Bio


Dr. Lee is a nephrologist and Clinical Assistant Professor in the Nephrology Division of the Stanford Department of Medicine.

He delivers expert, compassionate kidney care personalized to each patient he serves. Dr. Lee is committed to improving both the health and quality of life of his patients.

His work scholarship has appeared in the Journal of the American Society of Nephrology, Kidney Week, and Blood Purification.

Dr. Lee has received honors and awards including the prestigious Ben J. Lipps Research Fellowship from the American Society of Nephrology. The program funds original research projects by nephrology fellows.

Clinical Focus


  • Nephrology

Academic Appointments


Professional Education


  • Board Certification: American Board of Internal Medicine, Internal Medicine (2020)
  • Board Certification: American Board of Internal Medicine, Nephrology (2021)
  • Fellowship: Stanford University Nephrology Fellowship (2020) CA
  • Residency: Cooper University Hospital Internal Medicine Program (2014) NJ
  • Medical Education: Chungnam National University School of Medicine (2007) South Korea

All Publications


  • Removal of Uremic Solutes from Dialysate by Activated Carbon. Clinical journal of the American Society of Nephrology : CJASN Lee, S., Sirich, T. L., Blanco, I. J., Plummer, N. S., Meyer, T. W. 2022

    Abstract

    BACKGROUND AND OBJECTIVES: Adsorption of uremic solutes to activated carbon provides a potential means to limit dialysate volumes required for new dialysis systems. The ability of activated carbon to take up uremic solutes has, however, not been adequately assessed.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Graded volumes of waste dialysate collected from clinical hemodialysis treatments were passed through activated carbon blocks. Metabolomic analysis assessed the adsorption by activated carbon of a wide range of uremic solutes. Additional experiments tested the ability of the activated carbon to increase the clearance of selected solutes at low dialysate flow rates.RESULTS: Activated carbon initially adsorbed the majority, but not all, of 264 uremic solutes examined. Solute adsorption fell, however, as increasing volumes of dialysate were processed. Moreover, activated carbon added some uremic solutes to the dialysate, including methylguanidine. Activated carbon was particularly effective in adsorbing uremic solutes that bind to plasma proteins. In vitro dialysis experiments showed that introduction of activated carbon into the dialysate stream increased the clearance of the protein-bound solutes indoxyl sulfate and p-cresol sulfate by 77%±12% (mean±SD) and 73%±12%, respectively, at a dialysate flow rate of 200 ml/min, but had a much lesser effect on the clearance of the unbound solute phenylacetylglutamine.CONCLUSIONS: Activated carbon adsorbs many but not all uremic solutes. Introduction of activated carbon into the dialysate stream increased the clearance of those solutes that it does adsorb.

    View details for DOI 10.2215/CJN.01610222

    View details for PubMedID 35835518

  • Improving Solute Clearances by Hemodialysis. Blood purification Lee, S., Sirich, T. L., Meyer, T. W. 2022: 1-12

    Abstract

    The adequacy of hemodialysis is now assessed by measuring the removal of the single-solute urea. The urea clearance provided by contemporary dialysis is a large fraction of the blood flow through the dialyzer and therefore cannot be increased much further. Other solutes however likely contribute more than urea to the residual uremic illness suffered by hemodialysis patients. We here review methods which could be employed to increase the clearance of nonurea solutes. We will separately consider the clearances of free low-molecular-mass solutes, free larger solutes, and protein-bound solutes. New clinical studies will be required to test the extent to which increasing the clearance on nonurea solutes with these various characteristics can improve patients' health.

    View details for DOI 10.1159/000524512

    View details for PubMedID 35613554

  • Impaired Tubular Secretion of Organic Solutes in Advanced CKD. Journal of the American Society of Nephrology : JASN Mair, R., Lee, S., Plummer, N., Sirich, T., Meyer, T. 2021

    Abstract

    Background The clearance of solutes removed by tubular secretion may be altered out of proportion to the glomerular filtration rate (GFR) in chronic kidney disease (CKD). Recent studies have described considerable variability in the secretory clearance of waste solutes relative to the GFR in patients with CKD. Methods To test the hypothesis that secretory clearance relative to GFR is reduced in patients approaching dialysis, we used metabolomic analysis to identify solutes in simultaneous urine and plasma samples from 16 CKD patients with an estimated GFR of 7±2 ml/min per 1.73m2 and 16 control participants. Fractional clearances were calculated as the ratios of urine to plasma levels of each solute relative to those of creatinine and urea in CKD patients and to those of creatinine in controls. Results Metabolomic analysis identified 39 secreted solutes with fractional clearance >3.0 in control participants. Fractional clearance values in CKD patients were reduced on average to 65%±27% of those in controls. These values were significantly lower for 18 of 39 individual solutes and significantly higher for only one. Assays of the secreted anions phenylacetyl glutamine, p-cresol sulfate, indoxyl sulfate, and hippurate confirmed variable impairment of secretory clearances in advanced CKD. Fractional clearances were markedly reduced for phenylacetylglutamine (4.2±0.6 for controls versus 2.3±0.6 for CKD patients, P<0.001), p-cresol sulfate (8.6±2.6 for controls versus 4.1±1.5 for CKD patients, P<0.001), and indoxyl sulfate (23.0±7.3 versus 7.5±2.8, P<0.001), but not for hippurate (10.2±3.8 versus 8.4±2.6, P=0.13). Conclusions Secretory clearances for many solutes are reduced more relative to the reduction in GFR in advanced CKD. Impaired secretion of these solutes might contribute to uremic symptoms as patients approach dialysis.

    View details for DOI 10.1681/ASN.2021030336

    View details for PubMedID 34408065

  • Improving Clearance for Renal Replacement Therapy. Kidney360 Lee, S., Sirich, T. L., Meyer, T. W. 2021; 2 (7): 1188-1195

    Abstract

    The adequacy of hemodialysis is now assessed by measuring the removal of a single solute, urea. The urea clearance provided by current dialysis methods is a large fraction of the blood flow through the dialyzer, and, therefore, cannot be increased much further. However, other solutes, which are less effectively cleared than urea, may contribute more to the residual uremic illness suffered by patients on hemodialysis. Here, we review a variety of methods that could be used to increase the clearance of such nonurea solutes. New clinical studies will be required to test the extent to which increasing solute clearances improves patients' health.

    View details for DOI 10.34067/kid.0002922021

    View details for PubMedID 35355887

    View details for PubMedCentralID PMC8786098