Julie Anne Wright Nunes, M.D., M.P.H
Julie Anne Wright Nunes, M.D., M.P.H
Julie Anne Wright Nunes, M.D., M.P.H
Assistant Professor
Department of Internal Medicine, University of Michigan
311 Simpson Memorial Institute, 102 Observatory
Ann Arbor, Michigan 48109-5725
734-764-5178
juwright@med.umich.edu
Post-Doctoral Training
07/04 - 06/07 Residency, Wayne State University, Detroit Medical Center, Detroit,
Michigan
07/07 - 06/11 Fellowship, Nephrology and Hypertension, Vanderbilt University Medical
Center, Nashville, Tennessee
09/08 - 05/10 Masters Degree in Public Health, Vanderbilt University, Nashville,
Tennessee
07/09 - 12/10 Public Health Practicum, Agency for Healthcare Research and Quality,
Rockville, Maryland
09/13-05/14 Patient Safety and Quality Leadership Scholar Program, Ann Arbor,
Michigan
1990 - 1995 Engineer, Assistant Plant Start Up Manager, Team Leader, General Mills
Corporation, Toledo, Ohio
1995 - 2000 Senior Project Manager, McLaren Health Care Corporation, Flint,
Michigan
2009 - 2011 Research Fellow, Nephrology, Vanderbilt University Medical Center,
Nashville, Tennessee
2011 - 2012 Clinical Lecturer, University of Michigan Health System, Department of
Internal Medicine, Division of Nephrology, Ann Arbor, Michigan
2012 - Present Assistant Professor, University of Michigan Health System, Department of
Internal Medicine, Division of Nephrology, Ann Arbor, Michigan
Research Interests
My primary focus is on clinical research in the area of Chronic Kidney Disease (CKD) and its
prevention, along with development of methods and tools to help facilitate and optimize patient-
provider communication and improve quality in kidney disease care.
Grants
1R01 DK115844-01
Role: Principal Investigator $1,702,503 TDC
Improving Outcomes in Kidney Disease Using Systems-Driven Education and Coaching
The proposed research is significant; it will result in a rigorously tested provider-delivered
patient education tool, and an efficient process for follow up (health coaching) that supports
patients early in the CKD care continuum to achieve optimal blood pressure goals. This
research will deliver a streamlined and efficient patient-centered intervention that will be well-
poised for dissemination into community practice settings.
12/26/2017-11/30/2022
1K23-DK097183-02
Role: Principal Investigator $910,320 TDC
NIH, NIDDK
Patient Oriented Research Mentored Career Development Award
Title: Non-Traditional Patient Characteristics and Attainment of Self-Care Goals in CKD
Principal Investigator: Julie Anne Wright Nunes
09/18/13 – 06/30/18
T32 DK0077569
NIH Training Grant (Vanderbilt Division of Nephrology & Hypertension)
Trainee: Julie Anne Wright Nunes
07/01/08 – 06/30/09
Teaching
2007 “Nephrology Journal Article Review: Intradialytic Blood Volume Monitoring
in Ambulatory Hemodialysis Patients, a Randomized Trial”, Nashville,
Tennessee
2007 “BK Virus in Kidney Transplant Recipients”, Nashville, Tennessee
2008 “Medication (Nonadherence, Noncompliance, Nonconcordance) in Renal
Transplant Recipients”, Nashville, Tennessee
2008 “Review of K/DOQI Guidelines, Bone and Mineral Metabolism”, Nashville,
Tennessee
2008 “Systemic Capillary Leak Syndrome, Clarkson’s Syndrome”, Nashville,
Tennessee
2008 “Nephrology Biopsy Conference: HIVAN and Hypertension”, Nashville,
Tennessee
2008 “The CKD Patient Undergoing Surgical Weight Loss: Nutritional and
Metabolic Considerations, Before, and Immediately After Surgery”,
Nashville, Tennessee
2009 “Nephrology Journal Article Review: Rosuvastatin and Cardiovascular
Events in Patients Undergoing Hemodialysis”, Nashville, Tennessee
2009 “Nephrology Biopsy Conference: FSGS”, Nashville, Tennessee
2010 “Facilitating Physician Delivered CKD Patient Education”, Intervention
Curriculum to Fellows, Vanderbilt, Nashville, Tennessee
2010 “Kidney Disease Awareness and Knowledge Survey”, Renal Research
Conference, Vanderbilt, Nashville, Tennessee
2011 “Patient Kidney Disease Knowledge: Opportunities to Optimize Care”,
Renal Grand Rounds, Vanderbilt, Nashville, Tennessee
