Stephen Richard Smith | Scholars@Duke

Stephen Richard Smith
Professor of Medicine

Ongoing work focuses on problems of immediate clinical relevance in renal and pancreas transplantation, including issues related to immunosuppression, infection, and cardiovascular events as well as hypertension.

Research methodologies employed include randomized clinical trials, cohort studies, and retrospective multivariable analyses based on the transplant database.

Current Appointments & Affiliations

Professor of Medicine, Medicine, Nephrology, Medicine 2021

Contact Information

2424 Erwin Rd., Suite 605, Durham, NC 27705
Duke Box 2747, Durham, NC 27710
smith060@mc.duke.edu (919) 660-6860

Background
Education, Training, & Certifications
- Fellowship, Nephrology, Duke University School of Medicine 1989 - 1991
- Intern, Internal Medicine, Duke University School of Medicine 1985 - 1986
- M.D., Duke University 1985
Duke Appointment History
- Professor of Medicine, Medicine, Nephrology, Medicine 2007 - 2020
- Interim Chief of the Division of Nephrology, Medicine, Nephrology, Medicine 2015 - 2016
- Associate Professor of Medicine, Medicine, Nephrology, Medicine 2006 - 2007
- Associate Clinical Professor of Medicine, Medicine, Nephrology, Medicine 2002 - 2006
- Associate Professor of Medicine, Medicine, Nephrology, Medicine 1998 - 2002
- Assistant Professor of Medicine, Medicine, Nephrology, Medicine 1993 - 1998
- Associate in the Department of Medicine, Medicine, Clinical Science Departments 1991 - 1993
Research
Selected Grants
- ACO Model and Comprehensive ESRD Care Initiative awarded by Deloitte Consulting LLP 2016 - 2017
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Weiner, Daniel E., Meyeon Park, Hocine Tighiouart, Alin A. Joseph, Myra A. Carpenter, Nitender Goyal, Andrew A. House, et al. “Albuminuria and Allograft Failure, Cardiovascular Disease Events, and All-Cause Death in Stable Kidney Transplant Recipients: A Cohort Analysis of the FAVORIT Trial.” Am J Kidney Dis 73, no. 1 (January 2019): 51–61. https://doi.org/10.1053/j.ajkd.2018.05.015.
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  - Lunyera, Joseph, and Stephen R. Smith. “Heavy metal nephropathy: considerations for exposure analysis.” Kidney Int 92, no. 3 (September 2017): 548–50. https://doi.org/10.1016/j.kint.2017.04.043.
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  - Merhi, Basma, Theresa Shireman, Myra A. Carpenter, John W. Kusek, Paul Jacques, Marc Pfeffer, Madhumathi Rao, et al. “Serum Phosphorus and Risk of Cardiovascular Disease, All-Cause Mortality, or Graft Failure in Kidney Transplant Recipients: An Ancillary Study of the FAVORIT Trial Cohort.” Am J Kidney Dis 70, no. 3 (September 2017): 377–85. https://doi.org/10.1053/j.ajkd.2017.04.014.
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  - Malone, Andrew F., Paul J. Phelan, Gentzon Hall, Umran Cetincelik, Alison Homstad, Andrea S. Alonso, Ruiji Jiang, et al. “Rare hereditary COL4A3/COL4A4 variants may be mistaken for familial focal segmental glomerulosclerosis.” Kidney Int 86, no. 6 (December 2014): 1253–59. https://doi.org/10.1038/ki.2014.305.
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  - Carpenter, Myra A., Alin John, Matthew R. Weir, Stephen R. Smith, Lawrence Hunsicker, Bertram L. Kasiske, John W. Kusek, et al. “BP, cardiovascular disease, and death in the Folic Acid for Vascular Outcome Reduction in Transplantation trial.” J Am Soc Nephrol 25, no. 7 (July 2014): 1554–62. https://doi.org/10.1681/ASN.2013040435.
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  - Phelan, P. J., D. N. Howell, S. R. Smith, and M. J. Ellis. “Late coexistent acute cellular and antibody-mediated rejection in non-sensitized renal transplant patients.” Int Urol Nephrol 46, no. 5 (May 2014): 1031–33. https://doi.org/10.1007/s11255-013-0525-9.
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  - Malone, Andrew F., Matthew A. Sparks, David N. Howell, John Paul Middleton, Stephen R. Smith, and Ruediger W. Lehrich. “IgG4-related tubulointerstitial nephritis associated with chronic lymphocytic leukemia.” J Nephrol 26, no. 6 (November 2013): 1195–98. https://doi.org/10.5301/jn.5000298.
