The History of the Division of Nephrology at Massachusetts General Hospital
The MGH Bulfinch Building and Harvard Medical School, c.1856
In 1949 Dr. Alex Leaf returned to the Massachusetts General Hospital, after his residency at the Mayo Clinic. There was no Division of Nephrology or even Nephrologists. The study of physiology, diseases involving fluids, electrocytes, and kidney function was included under "Metabolism" and headed by renowned physician Fuller Albright. In 1949, Alex Leaf joined Albright to study calcium and phosphorus metabolism, bone disease, and parathyroids. In 1950, he set up his own lab with a rat bio-assay for anti-diuretic hormone. He soon had two fellows working with him, Audley Mamby and Oliver Wrong. Their studies chiefly involved regulation of body fluids and renal excretion of water and sodium. In 1953, they moved to the third floor of the Domestic building, and were joined by E.P. Tuttle and Walter Kerr.
In 1954, Leaf spent four months in Copenhagen in the laboratory of Hans Ussing, and in 1955 he began two years in Oxford in the laboratory of Professor Hans Krebs. Returning to MGH in 1957, he was appointed Chief of the new Cardiorenal Laboratories. Dr. Leaf's groups continued their studies of membrane transport, antidiuretic hormone, and aldosterone action and were joined by biochemist, Dr. Geoffrey Sharp. Howard Frazier was also actively involved in the activities of the Cardiorenal Division. A number of fellows were present during the next years, including Norman Lichtenstein and Cecil Coggins. The group served the hospital as consultants for patients with kidney disease or disorders of fluid and electrocyte metabolism and assisted in teaching the Harvard Medical School students. Donald Dibona, a Ph.D. in Biophysics, joined the group.
During the 1960's, both renal transplantation and Hemodialysis were coming of age. Leaf decided not to invest heavily in Hemodialysis, especially when the Brigham had a very active program, but agreed that the surgical services needed a dialysis unit to support their transplantation efforts. A Dialysis Unit was established under the Department of Surgery, but staffed by members of the Medical Services. George Baker was the first director, and was later followed by Clyde Beck and Nina Tolkoff-Rubin.
Dr. Lot Page (of the Endocrine Unit) and Frazier had performed a few closed kidney biopsies, and Coggins reintroduced the technique, beginning an active collaboration with Robert McCluskey, Robert Colvin, and Vivian Pinn of Pathology.
In 1967, the Nephrology Division moved to the 7th floor of the Jackson building and Leaf was appointed the Chief of Medicine. The Division was divided into a Clinical Nephrology Division, directed by Samuel Thier; a Biochemical Pharmacology research activity, directed by Geoff Sharp; and a Renal Biophysics program, directed by Dibona and Leaf. Sam Thier departed to become Associate Chief of Medicine with Arnold Relman, at the University of Pennsylvania, Chief of Medicine at Yale, and then President of Partners Healthcare Inc. Coggins took over as acting Clinical Chief assisted by Norm Lichtenstein and Nina Tolkoff -Rubin. Geoff Sharp departed to Tufts and then to Cornell in the 1970's and Dibona moved south, becoming a professor at the University of Alabama, and then Chairman of Anatomy in South Carolina. He was replaced by John Mils in the Laboratory of Renal Biophysics.
On stepping down as chief of Medical Services, Leaf returned to the Division of Nephrology in May of 1981, to re assume the position of Chief. Coggins remained the Director of Clinical Nephrology. In 1984, Alex stepped down to become Professor of Preventive Medicine and Epidemiology. Dennis Ausiello, who had been a fellow in 1975, then became the chief of the Division of Nephrology. In the summer of 1988, the bulk of the research laboratories moved to the new Mass General facilities at the former Charlestown Navy Yard. That year, Dr. M. Amin Arnaout was recruited from Boston Children's Hospital and Brigham & Women's Hospital. In 1991, Dr. Arnaout established the Leukocyte Biology and Inflammation Program at Mass General.
In 1995, a portion of the clinical activity moved to new quarters, on the 5th floor of Charles River Plaza. In 1997, we began a formal collaboration with the Renal Division of Brigham & Women's Hospital, under the direction of Dr. Barry M. Brenner, to combine the clinical year of two fellowship programs. In 1996, Dennis Ausiello was appointed Chief of the Medical Services at the Massachusetts General Hospital, and in July 1998, Dr. Arnaout was appointed Chief of the Division of Nephrology. In 1997, Dr. Arnaout founded and became the first Director of the Mass General Structural Biology Facility. In addition to the active research programs of the Division of Nephrology and the clinical services performed, a large number of renal fellows received their clinical and research training in the division as well. Many of them have gone on to positions of leadership in the academic, research, and clinical fields in the U.S. and in countries throughout the world.