Faculty ProfilesMichelle Estrella, MD
4150 Clement St
San Francisco, CA 94121
The overall goals of my research are to improve our understanding of chronic kidney disease and its consequences (e.g. cardiovascular disease and bone mineral disease), and to develop strategies to mitigate the risk of chronic kidney disease development and progression, particularly among minority groups and HIV-infected individuals. My previous projects emphasized the ongoing burden of kidney disease in treated HIV-infected persons and shed light on risk factors that contribute to this burden. Through collaborative efforts, my work has grown to encompass the identification of early markers of kidney injury, with the hope of ultimately translating our findings to earlier detection and management of acute kidney injury and chronic kidney disease.
In addition, I have had a long-standing interest in medical education and clinical research training. To that end, I have recently joined the Kidney Health Research Collaborative (KHRC), which aims to improve kidney health globally through highly innovative research in a collaborative environment and through mentorship of promising young investigators.
Education and Training
|Location||Degree or Training||Specialty||Date|
|Johns Hopkins University||M.H.S.||Bloomberg School of Public Health||2009|
|Johns Hopkins University||Nephrology Fellowship||School of Medicine||2006|
|Johns Hopkins University||Internal Medicine||School of Medicine||2004|
|University of Texas - Houston||M.D.||School of Medicine||2001|
|Centenary College of Louisiana||B.S.||Biology||1997|
Awards and Honors
Center for AIDS Research Career Development Award, Johns Hopkins University School of Medicine, 2013
Department of Medicine Junior Faculty Excellence in Clinical Research, Johns Hopkins University School of Medicine, 2012
Career Development Award, TNC-Center for Drug Abuse and AIDS Research, 2010
Loan Repayment Program for Health Disparities Research, National Institutes of Health, 2010
Professional Development Award, National Kidney Foundation - Maryland, 2008
Alpha Omega Alpha Honor Society, 2000
Related Web Sites
Recent Articles (85)
Swanepoel CR, Atta MG, D'Agati VD, Estrella MM, Fogo AB, Naicker S, Post FA, Wearne N, Winkler CA, Cheung M, Wheeler DC, Winkelmayer WC, Wyatt CM. Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: ImprovingÂ Global Outcomes (KDIGO) ControversiesÂ Conference. Kidney Int. 2018 Feb 02.
Chen TK, Katz R, Estrella MM, Gutierrez OM, Kramer H, Post WS, Shlipak MG, Wassel CL, Peralta CA. Association Between APOL1 Genotypes and Risk of Cardiovascular Disease in MESA (Multi-Ethnic Study of Atherosclerosis). J Am Heart Assoc. 2017 Dec 21; 6(12).
Alasfar S, Matar D, Montgomery RA, Desai N, Lonze B, Vujjini V, Estrella MM, Dieck JM, Khneizer G, Sever S, Reiser J, Alachkar N. Rituximab and Therapeutic Plasma Exchange in Recurrent Focal Segmental Glomerulosclerosis Postkidney Transplantation. Transplantation. 2017 Nov 20.
Chen TK, Tin A, Peralta CA, Appel LJ, Choi MJ, Lipkowitz MS, Winkler CA, Estrella MM. APOL1 Risk Variants, Incident Proteinuria, and Subsequent eGFR Decline in Blacks with Hypertension-Attributed CKD. Clin J Am Soc Nephrol. 2017 Nov 07; 12(11):1771-1777.
Corona-Villalobos CP, Shlipak MG, Tin A, Parikh C, Moore RD, Vittinghoff E, Monroy-Trujillo JM, Atta MG, Estrella MM. Predictors of Acute Renal Injury Study (PARIS) among HIV-positive individuals: design and methods. BMC Nephrol. 2017 Sep 07; 18(1):289.
Tin A, Zhang L, Estrella MM, Hoofnagle A, Rebholz CM, Brown TT, Palella FJ, Witt MD, Jacobson LP, Kingsley LA, Abraham AG. Vitamin D Status and Kidney Function Decline in HIV-Infected Men: A Longitudinal Study in the Multicenter AIDS Cohort Study. AIDS Res Hum Retroviruses. 2017 Sep 05.
Kim ED, Meoni LA, Jaar BG, Shafi T, Linda Kao WH, Estrella MM, Parekh R, Sozio SM. Association of Arterial Stiffness and Central Pressure With Cognitive Function in Incident Hemodialysis Patients: The PACE Study. Kidney Int Rep. 2017 Nov; 2(6):1149-1159.