2011 “Optimizing the Process of Chronic Kidney Disease Patient Education”,
Center of Bioethics and Social Sciences in Medicine, Ann Arbor, Michigan
2011 “Patient Kidney Disease Knowledge: Opportunities to Optimize Chronic
Kidney Disease Care”, Kidney Epidemiology and Cost Center, Ann Arbor,
Michigan
2011 “Optimizing Patient-Provider Communication in Chronic Kidney Disease”,
Pediatric Nephrology Research Conference, Ann Arbor, Michigan
2013 “Patient Kidney Disease Education: Research in CKD and ESRD”, VA
Ann Arbor Health System, Resident Lecture, Ann Arbor, Michigan
2013 – 2014 “Urinalysis,” Renal Physiology U.M. Medical School / M2 Student Course,
extensive development and revision of course materials for medical
student curriculum, Ann Arbor, Michigan
2014 “Approaches to Moral Decision Making in Medical Practice”, Ethics
course facilitator, M1 U.M. Medical School Student Course
2015 “Toxins and Tubules”, Resident Lunch Lecture, Veterans Administration
Hospital, Ann Arbor, Michigan
2015 “Health Literacy and Patient Education in the Clinical Encounter”,
Nephrology Division Conference, Ann Arbor, Michigan
2015 “Kidney Disease Education at the Patient-Provider Interface:
Implications for Nephrotic Syndrome” NACI / Nephcure meeting,
Nephrology, Ann Arbor, Michigan
2015-2016 Research mentor for renal fellow Dr. Hannah Tiu. Under my mentorship,
Dr. Tiu conceptualized, designed, and implemented a study examining
provider perspectives about CKD diagnosis messaging to patients. This
collaboration was highly productive and resulted in one national poster
presentation, and development of a manuscript currently under
consideration.
2016 “I Have What?”: Talking to Patients About a Diagnosis of Chronic Kidney
Disease, O’Brien Student Lecture Series, Ann Arbor, Michigan
2016 “Urinalysis”, M2 Medical Student Renal Pathophysiology Course, Ann
Arbor, Michigan
2017 “I Have What?” Talking to Patients About a Diagnosis of Chronic (Kidney)
Disease, O’Brien Student Lecture Series, Ann Arbor, Michigan
2017 (“Avoid”) Nephrotoxins, Lunch-time resident / medical education
conference, Ann Arbor, Michigan
Invited Lectures
2002 Immunology & Allergy National Meeting on Informatics, “Using Informatics
in Medical Education”, Myrtle Beach, North Carolina
2009 Department of Bariatric Surgery Vanderbilt University Medical Center,
“The CKD Patient Undergoing Surgical Weight Loss: Nutritional and
Metabolic Considerations, Before, and Immediately After Surgery”,
Nashville, Tennessee
2010 Board of Directors Meeting, the American Kidney Fund, “Facilitating
Physician Delivered CKD Patient Education”, Rockville, Maryland
2010 Medical Grand Rounds, Detroit Medical Center, Department of Internal
Medicine, “Across the Continuum of Care, Disease Specific Knowledge in
Patients with Chronic Kidney Disease: Outcomes and Associations with
Health Literacy”, Detroit, Michigan
2011 National Kidney Foundation Spring Clinical Meeting, “Mind Your ABC’s
and 123’s: Communicating Effectively to Educate Your Patients”, Las
Vegas, Nevada
2011 Board of Directors Meeting, the American Kidney Fund, “Facilitating
Physician Delivered CKD Patient Education, the Next Step”, Rockville,
Maryland
2011 “Physician Delivered Education Intervention Increases Patient Knowledge
About CKD”, NIH National Kidney Disease Education Program,
Washington, D.C.
2013 “Hyper and Hypokalemia: Nephrology Updates for the Primary Care
Provider,” Updates in Nephrology for the Primary Care Provider,
Plymouth, Michigan
2013 “Health Literacy, Education and Research in CKD and ESRD,” Network
11 Regional ESRD Meeting, Minneapolis, Minnesota
2014 Kidney Interagency Coordinating Meeting, “Low Patient CKD Awareness,”
NIH, Bethesda, Maryland
2014 American Society of Nephrology International Conference, “Overcoming
Limited Health Literacy During the Clinic Encounter,” Philadelphia,
Pennsylvania
2015 “CKD Provider-Led Web-based Initiative,” University of Michigan, Patient
Education Forum, Ann Arbor, Michigan
2015 “Toxins and Tubules: What Hurts the Kidney and How Do You Know?”
