Patrick Hank Pun
Associate Professor of Medicine
My current research interest is in understanding the mechanisms of cardiovascular disease among patients with chronic kidney disease, with a particular focus on the epidemic of sudden cardiac death. The ultimate goal is to reduce the impact of sudden death through improved risk stratification and novel risk mitigation therapies. Current investigations are focused on identifying novel genetic and biomarker risk factors among CKD patients, understanding the interplay of hemodialysis-specific exposures in the development of arrhythmias, and examining the risks and benefits of implantable cardioverter defibrillators among CKD patients using clinical trial and registry data.
Current Appointments & Affiliations
- Associate Professor of Medicine, Medicine, Nephrology, Medicine 2017
- Member of the Duke Clinical Research Institute, Duke Clinical Research Institute, Institutes and Centers 2015
Contact Information
- Duke Box 17969, Durham, NC 27705
- PO Box 17969, 2400 Pratt St Rm 0311 Terrace Level, Durham, NC 27705
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(919) 668-8529
- Background
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Education, Training, & Certifications
- Fellow in Nephrology, Medicine, Duke University 2004 - 2007
- Medical Resident, Medicine, Duke University 2001 - 2004
- M.D., Vanderbilt University 2001
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Duke Appointment History
- Assistant Professor of Medicine, Medicine, Nephrology, Medicine 2010 - 2017
- Medical Instructor in the Department of Medicine, Medicine, Nephrology, Medicine 2007 - 2010
- Instructor, Temporary in the Department of Medicine, Medicine, Nephrology, Medicine 2007
- Research
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Selected Grants
- Evaluating and Improving Cardiac Arrest Resuscitation Efforts in Hemodialysis Clinics awarded by National Institutes of Health 2017 - 2019
- Randomized trials using point of care guided manipulation of dialysate potassium, dialysate bicarbonate, and ultrafiltration rate to prevent hemodialysis-associated arrhythmia awarded by Brigham and Women's Hospital 2018 - 2019
- Wearable Cardioverter Defibrillator ( Zoll Study) awarded by DaVita Clinical Research 2016 - 2017
- ACO Model and Comprehensive ESRD Care Initiative awarded by Deloitte Consulting LLP 2016 - 2017
- Risk Factors for Sudden Cardiac Death in Patients with Chronic Kidney Disease awarded by National Institutes of Health 2014 - 2017
- EPC_TO#3_WA#7_Anemia Management in Renal Disease Populations - Part 2 awarded by Agency for Healthcare Research and Quality 2010
- EPC _TO #1_WA #3_Anemia Management in Renal Disease Populations - (Part 1) awarded by Agency for Healthcare Research and Quality 2010
- Publications & Artistic Works
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Selected Publications
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Academic Articles
- Pun, PH, Dupre, ME, Starks, MA, Tyson, C, Vellano, K, Svetkey, LP, Hansen, S, Frizzelle, BG, McNally, B, Jollis, JG, Al-Khatib, SM, Granger, CB, and CARES Surveillance Group, . "Outcomes for Hemodialysis Patients Given Cardiopulmonary Resuscitation for Cardiac Arrest at Outpatient Dialysis Clinics." Journal of the American Society of Nephrology : Jasn (February 7, 2019). Full Text
- Massicotte-Azarniouch, D, Kuwornu, JP, McCallum, MK, Bansal, N, Lam, N, Molnar, AO, Pun, P, Zimmerman, D, Garg, AX, and Sood, MM. "The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study." The Canadian Journal of Cardiology 34, no. 12 (December 2018): 1631-1640. Full Text
- Pun, PH. "Dialysate potassium concentration: Should mass balance trump electrophysiology?." Seminars in Dialysis 31, no. 6 (November 2018): 569-575. Full Text
- Pun, PH, and Wyatt, CM. "Utility of implantable cardioverter defibrillators in chronic kidney disease." Kidney International 93, no. 5 (May 2018): 1028-1030. Full Text
- Pun, PH, and Middleton, JP. "Dialysate Potassium, Dialysate Magnesium, and Hemodialysis Risk." Journal of the American Society of Nephrology : Jasn 28, no. 12 (December 2017): 3441-3451. (Review) Full Text
