Bansal, ShwetaSchool of Medicine |
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I am a board certified specialist in Internal Medicine and Nephrology. My main clinical interests are: Peritoneal Dialysis (PD), Chronic Kidney Disease (CKD) and role of salt in the hypertension. To that end, I reestablished the PD program at University Health System (UHS) and have increased the patient?s census from 2 to 30 adopting a multi-disciplinary approach. This approach included establishment of a) renal replacement therapy education protocol at advanced CKD clinic, b) placement of PD catheter by interventional radiologists and general surgeons, c) an urgent-start protocol to initiate PD in an emergent setting, and d) hiring of new clinic staff including 3 RNS and 1 LVN. In 2014, I was appointed as the medical director of all four UHS outpatient renal clinics to oversee their clinical operations. As a director, over last year, I have significantly improved patient care including reduction of wait times from average of 2-3 months to 2 weeks, development and implementation of multiple policies and procedures to streamline the administration of treatments like intravenous iron, hepatitis B vaccine, and erythropoietin simulating agents etc. Additionally, as a medical director of advanced CKD clinic since 2012, I reorganized the dialysis access placement procedures that the interested and funded patients get the dialysis access within 2 months instead of 12 months previously. Over the past 5 years, I have continued my interest in basic and clinical research. My basic research is regarding the role of inflammation in CKD with the focus on two biological proteins (neutrophil gelatinase-associated lipocalin [NGAL] and fibroblast growth factor 23 [FGF23] as the pathogenic factors in the progression of CKD and associated cardiovascular disease. I received a sub award by NIDDK ($100,000) in 2013 and an institutional grant ($50,000) in 2014 to support my research. The results of the work have been presented at American Society of Nephrology national meetings and are under review for publication by a peer-reviewed journal. On the clinical side, I have started 4 investigator initiated projects involving nephrology research fellows in few. The results of these projects have been presented at national level during National Kidney Foundation and Southern Society of Clinical Investigation meetings and also published in reputed journal. I am also the principal investigator of 2 and co-investigator for few industry-sponsored clinical trials. I have been passionate about education since my residency time and have continued this interest as clinical faculty as well. I received award of excellence in teaching by the outgoing nephrology fellows with in first year of my joining as an assistant professor in the division. Currently, I am actively involved in teaching medical students, residents and nursing students. I have been serving the institute as the IRB member since 2013 and recently been appointed as the chair of IRB-2. I also chair the UHS pharmaceutical and therapeutic renal sub-committee since 2012. In this role I have revised many unclear policies and achieved approval for new medications needed by our dialysis population. For the patient care, I strongly believe that empowering patients by health education is the best way to achieve the healthiest outcomes. |
3/2012 - Present | Staff Physician | South Texas Veterans Health Care System, Medicine, San Antonio, TX |
3/2011 - Present | Research Co-Investigator | South Texas Veterans Health Care System, Medicine, San Antonio, TX |
8/2010 - Present | Assistant Professor/Clinical | University of Texas Health Science Center at San Antonio, Medicine, San Antonio, TX |
Year | Degree | Discipline | Institution |
2009 | Postdoctoral Fellowship | Nephrology | University of Colorado Health Sciences Center Denver , CO |
2009 | Clinical Fellowship | Nephrology | University of Colorado Health Sciences Center Denver , CO |
2009 | Certificate | Public Health | University of Colorado Health Sciences Center Denver , CO |
2006 | Residency | Internal Medicine | University of Colorado Health Sciences Center Denver , CO |