Updates in Nephrology for the Primary Care Provider, Plymouth,
Michigan
2016 “I Have What? Tips for Talking to Patients about a New Diagnosis of
Kidney Disease” Updates in Nephrology for the Primary Care Provider,
Plymouth, Michigan
2017 “Opportunities to Optimize Patient-Centered Care in the Silent Epidemic
of Kidney Disease”, Center for Social Epidemiology and Population
Health, Ann Arbor, Michigan
2017 “Patient Education and Care: Challenges and Opportunities in Chronic
Kidney Disease”, Center for Bioethics and Social Sciences, Ann Arbor,
Michigan
2017 “Optimizing Outcomes Using Systems Driven Patient Education”,
Nephrology Division, University of Utah, Salt Lake City, Utah
2018 “Opportunities to Improve Outcomes in Kidney Disease Using Systems-
Driven Patient Education”, Department of Nutrition and Food Science,
Wayne State University, Detroit, Michigan
2018 “I have what? Tips for talking to patients about their kidney disease
diagnosis and treatments” Updates in Nephrology for the Primary Care
Provider, Plymouth, Michigan
2018 “Two Approaches of Promoting Kidney Education to Prevent ESRD”,
Arbor Collaborative for Health, Ann Arbor, Michigan
Bibliography
Peer-Reviewed Publications
1. Hannah Tiu , Angela Fagerlin , Meghan Roney , Eve Kerr , Akinlolu Ojo , Ed Rothman , Julie
Wright Nunes. Provider Perspectives on Chronic Kidney Disease Diagnosis Delivery. Clin
Nephrology, Vol. 89, Number 3/2018 (205-213)
2. Wild MG, Wallston KA, Green JA, Beach LB, Umeukeje E, Wright Nunes JA, Ikizler
TA, Steed J, Cavanaugh KL. The Perceived Medical Condition Self-Management Scale
can be applied to patients with chronic kidney disease. Kidney Int. 2017 May 18.
pii: S0085-2538(17)30213-2. doi: 10.1016/j.kint.2017.03.018. [Epub ahead of
print] PubMed PMID: 28528132.
3. Rao PS, Wright Nunes JA, Gillespie BW, Perlman RL, Ravichandran R. Education
and screening for chronic kidney disease in Indian youth: pilot program results.
Int J Nephrol Renovasc Dis. 2017 Apr 24;10:85-90. doi: 10.2147/IJNRD.S128417.
eCollection 2017. PubMed PMID: 28490898; PubMed Central PMCID: PMC5414574.
4. Ahmad FS, Cai X, Kunkel K, Ricardo AC, Lash JP, Raj DS, He J, Anderson AH,
Budoff MJ, Wright Nunes JA, Roy J, Wright JT Jr, Go AS, St John Sutton MG, Kusek
JW, Isakova T, Wolf M, Keane MG; CRIC Study Investigators. Racial/Ethnic
Differences in Left Ventricular Structure and Function in Chronic Kidney Disease:
The Chronic Renal Insufficiency Cohort. Am J Hypertens. 2017 Apr 24. doi:
10.1093/ajh/hpx058. PubMed PMID: 28444108.
6. Wright Nunes JW, Seagull FJ, Rao P, Segal JH, Mani NS, Heung M. Continuous quality
improvement in nephrology: a systematic review. BMC Nephrol. 2016 Nov
24;17(1):190. PubMed PMID: 27881093; PubMed Central PMCID: PMC5121952.
7. Cavanaugh KL, Wright Nunes JA. Establishing Evidence for the Future of
Kidney Disease Education. Am J Kidney Dis. 2016 Sep;68(3):335-7. doi:
10.1053/j.ajkd.2016.06.008. PubMed PMID: 27561665; PubMed Central PMCID:
PMC5003322.
10. Porter AC, Lash JP, Xie D, Pan Q, DeLuca J, Kanthety R, Kusek JW, Lora CM,
Nessel L, Ricardo AC, Wright Nunes J, Fischer MJ; CRIC Study Investigators.
Predictors and Outcomes of Health-Related Quality of Life in Adults with CKD.
Clin J Am Soc Nephrol. 2016 Jul 7;11(7):1154-62. doi: 10.2215/CJN.09990915. Epub
2016 May 31. PubMed PMID: 27246012; PubMed Central PMCID: PMC4934840.
11. Wright Nunes JA, Cavanaugh KL, Fagerlin A. An Informed and Activated Patient:
Addressing Barriers in the Pathway From Education to Outcomes. Am J Kidney Dis.