Tin A, Scharpf R, Estrella MM, Yu B, Grove ML, Chang PP, Matsushita K, Köttgen A, Arking DE, Boerwinkle E, Le TH, Coresh J, Grams ME. The Loss of GSTM1 Associates with Kidney Failure and Heart Failure. J Am Soc Nephrol. 2017 Jul 18.
Chen TK, Appel LJ, Grams ME, Tin A, Choi MJ, Lipkowitz MS, Winkler CA, Estrella MM. APOL1 Risk Variants and Cardiovascular Disease: Results From the AASK (African American Study of Kidney Disease and Hypertension). Arterioscler Thromb Vasc Biol. 2017 Sep; 37(9):1765-1769.
Chen TK, Estrella MM, Vittinghoff E, Lin F, Gutierrez OM, Kramer H, Lewis CE, Kopp JB, Allen NB, Winkler CA, Bibbins-Domingo KB, Peralta CA. APOL1 genetic variants are not associated with longitudinal blood pressure in young black adults. Kidney Int. 2017 Oct; 92(4):964-971.
Sheets KM, Atta MG, Fine DM, Zook K, Mcfall AM, Estrella MM, Schwartz GJ, Lucas GM. Longitudinal Assessment of Proximal Tubular Dysfunction in HIV Seropositive and Seronegative Persons: Correlates and Implications. J Acquir Immune Defic Syndr. 2017 May 01; 75(1):45-51.
Chen R, Scherzer R, Hsue PY, Jotwani V, Estrella MM, Horberg MA, Grunfeld C, Shlipak MG. Association of Tenofovir Use With Risk of Incident Heart Failure in HIV-Infected Patients. J Am Heart Assoc. 2017 Apr 24; 6(4).
Baxi SM, Scherzer R, Jotwani V, Estrella MM, Abraham AG, Parikh CR, Bennett MR, Cohen MH, Nowicki MJ, Gustafson DR, Sharma A, Young MA, Shlipak MG. Changes in Urinary Biomarkers Over 10 Years Is Associated With Viral Suppression in a Prospective Cohort of Women Living With HIV. J Acquir Immune Defic Syndr. 2017 Apr 15; 74(5):e138-e145.
Jotwani V, Scherzer R, Estrella MM, Jacobson LP, Witt MD, Palella F, Ho K, Bennett M, Parikh CR, Ix JH, Shlipak M. Association of HIV infection with biomarkers of kidney injury and fibrosis in the Multicenter AIDS Cohort Study. Antivir Ther. 2017 Jan 05.
Roy SK, Estrella MM, Darilay AT, Budoff MJ, Jacobson LP, Witt MD, Kingsley LA, Post WS, Palella FJ. Glomerular filtration rate and proteinuria associations with coronary artery calcium among HIV-infected and HIV-uninfected men in the Multicenter AIDS Cohort Study. Coron Artery Dis. 2017 Jan; 28(1):17-22.
Ascher SB, Scherzer R, Peralta CA, Tien PC, Grunfeld C, Estrella MM, Abraham A, Gustafson DR, Nowicki M, Sharma A, Cohen MH, Butch AW, Young MA, Bennett MR, Shlipak MG. Association of Kidney Function and Early Kidney Injury With Incident Hypertension in HIV-Infected Women. Hypertension. 2017 Feb; 69(2):304-313.
Kabir MM, Sedaghat G, Meoni LA, Kim ED, Rami T, Maly M, Lima JA, Jaar BG, Sozio SM, Estrella M, Kao L, Parekh RS, Tereshchenko LG. Very-Low Frequency Heart Rate Variability is Depressed During Hemodialysis Session. J Electrocardiol. 2016 Nov - Dec; 49(6):929.
Jotwani V, Scherzer R, Estrella MM, Jacobson LP, Witt MD, Palella F, Macatangay B, Bennett M, Parikh CR, Ix JH, Shlipak M. Brief Report: Cumulative Tenofovir Disoproxil Fumarate Exposure is Associated With Biomarkers of Tubular Injury and Fibrosis in HIV-Infected Men. J Acquir Immune Defic Syndr. 2016 Oct 01; 73(2):177-81.
Lucas GM, Atta MG, Fine DM, McFall AM, Estrella MM, Zook K, Stein JH. HIV, Cocaine Use, and Hepatitis C Virus: A Triad of Nontraditional Risk Factors for Subclinical Cardiovascular Disease. Arterioscler Thromb Vasc Biol. 2016 Oct; 36(10):2100-7.