2004 | Internship | Internal Medicine | University of Colorado Health Sciences Center Denver , CO |
2001 | Residency | Internal Medicine | Moulana Azad Medical College New Delhi , India |
1998 | BM BS | Medicine | Swai Man Singh Medical College Jaipur , India |
Chronic Kidney Disease- On the clinical side, my expertise in the CKD is related to focusing on prevention of progression of CKD and associated cardiovascular disease through health education and lifestyle modification specifically control of dietary salt to manage HTN, proteinuria and over all prognosis. My research is in the area of inflammation in CKD with the focus on two biological proteins (neutrophil gelatinase-associated lipocalin [NGAL] and fibroblast growth factor 23 [FGF23] as the pathogenic factors in the progression of CKD and associated cardiovascular disease. |
Hypertension- Inadequate excretion of sodium by the kidney is the basis of most of the HTN, and main cause of HTN in CKD. I practice and teach to focus on salt management (details education about presence of high salt food ubiquitously, and proper use of diuretics) to improve control of HTN. |
Peritoneal Dialysis- I recieved training in peritoneal dialysis from Dr. Isaac Tietelbaum, the current president of International Society of PD, at Univeristy of Colorado Health Sciences Center. His mentorship and co-authorship of a chapter on PD with him provided me with the expertise in this modality of renal replacement therapy and enabled me to be the director of an independent PD unit at this Institute. I focus to improve the utilization of this modality in both regular setting and emergent setting. To that end, I am actively involved in teaching fellows to improve their comfort level with this modality. |
Date | Description | Institution | # Students |
5/2015 - Present | Family and Community Medicine | UTHSCSA | 30 students |
I started giving lecture to the family practice residents this year. The first I covered "Salt and HTN in CKD patients". The feedback I recieved: Dr. Bansal was amazing. | |||
10/2014 - Present | Step 1 Preparation Development Team | UTHSCSA | 20 students |
To assist MS prepare for MLE examination. I spent 2 hrs last year and 30 minutes for the preparation. I have been asked for assistance for this year also. Feedback: "We truly enjoyed you teaching our class; you did such a wonderful job". | |||
11/2013 - Present | Pathophysiology for APN | The University of Texas Health Science Center | |
Renal disorders and Chronic Kidney Disease (CKD). It is an introductory lecture to advanced practioners (APN) students on basic renal physiology and disorders. I have made this lecture case based, interactive and have incorporated very practical information to give a comprehensive idea of renal disorders to an APN student. I give this lecture twice a year. I have been receiving very positive feedback from the organizer and the students. 11/27/2013, 04/10/2014, 12/04/2014. My overall goal of this activity is to ensure understanding of CKD to APN students to enable them to take better care of CKD patients in outpatient and inpatient settings. | |||
10/2013 - Present | Medicine Resident Noon Conference | University of Texas Health Science Center at San Antonio | 30 students |
The topics which I have presented are below and these are presented on annual basis. I spend about 3 hrs/year for these lectures. I spent 10 hrs for their initial preparation and since then about 2 hr/yr. 1. Dysnatremia 2. CKD for the residents 3. Hyponatremia | |||
5/2013 - Present | Medicine, Behavior & Society | The University of Texas Health Science Center | |
My goal for the renal module, for the 1st year medical students, is to provide them with a strong foundation in sodium and water homeostasis to enable them to make rational decisions while managing patients in clinical settings. My nephrology fellowship at University of Colorado Health Sciences Center under the mentorship of Dr. Robert Schrier, a pioneer in broadening our understanding of body fluid regulation, provided me with an excellent knowledge base in this area. Moreover, my passion for teaching and my effective communication skills give me the impetus to be an outstanding instructor. The feedback I have received from the student has been very