Bio

Dr. Shah is a board-certified, fellowship-trained nephrologist and clinical assistant professor in the Department of Medicine, Division of Nephrology at Stanford University School of Medicine.

She provides care for patients with a variety of kidney-related conditions, with a special interest in management of kidney stones and related conditions. Her goal is to collaborate with each patient to develop a personalized and comprehensive care plan. She has given several talks on kidney stones to trainees and peers. Dr. Shah previously served as medical director of one of the dialysis clinics at University of Connecticut Health Center and helped run the plasmapheresis treatments.

Some of Dr. Shah’s recent research is focused on efforts to prevent filter failure when performing membrane-based therapeutic plasma exchange—a blood purification treatment for removing large molecular weight substances from plasma.

Dr. Shah’s work has been published in the Journal of Onco-Nephrology, Therapeutic Apheresis and Dialysis, and Connecticut Medicine. She has presented to her peers at national and regional meetings of the American Society of Nephrology, the National Kidney Foundation, and the American College of Physicians, Connecticut Chapter.

Dr. Shah is a member of the American Society of Nephrology. She has a keen interest in education of trainees including medical students, residents and fellows; and served as core faculty of the Nephrology Fellowship at the University of Connecticut Health Center.

She is fluent in Hindi and Gujarati. Outside of work she enjoys traveling and spending time with her husband and daughter.

Clinical Focus

  • Nephrology
  • Kidney Stones

Academic Appointments

Professional Education

  • Board Certification: American Board of Internal Medicine, Nephrology (2017)
  • Fellowship: Yale New Haven Hospital Nephrology Fellowship (2017) CT
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2015)
  • Residency: University of Connecticut Internal Medicine Residency (2015) CT
  • Medical Education: KJ Somaiya Medical College and Research Center (2010) India

Contact

  • Academic
    University - Academic staff Department: Medicine - Med/Nephrology Position: Clinical Assistant Professor
  • Clinical (Primary)  Nephrology Clinic 300 Pasteur Dr Ste A175 MC 5309 Stanford, CA 94305 (650) 725-8418 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 5851

All Publications

  • Impact of prefilter dilution on IgG removal in membrane-based therapeutic plasma exchange. Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy Cabral, P., Kaplan, A. A., Phachu, D., Shah, M., Attique, H. B., Elali, I. 2022; 26 (4): 836-839

    Abstract

    Previous studies have demonstrated that a "one plasma volume exchange" would result in an estimated 63% decline in pretreatment IgG levels. We evaluated the use of prefilter dilution with normal saline as a method to prevent filter failure without decreasing the efficiency of IgG removal.Twenty-one treatment sessions were analyzed and all received prefilter dilution with normal saline. Primary outcome was to determine whether prefilter dilution resulted in decreased treatment efficiency in removing the targeted IgG. Secondary outcome was filter failure in conjunction with the combined use of prefilter heparin and saline infusions.All 21 treatments (100%) received prefilter dilution with saline solution and 19/21 (90.47%) also received prefilter heparin (bolus and/or hourly infusion). We demonstrated a 60%-70% decline in pretreatment IgG levels.Prefilter dilution during membrane-based therapeutic plasma exchange based treatment did not result in a demonstrable decrease in efficiency of IgG removal while maintaining filter patency.

    View details for DOI 10.1111/1744-9987.13757

    View details for PubMedID 34775681

  • Membrane-based therapeutic plasma exchange: Hemodynamics and operational characteristics leading to procedure failure. Journal of clinical apheresis Elali, I., Delasos, L., Phachu, D., Shah, M., Mu, J., Kaplan, A. A. 2021; 36 (6): 841-848

    Abstract

    Therapeutic plasma exchange (TPE) is a blood purification treatment capable of removing large molecular weight substances from plasma. It is commonly used for the removal of circulating pathogenic immunoglobulins presumed to be the cause of many autoimmune diseases. TPE can be performed with a membrane-based system (mTPE) or a centrifugal-based system (cTPE). When plasma separation is performed with a membrane, filter clotting can lead to longer treatment time, higher cost and can negatively impact patient satisfaction. In this study, we examine the operational characteristics that might influence filter life.We report on 24 patients, with a total of 135 mTPE treatments in a single tertiary care academic center using the NxStage machine. The study focuses on treatment specific parameters that may lead to procedure failure. The main parameters of interest were transmembrane pressure (TMP) and the filtration fraction as displayed on the machine (FFd) compared to the calculated filtration fraction (FFc). Primary outcome was to measure whether TMP, FFc, and FFd influenced filter survival. Secondary outcomes included factors that might have indirectly resulted in filter failure, including hematocrit (Hct), platelet count, heparin use, and intra-treatment calcium administration.In this study, we demonstrated that machine displayed filtration fractions (FFd) were lower than FFc and this difference was significantly larger in TPE sessions that experienced a clotting event (7.58 vs 6.22, P = .031). TPE sessions that clotted had a higher mean TMP (57.48 mmHg vs 44.43 mmHg, P = .001) and clotting events tended to have a lower mean blood flow rate (175.83 mL/min vs 189.55 mL/min, P = .002). In TPE sessions that received prefilter calcium administration, a higher mean dose of calcium gluconate was found in the sessions that experienced clotting (3.27 g vs 2.70 g, P = .013). Patients who experienced at least one clotting event were noted to be heavier than those patients without any clotting events (91.52 kg vs 72.15 kg, P = .040). Prefilter heparin administration was not associated with a lower incidence of filter clotting. We did not find a statistically significant difference in clotting events based upon type of intravenous access, pretreatment hematocrit, or pretreatment platelet counts.Among patients undergoing mTPE, machine FFd on the NxStage system are consistently lower than FFc. Treatments where there was a greater difference between displayed and FFc had a greater likelihood of filter clotting. Treatments with higher TMP were associated with failed treatments. Prefilter calcium administration during treatment was associated with increased filter clotting. Lower blood flow rates and higher patient weight were also associated with increased filter clotting. Prefilter heparin administration did not reduce the incidence of filter clotting.

    View details for DOI 10.1002/jca.21936

    View details for PubMedID 34486748