Telemedicine’s Inventor & Kidney Doctor - Dr. Jack W. Moncrief (#221)

Dr. Berkson's Best Health Radio Podcast

Jack W. Moncrief, MD

Dr. Moncrief has been in practice almost 50 years and was honored as one of the 7 physicians that made kidney medicine what it is today. In this show you will learn why and get in on a great conversation between colleagues and old friends.

Dr. Moncrief and Dr. Berkson worked together in his clinic and dialysis center for almost 10 years. Both, together with Dr. Kenneth Burton, co-invented and worked on a combination drug/herb pharmaceutical and published original research shown below.

Listen to Learn

In this show you will learn how telemedicine got its start with an Austin kidney doctor wanting to do dialysis in faraway cities. By the nephrologist Dr. Jack Moncrief. Dr. Moncrief was the firsts doctor to do organ transplantation, dialysis, and dialysis in an infant, here in Texas.

You hear about kidney health as well as how to treat brown recluse spider bites, so it doesn’t become an acute medical emergency requiring surgeries and wound care. You also hear about nitroglycerin and its application in medicine.

Also amazing is that Dr. Moncrief is still “seeing” patients, though mostly over telemedicine. But not all. So if you have any kidney issues that you need a set of truly experienced eyes on, you may want to reach out to him.

Dr. Moncrief’s accomplishments:

Co-inventor and patent holder primary self/home dialysis procedure (CAPD) continuous parenteral ambulatory dialysis Nephrology practice 40 years Austin Biomedical research Moncrief-Popovich Research Institute Dialysis and Transplant practice First dialysis in newborn infant Their study:

Free Radic Biol Med 2013 May;58:46-51.

doi: 10.1016/j.freeradbiomed.2013.01.020. Epub 2013 Jan 29.

Acute effects of hemodialysis on nitrite and nitrate: potential cardiovascular implications in dialysis patients

Nathan S Bryan 1, Ashley C Torregrossa, Asad I Mian, D Lindsey Berkson, Christian M Westby, Jack W Moncrief

• DOI: 10.1016/j.freeradbiomed.2013.01.020

Abstract

Cardiovascular mortality in dialysis patients remains a serious problem. It is 10 to 20 times higher than in the general population. No molecular mechanism has been proven to explain this increased mortality, although nitric oxide (NO) has been implicated. The objective of our study was to determine the extent of the removal of the NO congeners nitrite and nitrate from plasma and saliva by hemodialysis, as this might disrupt physiological NO bioactivity and help explain the health disparity in dialysis patients. Blood and saliva were collected at baseline from patients on dialysis and blood was collected as it exited the dialysis unit. Blood and saliva were again collected after 4-5h of dialysis. In the 27 patients on dialysis, baseline plasma nitrite and nitrate by HPLC were 0.21±0.03 and 67.25±14.68 μM, respectively. Blood immediately upon exit from the dialysis unit had 57% less nitrite (0.09±0.03 μM; P=0.0008) and 84% less nitrate (11.04 μM; P=0.0003). After 4-5h of dialysis, new steady-state plasma levels of nitrite and nitrate were significantly lower than baseline, 0.09±0.01 μM (P=0.0002) and 16.72±2.27 μM (P=0.001), respectively. Dialysis also resulted in a significant reduction in salivary nitrite (232.58±75.65 to 25.77±10.88 μM; P=0.01) and nitrate (500.36±154.89 to 95.08±24.64 μM; P=0.01). Chronic and persistent depletion of plasma and salivary nitrite and nitrate probably reduces NO bioavailability and may explain in part the increased cardiovascular mortality in the dialysis patient.