphate binders, active vitamin D, cinacalcet, etelcalcetide)
• CKD Anemia — Roxadustat (HIF-PHI) for dialysis and non-dialysis CKD anemia; daprodustat; vadadustat; ESA (epoetin alfa, darbepoetin, methoxy polyethylene glycol-epoetin beta); IV iron (ferric carboxymaltose, ferric derisomaltose)
• CKD-MBD — Phosphate restriction; calcium carbonate and sevelamer; lanthanum carbonate; sucroferric oxyhydroxide; active vitamin D (calcitriol, paricalcitol, alfacalcidol); cinacalcet; etelcalcetide for secondary hyperparathyroidism; parathyroidectomy coordination
• Hyperkalemia in CKD — Patiromer (Veltassa); sodium zirconium cyclosilicate (Lokelma); dietary potassium restriction; enabling full RAS blockade
• CKD Progression Slowing — SGLT2 inhibitors; finerenone; sparsentan; low-protein diet; uric acid lowering (allopurinol, febuxostat)

Acute Kidney Injury (AKI)

• AKI Assessment — KDIGO staging; urinary biomarkers (NGAL, KIM-1, TIMP-2 x IGFBP7 — NephroCheck); renal biopsy for unexplained AKI; renal replacement therapy (RRT) timing
• Contrast-Induced AKI Prevention — IV hydration; iso-osmolar contrast; N-acetylcysteine; sodium bicarbonate; minimizing contrast volume
• Cardiorenal Syndrome — Optimization of cardiac output; diuretic strategies; ultrafiltration; coordination with cardiology
• Hepatorenal Syndrome — Terlipressin + albumin; norepinephrine + albumin; TIPS coordination; liver transplantation evaluation
• Renal Replacement Therapy — Intermittent hemodialysis; continuous RRT (CRRT — CVVHDF, CVVHF); sustained low-efficiency dialysis (SLED); peritoneal dialysis for AKI

Dialysis

Hemodialysis

• Conventional HD — Three times weekly; high-flux dialyzers; online hemodiafiltration (HDF) for improved outcomes; high-volume HDF; nocturnal HD; short daily HD
• Vascular Access — AVF creation and surveillance; AVF salvage (PTA, thrombectomy); AV graft; tunneled dialysis catheter; coordination with vascular surgery
• Dialysis Adequacy — Kt/V monitoring; URR; residual kidney function preservation; volume management; blood pressure control
• HD Complications — Intradialytic hypotension; cramps; access infections; cardiovascular disease; anemia; CKD-MBD

Peritoneal Dialysis

• CAPD & APD — Continuous ambulatory PD; automated PD (cycler); icodextrin for long dwell; biocompatible PD solutions (low GDP); one of Shanghai's most experienced PD programs
• PD Catheter Placement — Laparoscopic and open Tenckhoff catheter insertion; fluoroscopic placement; catheter salvage
• PD Complications — Peritonitis management; exit-site infection; encapsulating peritoneal sclerosis; ultrafiltration failure; hernia
• Home PD Training — Patient and caregiver training; remote monitoring; telemedicine follow-up

Kidney Transplantation

• Pre-Transplant Evaluation — Transplant candidacy assessment; crossmatch; HLA typing; PRA; desensitization for highly sensitized patients; coordination with transplant surgery
• Living Donor Transplantation — Living related and unrelated donor evaluation; laparoscopic donor nephrectomy; ABO-incompatible transplantation with desensitization
• Deceased Donor Transplantation — Standard and extended criteria donors; DCD (donation after circulatory death) kidneys; machine perfusion
• Immunosuppression — Tacrolimus + mycophenolate + corticosteroids; belatacept-based regimens; steroid minimization; calcineurin inhibitor minimization; everolimus
• Rejection Management — Acute cellular rejection: pulse corticosteroids; thymoglobulin; antibody-mediated rejection (AMR): IVIG + rituximab; plasmapheresis; eculizumab for severe AMR; imlifidase for desensitization
• Post-Transplant Complications — BK virus nephropathy; CMV disease; PTLD; de novo DSA monitoring; chronic allograft nephropathy; recurrent glomerular disease

Hypertension & Renovascular Disease

• Resistant Hypertension — Spironolactone; eplerenone; finerenone; renal denervation (Symplicity Spyral); amiloride; doxazosin; secondary hypertension workup
• Renovascular Hypertension — Renal artery stenosis: endovascular stenting; FMD: balloon angioplasty; coordination with vascular surgery and interventional radiology
• Primary Hyperaldosteronism — Adrenal vein sampling; adrenalectomy coordination; mineralocorticoid receptor antagonists; coordination with endocrinology

Why International Patients Choose Shanghai First People's Hospital Nephrology

• IgA Nephropathy Expertise — One of Shanghai's most experienced IgAN programs; sparsentan; budesonide targeted-release (Tarpeyo); iptacopan
• Voclosporin for Lupus Nephritis — AURORA 1 trial evidence; calcineurin inhibitor with reduced nephrotoxicity
• Avacopan for AAV — Complement C5a receptor inhibitor replacing high-dose corticosteroids; ADVOCATE trial
• Roxadustat for CKD Anemia — HIF-PHI for dialysis and non-dialysis CKD anemia; oral administration
• Finerenone for Diabetic CKD — Non-steroidal MRA for CKD with T2DM; cardiorenal protection
• Cost-Effectiveness — World-class nephrology care at significantly lower cost than equivalent treatment in Western countries

The CMCS Patient Journey

1. Initial Inquiry — Share your kidney diagnosis, laboratory results (creatinine, eGFR, proteinuria, urinalysis), kidney biopsy reports, and prior treatment history with CMCS.
2. Medical Record Preparation — We translate and organize your records for specialist pre-consultation review.
3. Specialist Matching — We identify the most appropriate nephrologist based on your condition — glomerular disease, CKD, AKI, dialysis, kidney transplantation, or hypertension.
4. Priority Scheduling — We secure a consultation with minimal waiting time.
5. Travel & Logistics — Assistance with visa invitation letters, accessible accommodation near Shanghai First People's Hospital, and Shanghai airport transfers.
6. Diagnostic Assessment — Full coordination of kidney biopsy, laboratory evaluation, and imaging.
7. Treatment Coordination — Full coordination of immunosuppression initiation, dialysis access, or transplant evaluation.
8. Post-Consultation Follow-Up — Biopsy report translation, treatment plan interpretation, and remote follow-up coordination after you return home.

Book a Consultation

If you have IgA nephropathy, lupus nephritis, membranous nephropathy, chronic kidney disease, are on dialysis, or require kidney transplantation evaluation — CMCS can arrange a specialist consultation with Shanghai First People's Hospital's nephrology team.

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