positive and rewarding. My participation in this course includes of 4 hours of lectures (200+ students) and four (2 hours of each) small group discussions (30+ students) every year. Responses from the students 1. "I wanted to take a minute and let you know that I`ve been really excited this module about the small group sessions. My group has an AMAZING preceptor, Dr. Bansal. She has been extremely helpful in working through complicated cases and helping us develop a better understanding of the renal system and big picture concepts of function and pathology. She has never made me feel silly when I didn`t know the answer to a question and always helped us to really think through a problem to ensure our understanding (vs. memorization). I feel that I learned a great deal from these sessions and sincerely appreciate her willingness to work with us, stay late past small group sessions, and even meet with us outside of regular class time to answer questions. It`s easy to see that she really enjoys the subject matter and teaching students." 2. "Dr. Bansal really broke down the physiology of her lecture and did an incredible job at making it simplistic and easy to understand. I appreciated how attentive she was to us as a class during the lecture - always making sure that we understood what she had just explained and clarifying everything she thought was a little harder to grasp". 3. "Dr. Bansal seemed to really care about our learning". 4. "It is clear that Dr. Bansal is passionate about us learning the material". | |||
8/2012 - Present | Clinical Skills | The University of Texas Health Science Center | |
This course is designed to mentor and teach clinical skills to medical students in their first 18 months of medical school. My purpose of this preceptorship is to teach the skills and art of an excellent history and physical taking to the medical students in the very beginning of their career so they can be confident physicians in the future.Over this period I meet with students about 9 times in different settings including renal clinic, dialysis clinic and inpatient consult service. Initially students shadow me watching and learning the interview skills, physical examination techniques and during later part analyzing the assessment and plan. I have successfully preceptored two students in 7/12-11/14 and currently have one student 7/14--present. Comments from the students: You are truly very inspirational. Thank you for your gentle patient teaching methods that helped me feel comfortable presenting a case and asking you so many questions. I am really grateful for the time you took to sit down and explain procedures and physiological concepts to me. | |||
2/2012 - Present | Medicine Clerkship | The University of Texas Health Science Center | |
These presentations are given to 3rd year medical student during their inpatient Internal Medicine rotation. I meet with about 30 students twice during each rotation and lecture on sodium and water homeostasis. My goal for these lectures is to embellish the knowledge they received during their 1st year renal module. I provide them with a step wise approach to understand sodium and water homeostasis, and thereby enable them to correlate basic physiology with the complex clinical problems they encounter during their rotation. I have made these lectures case based and interactive to improve their learning experience. I have got excellent and positive feedback from medical students regarding my teaching approach. | |||
9/2011 - Present | Division of Nephrology: Monday Clinical Conference | University of Texas Health Science Center at San Antonio | 40 students |
The topics which I have presented are below. Some of these lectures I give on annual basis. I spend 3hr/yr for these lectures and approximately 30 hours/yr in the preparation. 1. Principle and practice of PD 2. Hypertensive Crisis 3. Salt and hypertension 4. CKD: just a diagnosis to bill or real disease 5. Urgent start PD 6. Ultrafiltration Failure and Peritonitis | |||
10/2010 - Present | Post Graduate Rotation Supervision | UTHSCSA | |
Abstract |
Sultan, G, Manickam, H, Dah, K, Patel, R, Auger, T, Bansal S. PERITONEAL DIALYSIS-RELATED PERITONITIS CAUSED BY STREPTOCCUS BOVIS BIOTYPE-II/1: Dallas, Texas; 2015 Mar. (American Journal of Kidney Diseases). |