Jotwani V, Scherzer R, Estrella MM, Jacobson LP, Witt MD, Palella FJ, Macatangay B, Bennett M, Parikh CR, Ix JH, Shlipak MG. HIV Infection, Tenofovir, and Urine a1-Microglobulin: A Cross-sectional Analysis in the Multicenter AIDS Cohort Study. Am J Kidney Dis. 2016 Oct; 68(4):571-581.
Tin A, Grams ME, Estrella M, Lipkowitz M, Greene TH, Kao WH, Li L, Appel LJ. Patterns of Kidney Function Decline Associated with APOL1 Genotypes: Results from AASK. Clin J Am Soc Nephrol. 2016 Aug 08; 11(8):1353-9.
Zachor H, Machekano R, Estrella MM, Veldkamp PJ, Zeier MD, Uthman OA, Taljaard JJ, Moosa MR, Nachega JB. Incidence of stage 3 chronic kidney disease and progression on tenofovir-based regimens. AIDS. 2016 May 15; 30(8):1221-8.
Atta MG, Estrella MM, Fine DM, Zook K, Monroy Trujillo JM, Stein JH, Lucas GM. Correlates and Longitudinal Renal and Cardiovascular Implications of FGF23 Levels in HIV-Positive Individuals. PLoS One. 2016; 11(5):e0155312.
Tereshchenko LG, Kim ED, Oehler A, Meoni LA, Ghafoori E, Rami T, Maly M, Kabir M, Hawkins L, Tomaselli GF, Lima JA, Jaar BG, Sozio SM, Estrella M, Kao WH, Parekh RS. Electrophysiologic Substrate and Risk of Mortality in Incident Hemodialysis. J Am Soc Nephrol. 2016 Nov; 27(11):3413-3420.
Kim JE, Scherzer R, Estrella MM, Ix JH, Shlipak MG. Tenofovir exposure alters associations of serum bicarbonate with chronic kidney disease risk in HIV-infected veterans. AIDS. 2016 Apr 24; 30(7):1049-57.
Atta MG, Estrella MM, Skorecki KL, Kopp JB, Winkler CA, Wasser WG, Shemer R, Racusen LC, Kuperman M, Foy MC, Lucas GM, Fine DM. Association of APOL1 Genotype with Renal Histology among Black HIV-Positive Patients Undergoing Kidney Biopsy. Clin J Am Soc Nephrol. 2016 Feb 05; 11(2):262-70.
Longenecker JC, Estrella MM, Segev DL, Atta MG. Patterns of Kidney Function Before and After Orthotopic Liver Transplant: Associations With Length of Hospital Stay, Progression to End-Stage Renal Disease, and Mortality. Transplantation. 2015 Dec; 99(12):2556-64.
Chen TK, Choi MJ, Kao WH, Astor BC, Scialla JJ, Appel LJ, Li L, Lipkowitz MS, Wolf M, Parekh RS, Winkler CA, Estrella MM, Crews DC. Examination of Potential Modifiers of the Association of APOL1 Alleles with CKD Progression. Clin J Am Soc Nephrol. 2015 Dec 07; 10(12):2128-35.
Kim ED, Sozio SM, Estrella MM, Jaar BG, Shafi T, Meoni LA, Kao WH, Lima JA, Parekh RS. Cross-sectional association of volume, blood pressures, and aortic stiffness with left ventricular mass in incident hemodialysis patients: the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) study. BMC Nephrol. 2015 Aug 07; 16:131.
Waheed S, Attia D, Estrella MM, Zafar Y, Atta MG, Lucas GM, Fine DM. Proximal tubular dysfunction and kidney injury associated with tenofovir in HIV patients: a case series. Clin Kidney J. 2015 Aug; 8(4):420-5.
Jotwani V, Shlipak MG, Scherzer R, Parekh RS, Kao WH, Bennett M, Cohen MH, Nowicki M, Sharma A, Young M, Tien PC, Parikh CR, Estrella MM. APOL1 Genotype and Glomerular and Tubular Kidney Injury in Women With HIV. Am J Kidney Dis. 2015 Jun; 65(6):889-98.
Parekh RS, Meoni LA, Jaar BG, Sozio SM, Shafi T, Tomaselli GF, Lima JA, Tereshchenko LG, Estrella MM, Kao WH. Rationale and design for the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) study. BMC Nephrol. 2015 Apr 24; 16:63.
Chen TK, Estrella MM, Astor BC, Greene T, Wang X, Grams ME, Appel LJ. Longitudinal changes in hematocrit in hypertensive chronic kidney disease: results from the African-American Study of Kidney Disease and Hypertension (AASK). Nephrol Dial Transplant. 2015 Aug; 30(8):1329-35.