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  - Westervelt, Justin D., Barbara D. Alexander, Sylvia F. Costa, Sara E. Miller, David N. Howell, and Stephen R. Smith. “Detection of BK polyomavirus after kidney transplantation: a comparison of urine electron microscopy with plasma polymerase chain reaction.” Clin Transplant 27, no. 1 (January 2013): E42–48. https://doi.org/10.1111/ctr.12048.
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  - Goetzinger, Amy M., James A. Blumenthal, C Virginia O’Hayer, Michael A. Babyak, Benson M. Hoffman, Lephuong Ong, R Duane Davis, et al. “Stress and coping in caregivers of patients awaiting solid organ transplantation.” Clin Transplant 26, no. 1 (January 2012): 97–104. https://doi.org/10.1111/j.1399-0012.2011.01431.x.
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  - Westervelt, Justin D., and Stephen R. Smith. “Can an arteriovenous dialysis access be salvaged when a clinically significant steal develops?” Semin Dial 24, no. 4 (July 2011): 392–93. https://doi.org/10.1111/j.1525-139X.2011.00910.x.
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  - Bostom, Andrew G., Myra A. Carpenter, John W. Kusek, Andrew S. Levey, Lawrence Hunsicker, Marc A. Pfeffer, Jacob Selhub, et al. “Homocysteine-lowering and cardiovascular disease outcomes in kidney transplant recipients: primary results from the Folic Acid for Vascular Outcome Reduction in Transplantation trial.” Circulation 123, no. 16 (April 26, 2011): 1763–70. https://doi.org/10.1161/CIRCULATIONAHA.110.000588.
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  - Smith, S. R. “Renal Function Posttransplant,” December 13, 2007, 460–72. https://doi.org/10.1002/9780470751541.ch26.
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  - Pun, Patrick H., Ruediger W. Lehrich, Stephen R. Smith, and John P. Middleton. “Predictors of survival after cardiac arrest in outpatient hemodialysis clinics.” Clin J Am Soc Nephrol 2, no. 3 (May 2007): 491–500. https://doi.org/10.2215/CJN.02360706.
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  - Lehrich, Ruediger W., Patrick H. Pun, Nadine D. Tanenbaum, Stephen R. Smith, and John P. Middleton. “Automated external defibrillators and survival from cardiac arrest in the outpatient hemodialysis clinic.” J Am Soc Nephrol 18, no. 1 (January 2007): 312–20. https://doi.org/10.1681/ASN.2006040392.
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  - Plumb, Troy J., Arthur Greenberg, Stephen R. Smith, David W. Butterly, Teresa Tram N. Pham, Timothy A. Fields, and David N. Howell. “Postinfectious glomerulonephritis in renal allograft recipients.” Transplantation 82, no. 9 (November 15, 2006): 1224–28. https://doi.org/10.1097/01.tp.0000232327.09757.7b.
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  - Palmer, Scott M., Lauranell H. Burch, Saad Mir, Stephen R. Smith, Paul C. Kuo, Walter F. Herczyk, Nancy L. Reinsmoen, and David A. Schwartz. “Donor polymorphisms in Toll-like receptor-4 influence the development of rejection after renal transplantation.” Clin Transplant 20, no. 1 (January 2006): 30–36. https://doi.org/10.1111/j.1399-0012.2005.00436.x.
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  - Hanish, S. I., R. P. Petersen, B. H. Collins, J. Tuttle-Newhall, C. E. Marroquin, P. C. Kuo, D. W. Butterly, S. R. Smith, and D. M. Desai. “Obesity predicts increased overall complications following pancreas transplantation.” Transplant Proc 37, no. 8 (October 2005): 3564–66. https://doi.org/10.1016/j.transproceed.2005.09.068.
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  - Rocha, Paulo N., Ana T. Rocha, Scott M. Palmer, R Duane Davis, and Stephen R. Smith. “Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality.” Am J Transplant 5, no. 6 (June 2005): 1469–76. https://doi.org/10.1111/j.1600-6143.2005.00867.x.
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  - Lehrich, Ruediger W., Paulo N. Rocha, Nancy Reinsmoen, Arthur Greenberg, David W. Butterly, David N. Howell, and Stephen R. Smith. “Intravenous immunoglobulin and plasmapheresis in acute humoral rejection: experience in renal allograft transplantation.” Hum Immunol 66, no. 4 (April 2005): 350–58. https://doi.org/10.1016/j.humimm.2005.01.028.