Phyo, N, Agarwal, G, Hirachan, P, Gelfond, J, Bansal S. Ergocalciferol supplementation does not reduce the rate of infections and all-cause mortality in hemodialysis patients Dallas, Texas; 2015 Mar. (American Journal of Kidney Diseases). |
Bansal S. Fluoroscopically-Guided Percutaneous Peritoneal Dialysis Catheters Placed by Interventional Nephrology for Urgent Start Peritoneal Dialysis Orlando, FL; 2015 Feb. (American Society of Diagnostic and Interventional Nephrology). |
Bansal S, Manickam, Hema, Auger, Tracy, Kessler, Ray, Sultan, Gayeth. PERITONEAL DIALYSIS-RELATED PERITONITIS CAUSED BY STREPTOCCUS BOVIS BIOTYPE-II/1; 2015 Feb. (Journal of Investigative Medicine; vol. 63, no. 2). |
Bansal S, Velagapudi, C, Friedrichs, W, Zarate-Abbott, P, Cunningham, S, Hu, S, Fanti P. Elevated NGAL level in CKD is function of both reduced GFR and circulating neutrophil count Philadelphia, PA; 2014 Nov. (Journal of American Society of Nephrology). |
Agarwal, G, Gelfond, J, Hirachan, P, Fanti P, Bansal S. Effect of Ergocalciferol Treatment on Erythropoietin utilization in Hemodialysis Patients Philadelphia, PA; 2014 Nov. (Journal of American Society of Nephrology). |
Bansal S, Velagapudi, C, Bhandari, B, Werner SL, Fanti P. NGAL and Inflammatory Mediators Stimulate FGF23 Production in in vitro Osteocytes Culture Philadelphia, PA; 2014 Nov. (Journal of American Society of Nephrology). |
Aderinto, O, Mehanni, C, Khan, F, Gelfond JA, Fanti P, Bansal S. Barriers to timely dialysis access creation: south texas university health system experience; 2014 May. (American Journal of Kidney Diseases; vol. 63, no. 5). |
Bansal S, Ahmad Mohammad. Emergence of Rapidly Growing Atypical Mycobacterial Exit Site Infection in Current Era of Wide-spread Use of Topical Gentamicin For Exit Site Infection Prophalxis; 2014 Feb. (Journal of Investigative Medicine; vol. 62, no. 2). |
Fanti P, Khalid, Khazim, Hirachan, P, Cunningham SE, Gross, G, Rossi, R, Giustarini, D, Folli F, Bansal S. Inadequate Dietary Intake Correlates with Thiol Markers of Oxidative Stress in Maintenance Hemodialysis Patients (HD) Atlanta, GA; 2013 Nov. (Journal of American Society of Nephrology). |
Bansal S, Khalid, Khazim, Bhandari, B, Werner SL, Abboud HE, Fanti P. NGAL is a Possible Stimulus for Increased FGF23 production Atlanta, GA; 2013 Nov. (Journal of American Society of Nephrology). |
Mehanni, C, Khan, F, Hirachan, p, Gelfond, J, Bansal S. Barriers to Timely Dialysis Access Creation: South Texas University Health System Experience; 2013 Nov. (Journal of American Society of Nephrology). |
Bansal S. NGAL is possible stimulus for FGF23 production in CKD patients; 2013 Mar. (Medicine Research Day and Translational Science Research Day). |
Bansal S, Heegard,K, Penagaluru, Neena, Salazar, M. New Onset Malignant Hypertension with Thrombotic Microangiopathy associated with Primary Hyperaldosteronism in a Patient on Peritoneal Dialysis; 2013 Feb. (Journal of Investigative Medicine; vol. 61, no. 2). |
Hirachan, Padam, Penagaluru, Neena, Fanti P, Bansal S. Effect of Ergocalciferol on Anemia and Mineral Metabolism Management in Hemodialysis Patients-A case control study; 2013 Feb. (Journal of Investigative Medicine; vol. 61, no. 2). |
Hirachan, Padam, Penagaluru, Neena, Williams, K, Fanti P, Bansal S. Effect of Ergocalciferol on Anemia and Mineral Metabolism Management in Hemodialysis Patients San Diego, California; 2012 Nov. (Journal of American Society of Nephrology). |
Khazim K, Giustarini D, Rossi R, Cunningham SE, Verkaik, S, Folli F, Bansal S, Fanti P. The Glutathione/Glutathione Disulfide (GSH/GSSG) Redox Potential (Eh) is Low in Erythrocyte (RBCs) of Maintenance Hemodialysis (MHD) Patients (Pts) and it Associates with Parameters of Dietary Intake San Diego, California; 2012 Nov. (Journal of American Society of Nephrology). |
Khazim K, Gear, C, Suri R, Fanti P, Bansal S. Tumor Induced osteomalacia: associated with elevated circulating plasma Fibroblast growth Factor-7 in addition to fiborblast Growth factor-23 San Diego, California; 2012 Nov. (Journal of American Society of Nephrology). |