- Pun, PH, Goldstein, BA, Gallis, JA, Middleton, JP, and Svetkey, LP. "Serum Potassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease." Kidney International Reports 2, no. 6 (November 2017): 1122-1131. Full Text
- Al-Khatib, SM, Friedman, DJ, Hess, PL, Pun, PH, and Sanders, GD. "Do Implantable Cardioverter-Defibrillators Lower the Risk of Sudden Death and Total Mortality in Patients with End-Stage Renal Disease?." Current Cardiovascular Risk Reports 11, no. 9 (September 1, 2017). (Review) Full Text
- Makar, MS, and Pun, PH. "Sudden Cardiac Death Among Hemodialysis Patients." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation 69, no. 5 (May 2017): 684-695. (Review) Full Text
- Pun, PH, Sheng, S, Sanders, G, DeVore, AD, Friedman, D, Fonarow, GC, Heidenreich, PA, Yancy, CW, Hernandez, AF, and Al-Khatib, SM. "Prescription of Guideline-Recommended Implantable Cardioverter Defibrillator and Cardiac Resynchronization Therapy Among Patients Hospitalized With Heart Failure and Varying Degrees of Renal Function." The American journal of cardiology 119, no. 6 (March 2017): 886-892. Full Text
- Wang, H, Pun, PH, Kwee, L, Craig, D, Haynes, C, Chryst-Ladd, M, Svetkey, LP, Patel, UD, Hauser, ER, Pollak, MR, Kraus, WE, and Shah, SH. "Apolipoprotein L1 Genetic Variants Are Associated with Chronic Kidney Disease but Not with Cardiovascular Disease in a Population Referred for Cardiac Catheterization." Cardiorenal Medicine 7, no. 2 (February 2017): 96-103. Full Text
- Pun, PH, Abdalla, S, Block, GA, Chertow, GM, Correa-Rotter, R, Dehmel, B, Drüeke, TB, Floege, J, Goodman, WG, Herzog, CA, London, GM, Mahaffey, KW, Moe, SM, Parfrey, PS, Wheeler, DC, and Middleton, JP. "Cinacalcet, dialysate calcium concentration, and cardiovascular events in the EVOLVE trial." Hemodialysis International. International Symposium on Home Hemodialysis 20, no. 3 (July 2016): 421-431. Full Text
- Pun, PH, Hellkamp, AS, Sanders, GD, Middleton, JP, Hammill, SC, Al-Khalidi, HR, Curtis, LH, Fonarow, GC, and Al-Khatib, SM. "Primary prevention implantable cardioverter defibrillators in end-stage kidney disease patients on dialysis: a matched cohort study." Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 30, no. 5 (May 2015): 829-835. Full Text
- Pun, PH. "The interplay between CKD, sudden cardiac death, and ventricular arrhythmias." Advances in chronic kidney disease 21, no. 6 (November 2014): 480-488. (Review) Full Text
- Hess, PL, Hellkamp, AS, Peterson, ED, Sanders, GD, Al-Khalidi, HR, Curtis, LH, Hammill, BG, Pun, PH, Curtis, JP, Anstrom, KJ, Hammill, SC, and Al-Khatib, SM. "Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease." Circulation. Arrhythmia and Electrophysiology 7, no. 5 (October 2014): 793-799. Full Text
- Pun, PH, Al-Khatib, SM, Han, JY, Edwards, R, Bardy, GH, Bigger, JT, Buxton, AE, Moss, AJ, Lee, KL, Steinman, R, Dorian, P, Hallstrom, A, Cappato, R, Kadish, AH, Kudenchuk, PJ, Mark, DB, Hess, PL, Inoue, LYT, and Sanders, GD. "Implantable cardioverter-defibrillators for primary prevention of sudden cardiac death in CKD: a meta-analysis of patient-level data from 3 randomized trials." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation 64, no. 1 (July 2014): 32-39. Full Text
- Surana, SP, Pun, PH, Keithi-Reddy, SR, Spiegel, SM, Middleton, JP, and Singh, AK. "Sudden cardiac arrest in ESRD patients." Clinical nephrology 81, no. 2 (February 2014): 121-131. Full Text
- Pun, PH, Al-Khatib, SM, Han, JY, Edwards, R, Bardy, GH, Bigger, JT, Buxton, AE, Moss, AJ, Lee, KL, Steinman, R, Dorian, P, Hallstrom, A, Cappato, R, Kadish, AH, Kudenchuk, PJ, Mark, DB, Hess, PL, Inoue, LYT, and Sanders, GD. "Implantable cardioverter-defibrillators for primary prevention of sudden cardiac death in CKD: A meta-analysis of patient-level data from 3 randomized trials." American Journal of Kidney Diseases 64, no. 1 (January 1, 2014): 32-39. Full Text
- Tyson, CC, Kuchibhatla, M, Patel, UD, Pun, PH, Chang, A, Nwankwo, C, Joseph, MA, and Svetkey, LP. "Impact of Kidney Function on Effects of the Dietary Approaches to Stop Hypertension (Dash) Diet." Journal of Hypertension : Open Access 3 (January 2014). Full Text Open Access Copy
