As a pediatric nephrologist, Howard Trachtman treats children with a wide range of kidney problems, from acute kidney disease to chronic kidney failure. The kidneys play a critical role in the body by acting as a filtering system, controlling water levels and eliminating wastes through urine. They also help regulate blood pressure, red blood cell production, and levels of calcium and minerals. The annual rate of kidney disease is only 1 or 2 new cases in every 100,000 children ages 19 and under. In the past two decades, however, the incidence of chronic kidney disease in children has steadily increased, especially among ethnic minorities and the poor.
Dr. Trachtman is particularly interested in glomerular diseases (i.e., diseases that affect kidney function by attacking the glomeruli—the tiny units inside the kidney where blood is cleaned), hemolytic uremic syndrome (a disorder that can occur when an infection in the digestive system produces toxic substances that destroy red blood cells), and hypertension (also known as high blood pressure).
In the Pediatric Trials Network, he acts as the lead investigator for trials concerning the treatment of hypertension. The first of these trials focuses on hypertension in child recipients of kidney transplants—the Safety and Pharmacokinetics of Lisinopril in Pediatric kidney Transplant Recipients trial. Lisinopril is approved by the U.S. Food and Drug Administration for use in children ages 6 years and older and adults with hypertension, heart failure, and heart attack. However, the appropriate dose of lisinopril in children below the age of 6 is not well known, nor is it known what dose should be given to children and adolescents who have received a kidney transplant and in whom hypertension is common. Because the drug likely behaves differently in these groups than it does in older children and adults, the lisinopril trial will meet an unmet public health need.
In his down time, Dr. Trachtman enjoys creative writing, as well as writing about bioethical issues inherent to research, often drawing on his knowledge of Jewish philosophy to inform his views. When he puts down his pen, he may be found running, playing with his grandchildren, or rooting for the Philadelphia professional sports teams. Dr. Trachtman also calls himself a very, very amateur piano player (“I think amateur overstates the case”).