Bansal S, Khalid, Khazim, Nagarjun, k, Arar, N, Abboud, H, Fanti P. Strong Association of Fibroblast Growth Factor-23 with Neutrophil Gelatinase-Associated Lipocalin Than C-Reactive Protein in Mexican Americans with Type 2 Diabetes and Chronic Kidney Disease San Diego, California; 2012 Nov. (Journal of American Society of Nephrology). |
Bansal S. Association of Dietary intake with renal function in patients with chronic kidney disease; 2012 May. (Annual Medicine Research Day). |
Book Chapter |
Bansal S Linas, S. Management of Hypertension in the ICU. In: Jean-Louis Vincent. Textbook of Critical Care. 2015. |
Electronic/Web Publication |
Bansal S Nolan C. Hypertensive Crisis 2013 Jan. |
Journal Article |
Agarwal, G, Gelfond, J, Hirachan, P, Fanti P, Hura CE, Bansal S. Ergocalciferol Treatment Does Not Improve Erythropoietin Utilization and Hospitalization Rate in Hemodialysis Patients: A case-control study BMC Nephrology 2016 Oct;17(1). |
Bansal S, Khalid, Khazim, Suri R, Martin, DA, Werner SL, Fanti P. Tumor induced osteomalacia: associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23 Clinical Nephrology 2016 Jan;85(1):57-62. |
Cunningham SED, Verkaik D, Gross G, Khazim K, Hirachan P, Agarwal G, Lorenzo C, Matteucci E, Bansal S, Fanti P. Comparison of nutritional profile and diet record between veteran and non-veteran ESRD patients receiving hemodialysis in VA and community clinics in metropolitan South-Central Texas Nutrition in Clinical Practice 2015 Oct;30(5):698-708. |
Fanti P, Giustarini D, Rossi R, Cunningham SED, Folli F, Khazim K, Cornell J, Matteucci E and Bansal S. Dietary Intake of Proteins and Calories is Inversely Associated with the Oxidation State of Plasma Thiols in End-Stage Renal Disease Patients J Renal Nutr 2015 Jun;26(6):494-503. |
Bansal S. Growing peritoneal dialysis program from 2 to 30 patients in 2 years Peritoneal Dialysis International 2014 Sep;34(6):678-680. |
Bansal S Eng M. Use of Natriuretic-doses of Spironolactone for Treatment of Loop Diuretic Resistant Acute Decompensated Heart Failure International Journal of Cardiology 2014 Jan;170(3):e68-e69. |
Khazim K, Giustarini D, Rossi R, Cornell J, Verkaik D, Cunningham SED, Mohammad M, Trochta K, Lorenzo C, Folli F, Bansal S, Fanti P. Glutathione Redox Potential is Low and Glutathionylated and Cysteinylated Hemoglobin Levels are Elevated in Maintenance Hemodialysis Patients Translational Research 2013 Jul;162(1):16-25. |
Bansal S, Lindenfeld J, Schrier RW. Sodium retention in heart failure and cirrhosis: potential role of natriuretic doses of mineralocorticoid antagonist? Circ Heart Fail 2009 Jul;2(4):370-376. |
Other |
Bansal S, Velagapudi, C, Friedrichs, W, Werner SL, Fanti P. Acute and Chronic Inflammation Raise Plasma FGF23 levels in Normal Mice Journal of American Society of Nephrology 2015 Nov;. |
Private |
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Funding Agency | AbbVie |
Title | A Randomized, Multicountry, Multicenter,Double-Blind, Parallel, Placebo-Controlled Study of the Effects of Atrasentan on Renal Outcomes in Subjects with Type 2 Diabetes and NephropathySONAR: Study Of Diabetic Nephropathywith Atrasentan |
Status | Active |
Period | 8/2013 - Present |
Role | Principal Investigator |
Grant Detail | Site PI. The study objective is to evaluate the effect of atrasentan compared with placebo on time to doubling of serum creatinine or the onset of end stage renal disease (ESRD) in subjects with type 2 diabetes and nephropathy who are treated with the maximum tolerated labeled daily dose (MTLDD) of a Renin-Angiotensin System (RAS) inhibitor. In addition, the study will assess the effects of atrasentan compared with placebo on cardiovascular morbidity and mortality, urine albumin excretion, changes in estimated glomerular filtration rate (eGFR), as well as on the impact on quality of life in subjects with type 2 diabetes and nephropathy. |
State |
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Funding Agency | UTHSCSA CTSA/IIMS |
Title | CTSA-IIMS Pilot 2014 |
Status | Active |
Period | 11/2014 - 10/2015 |
Role | Principal Investigator |
Grant Detail | The major goal of this project is to test if endotoxin induced inflammation and nephron reduction stimulates the production of FGF23 to generate foundation data for K08 award. |