Mario Funes Hernandez MD
Postdoctoral Medical Fellow, Nephrology
Bio
Dr. Mario Funes Hernandez is a clinical research nephrology fellow at Stanford University. He obtained his medical degree at the National Autonomous University of Honduras. His Internal Medicine residency was at Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School, serving as assistant chief resident and was a recipient of the Sister Marie de Pazzi award as best resident of the Internal Medicine Class of 2020. He had the privilege to serve as the Nephrology Chief Fellow in the 2021-2022 academic year. Dr. Funes Hernandez is a Heart Health Tech Fellow at the Stanford Center of Digital Health and has an American Heart Association Research Supplement to Promote Diversity in Science award to assist in the development of digital health technology tools in the management of hypertension in patients with chronic kidney disease and resistant hypertension.
Honors & Awards
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AΩA Member, Alpha Omega Alpha Honor Medical Society (AΩA) at Stanford University School of Medicine (2022)
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UCSF-Stanford CERSI Diversity Scholars Program, UCSF-Stanford Center of Excellence in Regulatory Science and Innovation (CERSI) (2021-2022)
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Sister Marie de Pazzi Award (best resident award of the Internal Medicine Class of 2020), Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School (2020)
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Outstanding PGY2 Resident Award, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School (2019)
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Outstanding PGY1 Resident Award, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School (2018)
Professional Education
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Chief Fellow, Stanford University Nephrology Fellowship (2021)
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Assistant Chief Resident, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School, Internal Medicine (2020)
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Board Certification, American Board of Internal Medicine, Internal Medicine (2020)
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Residency, Saint Peter’s University Hospital/Rutgers Robert Wood Johnson Medical School, Internal Medicine Residency (2020)
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M.D., National Autonomous University of Honduras (2015)
Stanford Advisors
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Tara Chang, Postdoctoral Faculty Sponsor
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Vivek Bhalla, Postdoctoral Research Mentor
Contact
https://orcid.org/0000-0002-6545-3110All Publications
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Underdiagnosis of Primary Aldosteronism: A Review of Screening and Detection.
American journal of kidney diseases : the official journal of the National Kidney Foundation
2023
Abstract
A clinical condition may be missed due to its higher-than-recognized prevalence or inadequate diagnostic screening. Primary aldosteronism suffers from both of these factors and thus, is woefully underdiagnosed as a cause of hypertension and end-organ damage. Furthermore, screening tests should be strongly considered in diseases that pose significant morbidity or mortality if left untreated; have a high prevalence; and have treatments that lead to improvement or cure. In this review we present evidence on each of these points. We outline studies that estimate prevalence of primary aldosteronism in different at-risk populations and how the recognition has changed over time. We also evaluate myriad studies of screening rates for primary aldosteronism and what factors do and do not influence current screening practices. We discuss the ideal conditions for screening, the performance of the aldosterone-to-renin ratio in different populations that use plasma renin activity or direct renin concentration, and the steps for diagnostic work-up of primary aldosteronism. Finally, we conclude with potential strategies to implement higher rates of screening and diagnosis of this common, consequential, and treatable disease.
View details for DOI 10.1053/j.ajkd.2023.01.447
View details for PubMedID 36965825
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The Need to Reduce Variability in the Study of Blood Pressure Variability.
American journal of kidney diseases : the official journal of the National Kidney Foundation
2023
View details for DOI 10.1053/j.ajkd.2022.10.008
View details for PubMedID 36646618
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Health Techequity: Opportunities for Digital Health Innovations to Improve Equity and Diversity in Cardiovascular Care.
Current cardiovascular risk reports
2022: 1-20
Abstract
In this review, we define health equity, disparities, and social determinants of health; the different components of digital health; the barriers to digital health equity; and cardiovascular digital health trials and possible solutions to improve health equity through digital health.Digital health interventions show incredible potential to improve cardiovascular diseases by obtaining longitudinal, continuous, and actionable patient data; increasing access to care; and by decreasing delivery barriers and cost. However, certain populations have experienced decreased access to digital health innovations and decreased representation in cardiovascular digital health trials.Special efforts will need to be made to expand access to the different elements of digital health, ensuring that the digital divide does not exacerbate health disparities. As the expansion of digital health technologies continues, it is vital to increase representation of minoritized groups in all stages of the process: product development (needs findings and screening, concept generation, product creation, and testing), clinical research (pilot studies, feasibility studies, and randomized control trials), and finally health services deployment.
View details for DOI 10.1007/s12170-022-00711-0
View details for PubMedID 36465151
View details for PubMedCentralID PMC9703416
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Rates Of Diagnostic Work-up By Magnetic Resonance Imaging Of The Abdomen For Patients With Resistant Hypertension
LIPPINCOTT WILLIAMS & WILKINS. 2022
View details for DOI 10.1161/hyp.79.suppl_1.P352
View details for Web of Science ID 000893734200373
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Cardiovascular and Renal Outcomes with Finerenone, a Selective Mineralocorticoid Receptor Antagonist.
Cardiology and therapy
2022
Abstract
Overactivation of the renin-angiotensin-aldosterone system (RAAS) has been shown to be pathologic in heart failure and albuminuric chronic kidney disease (CKD), triggering pro-inflammatory and pro-fibrotic cellular pathways. The standard of care in these disease states includes treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers. Mineralocorticoid receptor antagonists (MRAs) are also a mainstay in the treatment of heart failure with reduced ejection fraction; however, therapy is often limited by treatment-related hyperkalemia. In albuminuric CKD, the risk of hyperkalemia, acute kidney injury (AKI), and hypotension also remains significant. Finerenone is a novel non-steroidal MRA that may obviate some of these concerns and have therapeutic potential in additional patient populations. Finerenone was developed using the chemical structure of a dihydropyridine channel blocker but optimized to create a bulky MRA without any activity at the L-type calcium channel. It has several novel cellular mechanisms that may account for its ability to reduce cardiac hypertrophy and proteinuria more efficiently than an equinatriuretic dose of a steroidal MRA, while retaining anti-inflammatory and anti-fibrotic properties. Finerenone also has a lower rate of treatment-related hyperkalemia and AKI than steroidal MRAs with a smaller effect on systolic blood pressure, greatly expanding its therapeutic utility. The recently published FIGARO-DKD and FIDELIO-DKD trials demonstrate that treatment with finerenone in patients with typeII diabetes and albuminuric CKD results in improved cardiovascular outcomes and a lower risk of CKD progression. Patients enrolled in these studies were already on maximally tolerated ACE inhibitor or angiotensin receptor blocker therapy. Trials investigating finerenone's therapeutic effect in patients with heart failure with preserved ejection fraction (HFpEF) and non-diabetic CKD, as well sodium-glucose cotransporter2 (SGLT2) and finerenone combination therapy in patients with diabetic nephropathy, are ongoing.
View details for DOI 10.1007/s40119-022-00269-3
View details for PubMedID 35737275
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Self-limited Hypertension Due to Kidney Infarction.
Kidney medicine
2022; 4 (5): 100454
View details for DOI 10.1016/j.xkme.2022.100454
View details for PubMedID 35509677
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Hypothesis: Accessory renal arteries may be an overlooked cause of renin-dependent hypertension.
Journal of human hypertension
2021
View details for DOI 10.1038/s41371-021-00632-2
View details for PubMedID 34785773