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  - Rocha, Paulo N., Troy J. Plumb, Sara E. Miller, David N. Howell, and Stephen R. Smith. “Risk factors for BK polyomavirus nephritis in renal allograft recipients.” Clin Transplant 18, no. 4 (August 2004): 456–62. https://doi.org/10.1111/j.1399-0012.2004.00191.x.
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  - Green, Bryan T., Janet Tuttle-Newhall, Paul Suhocki, Stephen R. Smith, and J Barry O’Connor. “Massive gastrointestinal hemorrhage due to rupture of a donor pancreatic artery pseudoaneurysm in a pancreas transplant patient.” Clin Transplant 18, no. 1 (February 2004): 108–11. https://doi.org/10.1111/j.1399-0012.2004.00111.x.
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  - Kurella, Manjula, David W. Butterly, and Stephen R. Smith. “Post transplant erythrocytosis in hypercalcemic renal transplant recipients.” Am J Transplant 3, no. 7 (July 2003): 873–77. https://doi.org/10.1034/j.1600-6143.2003.00131.x.
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  - Rocha, Paulo N., David W. Butterly, Arthur Greenberg, Donal N. Reddan, Janet Tuttle-Newhall, Bradley H. Collins, Paul C. Kuo, et al. “Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection.” Transplantation 75, no. 9 (May 15, 2003): 1490–95. https://doi.org/10.1097/01.TP.0000060252.57111.AC.
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  - Emovon, O. E., J. A. C. King, S. R. Smith, C. Op’t Holt, F. McDonald, D. N. Howell, and B. J. Browne. “Clinical significance of eosinophils in suspicious or borderline renal allograft biopsies.” Clin Nephrol 59, no. 5 (May 2003): 367–72. https://doi.org/10.5414/cnp59367.
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  - Smith, Stephen R., and David W. Butterly. “Declining influence of race on the outcome of living-donor renal transplantation.” Am J Transplant 2, no. 3 (March 2002): 282–86. https://doi.org/10.1034/j.1600-6143.2002.20314.x.
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  - Smith, S. R., D. W. Butterly, B. D. Alexander, and A. Greenberg. “Viral infections after renal transplantation.” Am J Kidney Dis 37, no. 4 (April 2001): 659–76. https://doi.org/10.1016/s0272-6386(01)80114-1.
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  - King, J. A. C., D. N. Howell, F. McDonald, C. L. O. Holt, S. R. Smith, O. E. Emovon, and B. J. Browne. “"Borderline" changes in renal allograft biopsies: What is the clinical significance of eosinophils?” Modern Pathology 14, no. 1 (January 1, 2001): 189A-189A.
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  - Howell, D. N., S. R. Smith, D. W. Butterly, P. S. Klassen, H. R. Krigman, J. L. Burchette, and S. E. Miller. “Diagnosis and management of BK polyomavirus interstitial nephritis in renal transplant recipients.” Transplantation 68, no. 9 (November 15, 1999): 1279–88. https://doi.org/10.1097/00007890-199911150-00011.
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  - Klassen, P. S., S. R. Smith, D. W. Butterly, A. Greenberg, H. R. Krigman, J. L. Burchette, D. N. Howell, and S. E. Miller. “DIAGNOSIS AND CLINICAL COURSE OF BK POLYOMAVIRUS INFECTION IN RENAL TRANSPLANT RECIPIENTS.” Transplantation 67, no. 7 (April 1999): S217–S217. https://doi.org/10.1097/00007890-199904150-00868.
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  - Kurella, M., S. R. Smith, and D. W. Butterly. “THE DEVELOPMENT OF POST TRANSPLANT ERYTHROCYTOSIS IN HYPERCALCEMIC RENAL TRANSPLANT PATIENTS.” Transplantation 67, no. 7 (April 1999): S169–S169. https://doi.org/10.1097/00007890-199904150-00675.
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  - Smith, S. R., D. W. Butterly, P. J. Conlon, R. C. Harland, and O. E. Emovon. “Incidence of cytomegalovirus disease in renal transplantation without antilymphocyte induction: is prophylaxis necessary?” Transplant Proc 30, no. 5 (August 1998): 2097–99. https://doi.org/10.1016/s0041-1345(98)00551-x.
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  - Conlon, P. J., G. W. Procop, V. Fowler, M. A. Eloubeidi, S. R. Smith, and D. J. Sexton. “Predictors of prognosis and risk of acute renal failure in patients with Rocky Mountain spotted fever.” Am J Med 101, no. 6 (December 1996): 621–26. https://doi.org/10.1016/s0002-9343(96)00332-4.
