Meet Dr. Meera Harhay
Dr. Meera Harhay joined the Drexel Medicine team in July 2015. She is a nephrologist practicing in Center City and has a special interest in kidney transplantation and clinical epidemiology. Prior to Drexel, Dr. Harhay served as a postdoctoral fellow and clinical researcher at the University of Pennsylvania from 2011 to 2014. She recently received a grant from the National Institutes of Health (NIH) to continue doing research at Drexel.
For those of us who simply know you as Dr. Harhay, can you tell me a little bit about your life before medical school?
I grew up just outside of Pittsburgh. My mom’s a nephrologist, so I grew up listening to her talk about taking care of patients with kidney disease, and I was always impressed by her passion for her work. It made me realize the importance of having a job that makes you want to come to work every day.
I always loved writing, so when I went to Johns Hopkins University I started off as an English major. I also loved science, though, and I took enough science courses out of interest that I fulfilled the biology degree requirement, too, and ended up being a double major. The two subjects may seem different, but I think writers and biologists both study life – just in different ways. English focuses on the arts and culture and biology focuses on the intricate inner workings of living beings. So I guess in a way, my college studies helped me to appreciate what it means to be alive.
While I was in college, I volunteered at a free health clinic. I loved what we were able to do for people there. At first, I helped register people at the clinic. Then I learned how to take blood pressure and ask basic questions about how they were feeling. I eventually became the assistant to the medical director. I loved the challenge of finding creative ways to help people improve their health. That experience turned my head to medicine and I never looked back.
Did your mom’s work as a nephrologist convince you to follow in her footsteps?
I’m sure it didn’t hurt to know a great nephrologist my whole life, but I didn’t just want to choose something because it was the only thing I knew. When I got to medical school, I wanted to keep my options open. I wanted to study all types of medicine and enjoy all my rotations. I wasn’t even sure if I was going to do internal medicine. I wanted to give surgery a chance as well as pediatrics. So I did all of it, but in the end, I still gravitated to internal medicine.
During medical school in 2006, I went to Botswana on a medical mission trip. Our small medical team in Botswana was led by Dr. Alden Doyle, who is now head of the transplant nephrology group at Drexel. Dr. Doyle was volunteering his time in Botswana, where a formal medical education system had yet to be in place, to improve medical education on the care of patients with kidney disease. While in Botswana, we saw all types of patients, but because of Dr. Doyle’s presence, we saw a number of patients with end-stage kidney disease and kidney transplants who came far distances to seek his advice and care. I benefited so much from his teaching and the opportunity to care for patients with kidney disease in a resource-poor setting, and the entire experience transformed me as a physician-in-training.
Did Dr. Doyle play a role in you coming to Drexel?
Absolutely. He became a mentor for me early on. Mentors are everything. You need to have people you can learn from and emulate. But the energy and talent of the Drexel Nephrology and Transplant groups are inspiring in general – I wanted to be a part of that!
Can you talk a little bit about the relationship between diabetes and kidney disease?
Unfortunately, kidney disease is a complication from poor diabetes care. A large portion of our patients have diabetes, and we’re seeing type 2 diabetes in children, likely because of the obesity epidemic. I certainly worry that more and more young people are at risk of developing kidney disease because of these trends.
When you combine kidney disease with diabetes and dialysis, it’s particularly dangerous. For those patients, getting care early can prevent bad outcomes. If you are one of the many patients who require dialysis from kidney disease as a result of diabetes, the key is to get a transplant as soon as possible if you are healthy enough to do so.
Speaking of transplants, you were featured in an article that discussed the racial disparities in access to living-donor kidney transplants. Working in a diverse city like Philadelphia, is this something you continue to see and work on?
I just received a grant from the government to do kidney transplant research, and this is actually what I plan to focus on. Our population of transplant candidates in this city is very diverse and faces several challenges, so I plan to focus on what keeps certain populations from getting a transplant and why those hurdles are there.
The kidney allocation system has changed dramatically in the last year. It used to be that you had to go and be evaluated at a transplant center, and if you were deemed healthy enough to get a transplant, you went on a waiting list. You moved up on that waiting list based on the amount of time you were on it. And it became clear that certain groups of people just weren’t getting transplants because they weren’t being evaluated in time. Instead, they were spending years and years on dialysis before getting evaluated, so by the time they got seen, they were much sicker.
About a year ago, kidney allocation changed so that your waiting time doesn’t start only after you’ve been evaluated. Your waiting time can begin when you started dialysis. That means if you come in and get evaluated after being on dialysis for five years, if you get on the waiting list you’re already going to be higher up because you’ve essentially been waiting for five years. This will hopefully give a leg-up to sicker patients who need kidneys. At Drexel Transplant, we want to give people a chance at a transplant, and we are sensitive to the fact that some people don’t have equal access. Hopefully the changes to the allocation system will help. And I will focus my clinical research on how to keep people healthy while waiting for a transplant.
How do you improve patient care before and after a kidney transplant?
When patients come in before a transplant, they’re usually very ill. They have kidney failure and they’re on dialysis. It’s very important that they stay healthy enough for the transplant, even if they have to wait many years. From the time they come into our doors for transplant evaluation, we see ourselves as part of their health team. And it’s not just nephrologists – there are surgeons, nurses, social workers, financial coordinators, dietitians and other professionals on the transplant team. I think that the team approach is important all the way through.
After the transplant, patients are able to enjoy a much different life. Imagine if every other day you had to go to a dialysis unit and sit there for four or five hours. Then you come home and you’re exhausted. The next day you might feel back to yourself, but you have to be careful about what you eat and you can’t travel much because you have to go to the dialysis unit the next day. Imagine going from that to being able to travel, work and eat things you like because you have a working kidney again. It’s amazing.
What do you like most about working at Drexel?
I really like that people’s doors are always open. I like the fact that so many people are looking to build bridges and collaborate. I think the School of Public Health is an amazing place. There’s an energy here that’s unique and growing. It’s also a place where patients throughout our region feel comfortable getting their care. I recently asked a patient what it is about our transplant program that she likes, and she said, “You solve our problems.” When patients face poor health and all the other challenges that go with it, it’s pretty wonderful to be part of the solution.
Meera Nair Harhay, MD, MSCE
kidney disease, kidney transplant, and clinical epidemiology
BA in English and Biology – Johns Hopkins University
MD – University of Pennsylvania School of Medicine
MSCE – Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
The Arnold T. Berman, MD Building
219 N. Broad Street, 9th Floor
Philadelphia, PA 19107
The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.
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