2016 Jan;67(1):1-4. doi: 10.1053/j.ajkd.2015.09.017. PubMed PMID: 26708191;
PubMed Central PMCID: PMC4878396.
12. Wright Nunes JA, Anderson CA, Greene JH, Ikizler TA, Cavanaugh KL. Results of
a novel screening tool measuring dietary sodium knowledge in patients with
chronic kidney disease. BMC Nephrol. 2015 Mar 31;16:42. doi:
10.1186/s12882-015-0027-3. PubMed PMID: 25880876; PubMed Central PMCID:
PMC4387682.
13. Rao PS, Wright Nunes J. Renal transplant failure has a devastating impact requiring
greater recognition and support. Evid Based Nurs. 2015 Jul;18(3):78. doi:
10.1136/eb-2014-102008. Epub 2015 Feb 4. PubMed PMID: 25653239; PubMed Central
PMCID: PMC4871270.
14. Ricardo AC, Anderson CA, Yang W, Zhang X, Fischer MJ, Dember LM, Fink JC,
Frydrych A, Jensvold NG, Lustigova E, Nessel LC, Porter AC, Rahman M, Wright
Nunes JA, Daviglus ML, Lash JP; CRIC Study Investigators. Healthy lifestyle and
risk of kidney disease progression, atherosclerotic events, and death in CKD:
findings from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney
Dis. 2015 Mar;65(3):412-24. doi: 10.1053/j.ajkd.2014.09.016. Epub 2014 Nov 20.
PubMed PMID: 25458663; PubMed Central PMCID: PMC4339665.
15. Wright Nunes JA, Osborn CY, Ikizler TA, Cavanaugh KL. Health numeracy:
perspectives about using numbers in health management from African American
patients receiving dialysis. Hemodial Int. 2015 Apr;19(2):287-95. doi:
10.1111/hdi.12239. Epub 2014 Oct 30. PubMed PMID: 25358522; PubMed Central PMCID:
PMC4489845.
16. Nadig SN, Wright Nunes JA. Preoperative medication management: filling in the
gaps. South Med J. 2013 Aug;106(8):447-8. doi: 10.1097/SMJ.0b013e3182a05875.
PubMed PMID: 23912136.
17. Wright Nunes JA. Education of patients with chronic kidney disease at the
interface of primary care providers and nephrologists. Adv Chronic Kidney Dis.
2013 Jul;20(4):370-8. doi: 10.1053/j.ackd.2013.03.002. Review. PubMed PMID:
23809290.
18. Wright Nunes J, Greene JH, Wallston K, Eden S, Shintani A, Elasy T, Rothman
RL, Ikizler TA, Cavanaugh KL. Pilot study of a physician-delivered education tool
to increase patient knowledge about CKD. Am J Kidney Dis. 2013 Jul;62(1):23-32.
doi: 10.1053/j.ajkd.2013.01.023. Epub 2013 Mar 27. PubMed PMID: 23540261; PubMed
Central PMCID: PMC3686835.
19. Wright-Nunes JA, Luther JM, Ikizler TA, Cavanaugh KL. Patient knowledge of
blood pressure target is associated with improved blood pressure control in
chronic kidney disease. Patient Educ Couns. 2012 Aug;88(2):184-8. doi:
10.1016/j.pec.2012.02.015. Epub 2012 Mar 27. PubMed PMID: 22459637; PubMed
Central PMCID: PMC3404190.
20. McCoy AB, Waitman LR, Lewis JB, Wright JA, Choma DP, Miller RA, Peterson JF.
A framework for evaluating the appropriateness of clinical decision support
alerts and responses. J Am Med Inform Assoc. 2012 May-Jun;19(3):346-52. doi:
10.1136/amiajnl-2011-000185. Epub 2011 Aug 17. PubMed PMID: 21849334; PubMed
Central PMCID: PMC3341775.
21. Wright Nunes JA, Wallston KA, Eden SK, Shintani AK, Ikizler TA, Cavanaugh KL.
Associations among perceived and objective disease knowledge and satisfaction
with physician communication in patients with chronic kidney disease. Kidney Int.
2011 Dec;80(12):1344-51. doi: 10.1038/ki.2011.240. Epub 2011 Aug 10. PubMed PMID:
21832984; PubMed Central PMCID: PMC3712792.