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  - Conlon, P. J., S. R. Smith, D. W. Butterly, and D. C. Brennan. “Losartan in post-transplant erythrocytosis.” Nephrol Dial Transplant 11, no. 12 (December 1996): 2524–25. https://doi.org/10.1093/oxfordjournals.ndt.a027238.
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  - Vallée, J. P., F. Lazeyras, H. D. Sostman, S. R. Smith, D. W. Butterly, C. E. Spritzer, and H. C. Charles. “Proton-decoupled phosphorus-31 magnetic resonance spectroscopy in the evaluation of native and well-functioning transplanted kidneys.” Acad Radiol 3, no. 12 (December 1996): 1030–37. https://doi.org/10.1016/s1076-6332(96)80040-7.
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  - Conlon, P. J., C. A. Fischer, M. C. Levesque, S. R. Smith, E. W. St Clair, N. B. Allen, J. A. Fleming, and D. N. Howell. “Clinical, biochemical and pathological predictors of poor response to intravenous cyclophosphamide in patients with proliferative lupus nephritis.” Clin Nephrol 46, no. 3 (September 1996): 170–75.
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  - Conlon, P. J., D. C. Brennan, W. W. Pfaf, W. F. Finn, T. Gehr, R. R. Bollinger, and S. R. Smith. “Renal transplantation in adults with thrombotic thrombocytopenic purpura/haemolytic-uraemic syndrome.” Nephrol Dial Transplant 11, no. 9 (September 1996): 1810–14.
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  - Conlon, P. J., G. J. Procop, V. Fowler, M. A. Eloubeidi, S. R. Smith, and D. J. Sexton. “Predictors of prognosis and risk of acute renal failure in Rocky Mountain spotted fever.” Journal of the American Society of Nephrology 7, no. 9 (September 1, 1996): A0628–A0628.
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  - Kovalik, E. C., S. J. Schwab, J. C. Gunnells, D. Bowie, and S. R. Smith. “No change in complication rate using spring-loaded gun compared to traditional percutaneous renal allograft biopsy techniques.” Clin Nephrol 45, no. 6 (June 1996): 383–85.
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  - CONLON, P. J., C. FISHER, M. LEVESQUE, E. W. STCLAIR, N. ALLEN, S. R. SMITH, and D. N. HOWELL. “PREDICTIVE VALUE OF RENAL BIOPSY IN PATIENTS WITH FOCAL AND DIFFUSE PROLIFERATIVE LUPUS NEPHRITIS (LN) TREATED WITH INTRAVENOUS CYCLOPHOSPHAMIDE.” Journal of the American Society of Nephrology 6, no. 3 (September 1, 1995): 415–415.
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  - CONLON, P. J., D. C. BRENNAN, W. W. PFAF, W. FINN, T. GEHR, R. R. BOLLINGER, and S. R. SMITH. “RENAL-TRANSPLANTATION IN ADULTS WITH THROMBOTIC THROMBOCYTOPENIC PURPURA HEMOLYTIC-UREMIC SYNDROME (TTP/HUS).” Journal of the American Society of Nephrology 6, no. 3 (September 1, 1995): 1078–1078.
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  - Smith, S. R., S. A. Minda, G. P. Samsa, F. E. Harrell, J. C. Gunnells, T. M. Coffman, and D. W. Butterly. “Late withdrawal of cyclosporine in stable renal transplant recipients.” Am J Kidney Dis 26, no. 3 (September 1995): 487–94. https://doi.org/10.1016/0272-6386(95)90495-6.
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  - Conlon, P. J., and S. R. Smith. “Transmission of cancer with cadaveric donor organs.” J Am Soc Nephrol 6, no. 1 (July 1995): 54–60. https://doi.org/10.1681/ASN.V6154.
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  - Conlon, P. J., D. N. Howell, G. Macik, E. C. Kovalik, and S. R. Smith. “The renal manifestations and outcome of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in adults.” Nephrol Dial Transplant 10, no. 7 (1995): 1189–93.
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  - Smith, S. R., V. B. Kubacki, A. Rakhit, L. L. Martin, A. V. Schaffer, M. K. Jasani, D. J. Hefty, T. Johnston, C. Cannon, and W. M. Bennett. “Chronic thromboxane synthase inhibition with CGS 12970 in human cyclosporine nephrotoxicity.” Transplantation 56, no. 6 (December 1993): 1422–26. https://doi.org/10.1097/00007890-199312000-00029.
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  - Smith, S. R., T. M. Coffman, and L. P. Svetkey. “Effect of low-dose aspirin on thromboxane production and the antihypertensive effect of captopril.” J Am Soc Nephrol 4, no. 5 (November 1993): 1133–39. https://doi.org/10.1681/ASN.V451133.