- Pun, PH, Horton, JR, and Middleton, JP. "Dialysate calcium concentration and the risk of sudden cardiac arrest in hemodialysis patients." Clinical Journal of the American Society of Nephrology : Cjasn 8, no. 5 (May 2013): 797-803. Full Text
- Pun, PH, Schumm, D, Sanders, GD, Hickey, D, Middleton, JP, Clapp-Channing, N, and Al-Khatib, SM. "A pilot study using an implantable device to characterize cardiac arrhythmias in hemodialysis patients: implications for future research." Ann Noninvasive Electrocardiol 17, no. 2 (April 2012): 159-. (Letter) Full Text Link to Item
- Pun, PH, Herzog, CA, and Middleton, JP. "Improving ascertainment of sudden cardiac death in patients with end stage renal disease." Clinical Journal of the American Society of Nephrology : Cjasn 7, no. 1 (January 2012): 116-122. Full Text
- Pun, PH, and Middleton, JP. "Sudden cardiac death in hemodialysis patients: a comprehensive care approach to reduce risk." Blood Purif 33, no. 1-3 (2012): 183-189. (Review) Full Text Link to Item
- Herzog, CA, Asinger, RW, Berger, AK, Charytan, DM, Díez, J, Hart, RG, Eckardt, K-U, Kasiske, BL, McCullough, PA, Passman, RS, DeLoach, SS, Pun, PH, and Ritz, E. "Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO)." Kidney International 80, no. 6 (September 2011): 572-586. Full Text
- Pun, PH, and Middleton, JP. "The Authors Reply." Kidney International 79, no. 11 (June 2011): 1259-1259. Full Text
- Pun, PH, Lehrich, RW, Honeycutt, EF, Herzog, CA, and Middleton, JP. "Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics." Kidney International 79, no. 2 (January 2011): 218-227. Full Text
- Middleton, JP, and Pun, PH. "Hypertension, chronic kidney disease, and the development of cardiovascular risk: a joint primacy." Kidney Int 77, no. 9 (May 2010): 753-755. Full Text Link to Item
- Pun, PH, Honeycutt, EF, Al-Khatib, SM, and Middleton, JP. "The authors reply." Kidney International 77, no. 7 (January 1, 2010): 648-649. (Letter) Full Text
- Pun, PH, Smarz, TR, Honeycutt, EF, Shaw, LK, Al-Khatib, SM, and Middleton, JP. "Chronic kidney disease is associated with increased risk of sudden cardiac death among patients with coronary artery disease." Kidney International 76, no. 6 (September 2009): 652-658. Full Text
- Pun, PH, and Kovalik, EC. "Methods of Hemodialysis Anticoagulation." (2008): 224-238. Full Text
- Pun, PH, Lehrich, RW, Smith, SR, and Middleton, JP. "Predictors of survival after cardiac arrest in outpatient hemodialysis clinics." Clin J Am Soc Nephrol 2, no. 3 (May 2007): 491-500. Full Text Link to Item
- Lehrich, RW, Pun, PH, Tanenbaum, ND, Smith, SR, and Middleton, JP. "Automated external defibrillators and survival from cardiac arrest in the outpatient hemodialysis clinic." J Am Soc Nephrol 18, no. 1 (January 2007): 312-320. Full Text Link to Item
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Book Sections
- Adam, MOA, Pun, PH, and Olson, JA. "Secondary hyperparathyroidism." In The Handbook of Endocrine Surgery, 179-202. January 1, 2011. Full Text
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Conference Papers
- Pun, PH, Dupre, M, Anderson, M, Hansen, SM, Tyson, C, Frizzelle, B, Vellano, K, Jollis, J, McNally, B, and Granger, C. "CHARACTERISTICS OF CARDIAC ARREST AND BYSTANDER RESUSCITATION WITHIN OUTPATIENT DIALYSIS CLINICS IN NORTH CAROLINA." March 2018. Full Text
- Pun, PH, Al-Khatib, SM, Edwards, R, Bardy, G, Bigger, JT, Buxton, A, Moss, A, Lee, K, Steinmann, R, Dorian, P, Hallstrom, A, Cappato, R, Kadish, A, Kudenchuk, P, Mark, D, Inoue, LYT, and Sanders, GD. "INFLUENCE OF CHRONIC KIDNEY DISEASE ON THE EFFICACY OF PRIMARY PREVENTION IMPLANTABLE CARDIOVERTER DEFIBRILLATORS: A META-ANALYSIS OF THREE RANDOMIZED TRIALS." March 12, 2013. Full Text Link to Item
- Pun, PH, Lehrich, RW, Smith, SR, and Middleton, JP. "Predictors of survival following sudden cardiac arrest in outpatient hemodialysis clinics." January 2006. Link to Item
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