22. Wright JA, Wallston KA, Elasy TA, Ikizler TA, Cavanaugh KL. Development and
results of a kidney disease knowledge survey given to patients with CKD. Am J
Kidney Dis. 2011 Mar;57(3):387-95. doi: 10.1053/j.ajkd.2010.09.018. Epub 2010 Dec
18. PubMed PMID: 21168943; PubMed Central PMCID: PMC3053083.
23. Wright JA, Cavanaugh KL. Dietary sodium in chronic kidney disease: a
comprehensive approach. Semin Dial. 2010 Jul-Aug;23(4):415-21. doi:
10.1111/j.1525-139X.2010.00752.x. Epub 2010 Jun 14. Review. PubMed PMID:
20557489; PubMed Central PMCID: PMC2921029.
Book Chapters
1. Valley SC, Wright Nunes JA. Hospital Medicine Clinics, 6th edition. Chapter 4: Management
Considerations for the Hospitalist Caring for Patients with End Stage Renal Disease.
Elsevier Health Sciences, (eBook eds D Scheurer, consulting J Li). 2013 Apr;2(2):e209-26.
[Epub 2012 Dec 22] http://www.sciencedirect.com/science/article/pii/S2211594312001074
Other
1. Gunjan Garg, Julie Wright Nunes. Commentary on “Awareness and knowledge among
Internal Medicine Resident Trainees for dose adjustment of analgesics and
neuropsychotropic medications in CKD”. Southern Medical Journal. Volume: 111, Issue: 3
March, 2018. Pages 163-164.
2. Soni A, Wright JA. Average Annual Health Care Use and Expenditures for Kidney Disease
among Adults 18 and Older, U.S. Civilian Non-institutionalized Population, 2003-2007.
Medical Expenditure Panel Survey, Statistical Brief 306. Agency for Healthcare Research
and Quality, (Technical report). 2010 Dec 13:7 pgs.
http://www.meps.ahrq.gov/mepsweb/data_files/publications/st306/stat306.shtml
Abstracts
1. “Non Seminomatous Germ Cell Tumor Presenting as Superior Vena Cava Syndrome,” First
Place Poster Presentation, Wayne State University, 2005
2. “Non Seminomatous Germ Cell Tumor Presenting as Superior Vena Cava Syndrome,”
Poster Presentation, American College of Physicians, National Meeting, 2006
4. “Perceived Disease Specific Knowledge is Limited in Patients with Chronic Kidney Disease”,
Southern Society of Clinical Investigation, 2010
6. “Limited Health Literacy Associated with Catheter Use for Chronic Hemodialysis”, National
Kidney Foundation Spring Clinical Meetings, 2010
7. “Patient Knowledge is Associated with Systolic Blood Pressure in Patients with Chronic
Kidney Disease”, American Society of Nephrology, 2010
10. “Physician Role in Patient CKD Education: Perspectives from Nephrology Trainees”,
American Society of Nephrology, 2011
11. “Satisfaction with Provider Communication is Associated with Perceived Disease Knowledge
in Patients with CKD”, National Kidney Foundation, Las Vegas, Nevada (Featured Poster –
NKF CME Learning Objectives), 2011
12. “Dietary Sodium Knowledge in Patients with Chronic Kidney Disease,” American Society of
Nephrology, 2012
13. “Healthy Lifestyle and Risk of Kidney Disease Progression, Cardiovascular Events and
Death in the Chronic Renal Insufficiency Cohort (CRIC) Study,” American Society of
Nephrology, 2012
14. “Low Health Related Quality of Life is Associated with Poor Health Outcomes among
Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study,” American Society of
Nephrology, 2012
17. “Promoting Awareness and Screening Indian Youth for Chronic Kidney Disease Risk
Factors: Pilot Program Results”, American Society of Nephrology, 2014
19. “Opportunities to Improve CKD Education: Gaining Insights From Patients Using Qualitative
Methods and Total Quality Management”, National Kidney Foundation, 2015
20. “The experience of getting a CKD diagnosis: Despite fears, patients want to know”,
American Society of Nephrology, 2015.
21. “Getting a “CKD” Diagnosis: Despite Fears, Patients Want to Know Early”, American Society
of Nephrology, 2015
22. “Optimizing CKD Patient Education: Exploring Provider Attitudes and Opinions about CKD
Diagnosis Delivery”, National Kidney Foundation, 2016
23. “Quantitative Analysis: What Patients Want From Kidney Disease Education”, American
Society of Nephrology, 2016
24. “Disparities in Patient Reported Barriers to Optimal Self-Management for Chronic Kidney
Disease”, American Society of Nephrology, 2016
25. “The Portal Patient in Kidney Disease: One Center’s Experience on Who Uses Health
Portals and How” American Society of Nephrology, 2016
27. Disease specific stress in patients with CKD”, American Society of Nephrology, 2017