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  - Smith, S. R., P. E. Klotman, and L. P. Svetkey. “Potassium chloride lowers blood pressure and causes natriuresis in older patients with hypertension.” J Am Soc Nephrol 2, no. 8 (February 1992): 1302–9. https://doi.org/10.1681/ASN.V281302.
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  - Smith, S. R., E. A. Creech, A. V. Schaffer, L. L. Martin, A. Rakhit, F. L. Douglas, P. E. Klotman, and T. M. Coffman. “Effects of thromboxane synthase inhibition with CGS 13080 in human cyclosporine nephrotoxicity.” Kidney Int 41, no. 1 (January 1992): 199–205. https://doi.org/10.1038/ki.1992.27.
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  - Svetkey, L. P., R. Wilkinson, N. R. Dunnick, S. R. Smith, C. B. Dunham, M. Lambert, and P. E. Klotman. “Captopril renography in the diagnosis of renovascular disease.” Am J Hypertens 4, no. 12 Pt 2 (December 1991): 711S-715S. https://doi.org/10.1093/ajh/4.12.711s.
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  - Smith, S. R., L. P. Svetkey, and V. W. Dennis. “Racial differences in the incidence and progression of renal diseases.” Kidney Int 40, no. 5 (November 1991): 815–22. https://doi.org/10.1038/ki.1991.281.
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  - Svetkey, L. P., S. Kadir, N. R. Dunnick, S. R. Smith, C. B. Dunham, M. Lambert, and P. E. Klotman. “Similar prevalence of renovascular hypertension in selected blacks and whites.” Hypertension 17, no. 5 (May 1991): 678–83. https://doi.org/10.1161/01.hyp.17.5.678.
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  - COFFMAN, T. M., S. R. SMITH, E. A. CREECH, A. V. SCHAFFER, L. L. MARTIN, A. RAKHIT, F. L. DOUGLAS, and P. E. KLOTMAN. “THE THROMBOXANE (TX) SYNTHETASE INHIBITOR CGS-13080 IMPROVES RENAL-ALLOGRAFT FUNCTION IN PATIENTS TAKING CYCLOSPORINE (CYA).” Kidney International 37, no. 1 (January 1, 1990): 604–604.
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  - KLOTMAN, P. E., S. R. SMITH, B. D. VOLPP, T. M. COFFMAN, and W. E. YARGER. “THROMBOXANE SYNTHETASE INHIBITION IMPROVES FUNCTION OF HYDRONEPHROTIC RAT KIDNEYS.” American Journal of Physiology 250, no. 2 (February 1, 1986): F282–87.
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  - Smith, S., P. Laprad, and J. Grantham. “Long-term effect of uninephrectomy on serum creatinine concentration and arterial blood pressure.” Am J Kidney Dis 6, no. 3 (September 1985): 143–48. https://doi.org/10.1016/s0272-6386(85)80017-2.
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- Book Sections
  - Smith, S. R. “Renal Function in the Liver Transplant Patient.” In Medical Care of the Liver Transplant Patient, edited by P. G. Killenberg and P. Clavien, n.d.
- Conference Papers
  - Pun, P. H., R. W. Lehrich, S. R. Smith, and J. P. Middleton. “Predictors of survival following sudden cardiac arrest in outpatient hemodialysis clinics.” In Journal of Investigative Medicine, 54:S298–S298. B C DECKER INC, 2006.
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  - Collins, B. H., C. E. Marroquin, J. E. Tuttle-Newhall, D. M. Desai, S. R. Smith, D. W. Butterly, R. R. Bollinger, and P. C. Kuo. “The management of end stage renal disease in the recipients of extrarenal transplants.” In American Journal of Transplantation, 4:537–537. BLACKWELL MUNKSGAARD, 2004.
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  - Rocha, A. T. C., P. N. Rocha, S. R. Smith, and S. Palmer. “Chronic kidney disease after lung transplantation.” In American Journal of Transplantation, 4:226–226. BLACKWELL MUNKSGAARD, 2004.
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  - Rocha, P. N., A. T. C. Rocha, S. Palmer, and S. R. Smith. “Acute renal failure after lung transplantation: Incidence, risk factors, and impact on perioperative morbidity and mortality.” In American Journal of Transplantation, 4:270–270. BLACKWELL MUNKSGAARD, 2004.
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Education, Training, & Certifications

Duke Appointment History

Selected Grants

Selected Publications

Academic Articles

Book Sections

Conference Papers