Abraham AG, Darilay A, McKay H, Margolick JB, Estrella MM, Palella FJ, Bolan R, Rinaldo CR, Jacobson LP. Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study. J Infect Dis. 2015 Oct 01; 212(7):1100-10.
Abraham AG, Althoff KN, Jing Y, Estrella MM, Kitahata MM, Wester CW, Bosch RJ, Crane H, Eron J, Gill MJ, Horberg MA, Justice AC, Klein M, Mayor AM, Moore RD, Palella FJ, Parikh CR, Silverberg MJ, Golub ET, Jacobson LP, Napravnik S, Lucas GM. End-stage renal disease among HIV-infected adults in North America. Clin Infect Dis. 2015 Mar 15; 60(6):941-9.
Jotwani V, Scherzer R, Abraham A, Estrella MM, Bennett M, Cohen MH, Nowicki M, Sharma A, Young M, Tien PC, Ix JH, Sarnak MJ, Parikh CR, Shlipak MG. Association of urine a1-microglobulin with kidney function decline and mortality in HIV-infected women. Clin J Am Soc Nephrol. 2015 Jan 07; 10(1):63-73.
Estrella MM, Li M, Tin A, Abraham AG, Shlipak MG, Penugonda S, Hussain SK, Palella FJ, Wolinsky SM, Martinson JJ, Parekh RS, Kao WH. The association between APOL1 risk alleles and longitudinal kidney function differs by HIV viral suppression status. Clin Infect Dis. 2015 Feb 15; 60(4):646-52.
Murakami CA, Attia D, Carter-Monroe N, Lucas GM, Estrella MM, Fine DM, Atta MG. The clinical characteristics and pathological patterns of postinfectious glomerulonephritis in HIV-infected patients. PLoS One. 2014; 9(10):e108398.
Lang J, Scherzer R, Tien PC, Parikh CR, Anastos K, Estrella MM, Abraham AG, Sharma A, Cohen MH, Butch AW, Nowicki M, Grunfeld C, Shlipak MG. Serum albumin and kidney function decline in HIV-infected women. Am J Kidney Dis. 2014 Oct; 64(4):584-91.
Johns TS, Estrella MM, Crews DC, Appel LJ, Anderson CA, Ephraim PL, Cook C, Boulware LE. Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients. J Am Soc Nephrol. 2014 Nov; 25(11):2649-57.
Scherzer R, Gandhi M, Estrella MM, Tien PC, Deeks SG, Grunfeld C, Peralta CA, Shlipak MG. A chronic kidney disease risk score to determine tenofovir safety in a prospective cohort of HIV-positive male veterans. AIDS. 2014 Jun 01; 28(9):1289-95.
Ng DK, Jacobson LP, Brown TT, Palella FJ, Martinson JJ, Bolan R, Miller ER, Schwartz GJ, Abraham AG, Estrella MM. HIV therapy, metabolic and cardiovascular health are associated with glomerular hyperfiltration among men with and without HIV infection. AIDS. 2014 Jan 28; 28(3):377-86.
Bhasin B, Lau B, Atta MG, Fine DM, Estrella MM, Schwartz GJ, Lucas GM. HIV viremia and T-cell activation differentially affect the performance of glomerular filtration rate equations based on creatinine and cystatin C. PLoS One. 2013; 8(12):e82028.
Estrella MM, Jaar BG, Cavanaugh KL, Fox CH, Perazella MA, Soman SS, Howell E, Rocco MV, Choi MJ. Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers. BMC Nephrol. 2013 Oct 24; 14:230.
Alachkar N, Wei C, Arend LJ, Jackson AM, Racusen LC, Fornoni A, Burke G, Rabb H, Kakkad K, Reiser J, Estrella MM. Podocyte effacement closely links to suPAR levels at time of posttransplantation focal segmental glomerulosclerosis occurrence and improves with therapy. Transplantation. 2013 Oct 15; 96(7):649-56.
Driver TH, Scherzer R, Peralta CA, Tien PC, Estrella MM, Parikh CR, Butch AW, Anastos K, Cohen MH, Nowicki M, Sharma A, Young MA, Abraham A, Shlipak MG. Comparisons of creatinine and cystatin C for detection of kidney disease and prediction of all-cause mortality in HIV-infected women. AIDS. 2013 Sep 10; 27(14):2291-9.
Jotwani V, Scherzer R, Abraham A, Estrella MM, Bennett M, Devarajan P, Anastos K, Cohen MH, Nowicki M, Sharma A, Young M, Tien PC, Grunfeld C, Parikh CR, Shlipak MG. Does HIV infection promote early kidney injury in women? Antivir Ther. 2014; 19(1):79-87.
Lucas GM, Jing Y, Sulkowski M, Abraham AG, Estrella MM, Atta MG, Fine DM, Klein MB, Silverberg MJ, Gill MJ, Moore RD, Gebo KA, Sterling TR, Butt AA. Hepatitis C viremia and the risk of chronic kidney disease in HIV-infected individuals. J Infect Dis. 2013 Oct 15; 208(8):1240-9.
Abraham AG, Li X, Jacobson LP, Estrella MM, Evans RW, Witt MD, Phair J. Antiretroviral therapy-induced changes in plasma lipids and the risk of kidney dysfunction in HIV-infected men. AIDS Res Hum Retroviruses. 2013 Oct; 29(10):1346-52.
Estrella MM, Wyatt CM, Pearce CL, Li M, Shlipak MG, Aouizerat BE, Gustafson D, Cohen MH, Gange SJ, Kao WH, Parekh RS. Host APOL1 genotype is independently associated with proteinuria in HIV infection. Kidney Int. 2013 Oct; 84(4):834-40.
Foy MC, Estrella MM, Lucas GM, Tahir F, Fine DM, Moore RD, Atta MG. Comparison of risk factors and outcomes in HIV immune complex kidney disease and HIV-associated nephropathy. Clin J Am Soc Nephrol. 2013 Sep; 8(9):1524-32.
Estrella MM, Abraham AG, Jing Y, Parekh RS, Tien PC, Merenstein D, Pearce CL, Anastos K, Cohen MH, Dehovitz JA, Gange SJ. Antiretroviral-treated HIV-infected women have similar long-term kidney function trajectories as HIV-uninfected women. AIDS Res Hum Retroviruses. 2013 May; 29(5):755-60.
Abraham AG, Palella FJ, Li X, Estrella MM, Kingsley LA, Witt MD, Jacobson LP. The impact of impaired kidney function and HIV infection on the risk of anemia. AIDS Res Hum Retroviruses. 2012 Dec; 28(12):1666-71.
Atta MG, Estrella MM, Kuperman M, Foy MC, Fine DM, Racusen LC, Lucas GM, Nelson GW, Warner AC, Winkler CA, Kopp JB. HIV-associated nephropathy patients with and without apolipoprotein L1 gene variants have similar clinical and pathological characteristics. Kidney Int. 2012 Aug; 82(3):338-43.
Estrella MM, Kirk GD, Mehta SH, Brown TT, Fine DM, Atta MG, Lucas GM. Vitamin D deficiency and persistent proteinuria among HIV-infected and uninfected injection drug users. AIDS. 2012 Jan 28; 26(3):295-302.
Fine DM, Wasser WG, Estrella MM, Atta MG, Kuperman M, Shemer R, Rajasekaran A, Tzur S, Racusen LC, Skorecki K. APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. J Am Soc Nephrol. 2012 Feb; 23(2):343-50.
George E, Nadkarni GN, Estrella MM, Lucas GM, Sperati CJ, Atta MG, Fine DM. The impact of hepatitis C coinfection on kidney disease related to human immunodeficiency virus (HIV): a biopsy study. Medicine (Baltimore). 2011 Sep; 90(5):289-95.
Estrella MM, Parekh RS, Astor BC, Bolan R, Evans RW, Palella FJ, Jacobson LP. Chronic kidney disease and estimates of kidney function in HIV infection: a cross-sectional study in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr. 2011 Aug 15; 57(5):380-6.
Estrella MM, Parekh RS, Abraham A, Astor BC, Szczech LA, Anastos K, Dehovitz JA, Merenstein DJ, Pearce CL, Tien PC, Cohen MH, Gange SJ. The impact of kidney function at highly active antiretroviral therapy initiation on mortality in HIV-infected women. J Acquir Immune Defic Syndr. 2010 Oct; 55(2):217-20.
Estrella MM, Astor BC, Köttgen A, Selvin E, Coresh J, Parekh RS. Prevalence of kidney disease in anaemia differs by GFR-estimating method: the Third National Health and Nutrition Examination Survey (1988-94). Nephrol Dial Transplant. 2010 Aug; 25(8):2542-8.
Estrella M, Fine DM, Gallant JE, Rahman MH, Nagajothi N, Racusen LC, Scheel PJ, Atta MG. HIV type 1 RNA level as a clinical indicator of renal pathology in HIV-infected patients. Clin Infect Dis. 2006 Aug 01; 43(3):377-80.